Modern day research and clinical studies across the world have decisively confirmed that psychological impotence - also known as sexual performance anxiety - affects 10 to 20 per cent of adult males. As a result of the social perceptions associated to men's sexuality, and the oft-related emotions of frustration, inadequacy, anxiety and depression caused by erection problems, emotional erectile dysfunction can be an indirect result of male impotence brought about by a physical condition.

Impotence, or erectile dysfunction, in medicine, is a state in which a man is not capable of attaining an erect penis that is firm enough for sexual penetration or sexual fulfillment. Impotence, however, shouldn't be wrongly identified as premature ejaculation, lack of libido, or absence of orgasm; in every one of these situations, sufficient erection may be achieved. Impotence is a very common problem; in the USA between 10 and 15 million adult men are affected by severe impotency. The incidence of this problem increases with age. Fewer than one percent of the male adult population under 30 years of age is affected, 3% below 45 years, 7 percent between 45 and 55 years, 25 % at age 65, and up to 75 percent of males 80 years old.

Impotence looks like it's increasing, but this might be because of raising life-span. Impotence is categorized as either primary or secondary. Primary impotence is expressed at the start of adolescence as a basic inability to attain penile erection; secondary male impotence is more common and consists of an onset of erectile inability during the adult years, after a period of normal erectile capability. There are various causes of impotence. In primary anatomic male impotence the reproductive organs themselves may be faulty. In secondary erectile dysfunction, functional causes such as emotional problems and secondary effects of medication taken for other disorders are the reason for the highest number of cases. The most common psychological factors resulting in psychological male impotence are worry in a man's life or troubles in his erotic relationships. As an example, in case a man has suddenly lost his job, his sense of disappointment can result in non permanent impotence. It's possible to know if the cause of a man's impotence problems is primarily mental; if he still experiences regular erections during rapid eye movement (REM) sleep, there is unlikely to be any physical reason behind his erection problems while awake.

However, sometimes a physical problem this is not severe enough to cause erectile dysfunction on its own could make a man more likely to develop erectile dysfunction if mild emotional factors are also provide. A lot of drugs can result in impotence. Diuretics, tricyclic antidepressants, H2 blockers, beta-blockers, and hormones are some of the most common; once the drug treatment is stopped, regular erections typically resume, unless psychological problems have developed meanwhile. Other factors behind mental erectile dysfunction have to do with physical conditions, health problem, or stress. Among these, diabetes mellitus accounts for 40 percent of the cases in the USA; vascular diseases, 30 %; surgical procedures on the pelvis or penis, 13 percent; vertebrae injury, 8 percent; endocrine or glandular problems, 6 %, and multiple sclerosis, 3 %. Treatments of mental erectile dysfunction based on various forms of psychiatric therapy are commonly used for cure. In 1970 the team of William Masters and Virginia Johnson proposed a program of behavioral therapy for an affected man and his partner. This method has been highly accepted and involves abstinence from sexual intercourse for several weeks while the partners builds up other areas of their romantic relationship. Only once the man get an erection and sustain it on numerous periods should the couple test sexual intercourse.

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