Hippocrates, father of medicine, said: "There are in fact two things, science and opinion; former begets knowledge, latter ignorance". Those words still ring true today.

Many of myths and legends about impotence, borne out of ignorance thousands of years ago, still influence our sexual culture. Primitive cultures believed that male virility was intricately interwoven with power, wealth and domination.

So it's not surprising that beliefs still persist in a number of cultures that to lack virility, or worse still, to be impotent, is to lack very essence of life. Manhood and "ability to perform" are inextricably linked, so impotence is viewed as a "lack of manhood".

Despite fact that twentieth century brought about radical changes in gender roles, on ethnic, economic, social and cultural levels, sexuality and impotence are still shrouded in mystery, secrecy and a good deal of confusion.

• Myth #1 - "Real men" don't experience impotence

  ALL men over age of 30 experience impotence as least once in their lifetime. It's estimated that over 150 million men worldwide have impotence; in fact, reports suggest this figure could be as high as 300 million or more. Estimating numbers is difficult because less than 2 men in 10 seek treatment for impotence problems.

  Impotence (or erectile dysfunction) is defined as inability to produce and maintain an erection sufficient for sexual intercourse. Impotence is not considered to include lack of libido, inability to ejaculate or achieve orgasm, a lack of strength or loss of "manhood".

• Myth #2 - Impotence is "all in mind"

  Less than 20% of impotence cases have a primary psychological cause. The majority of men with impotence have an underlying physical condition such as diabetes, heart disease, high blood pressure or prostate cancer. Stress, anxiety and loss of self-esteem are often secondary psychological factors that occur if impotence remains undiagnosed and untreated.

• Myth #3 - Impotence is a natural part of growing old

  Although it's evident that chances of experiencing impotence increase with age, this is largely due to increased risk of having an underlying physical condition such as diabetes, high blood pressure or heart disease. To compound this factor, a number of medications prescribed for these conditions can cause impotence.

• Myth #4 - There is no "cure" for impotence

  Although medical science hasn't come up with a permanent "cure" for impotence, a number of very effective therapies are available. Oral medications such as Viagra have revolutionized treatment of impotence, however impotence pills don't work for everyone. Other safe and effective treatments include vacuum pumps, injections and penile implants.
  
  

Looking at psychology of impotence is a little like taking a trip down Amazon during wet season. It's a subject fraught with hidden currents, treacherous shallows and wide meanderings.

There is no doubt that Viagra, little blue pill that revolutionized treatment of impotence has had a profound effect on men who have erectile dysfunction. But simply finding a "quick fix" for impotence doesn't overcome other problems that may have been there before treatment began.

Overcoming impotence often gives men unrealistic expectations about their ability to immediately cure their emotional problems as well as their physical ones.

The Psychology of Impotence

Sadly it seems that for a large number of men, their ability to get an erection and have sex is viewed as an integral part of their masculinity and potency. So it's no wonder that onset of impotence, even when triggered by an underlying physical condition, can produce psychological problems that further impact on impotence.

Performance anxiety is a very real issue for most men at one time or another. The fear of not being able to perform adequately, dissatisfaction with penis size, and self-consciousness about body appearance can all lead to very thing that most men wish to avoid - failure to get an erection.

So, when this anxiety is coupled with knowledge there may have been an occasional episode of impotence in past, or when erectile dysfunction has been in existence for a period of time, this anxiety is multiplied. From a strictly physiological viewpoint, anxiety can effectively prevent a man from becoming aroused and getting and maintaining an erection.

And performance anxiety isn't only issue men have to contend with. The highest risk category for onset of impotence is so-called "baby-boomers" - men born in period from 1946 to 1964. Most of these men are in their peak performance years in terms of their job, status, family and financial success. And all these factors lead to an increase in stress levels and anxiety - one more reason for impotence to occur.

Taking a pill may temporarily overcome impotence, but relieving self-doubt and mental stress, which may have been brooding for any number of years, is harder to alleviate. The ability to regain quality of life by restoring sexual function is viewed by some men as a near miracle and by others with fear and trepidation.

It's important to honestly assess how you feel now and compare it to how you felt before impotence treatment began. Easier said than done, but unless negative feelings tied to impotence can be viewed objectively, it's akin to stories people who have gained a great deal of weight often say "I feel like a thin person trapped in a fat person's body". For men it's "I feel like an impotent man trapped in a body that now has full sexual function."

The psychology of impotence is about viewing your new life - with sexual function - as a new beginning, complete with all new emotions that may be experienced. There's no point in trying to "recapture" your life way it was prior to impotence, regardless of whether that was only months ago or many years ago. Time moves on, and trying to live out life way it used to be is a sure-fire bet for failure.

The Psychology of Impotence in a Relationship

Finding an effective treatment to restore erectile function is not a guarantee that you will find an effective treatment for a relationship in need of psychological, physical or emotional repair. And in most situations it's not a "cure" for intimacy, romance or monogamy.

The restoration of erectile function can quickly and unexpectedly alter dynamics of a relationship, particularly when impotence has been a long-term problem. A profound, and often immediate, change in male sexual function is no small matter, and cannot be dealt with in time it takes to swallow a little pill.