There are many possible causes for impotence — the inability to become or stay erect — which is also called erectile dysfunction or inhibited arousal. It is often, but not always, associated with lack of sexual desire. There are many psychological causes for impotence, and there are many physical causes. Sometimes desire and arousal are affected by a combination of both.
There are three basic kinds of psychological problems that lead to lack of desire and/or arousal. The first has to do with the way we each view our own as well as other people's sexuality. Our individual feelings about sex are unique and are shaped by our early learning experiences, including our family's attitudes about sexuality — positive and negative. Men with problematic feelings about sex may find it difficult to experience desire and/or arousal. For example, men who are raised to believe that potential sex partners are bad people who only want to harm them may be impotent with new partners.
The second kind of psychological problem has to do with selecting a partner and the time and place to have sex. For example a partner who was once thought of as very attractive may now be thought of as less attractive. The timing might also turn out to be wrong — like right after a heavy meal, for example, or when a man is too stressed out from work. It's possible that location may be just as wrong — some married couples find it impossible to have sex while staying for visits in their parents' homes.
The third kind of psychological problem has to do with the quality of the relationship between partners — the levels of trust and intimacy that are needed for sexual desire and arousal to take place. Desire and arousal are based, in part, on muscular relaxation. If there is not enough trust and intimacy to become relaxed, desire and arousal may be difficult. This can happen whenever we feel threatened or slighted or anxious. Keeping a secret from a partner, for example, may create anxiety and interfere with desire and arousal.
Besides psychological causes, there are hundreds of physical causes of impotence. A partial list includes abnormal nerve function, alcohol or other recreational drug use, diabetes, hormone deficiency, impaired blood flow, removal of a cancerous prostate gland or certain other surgical procedures, and smoking. Some medicines may also cause impotence, including certain medications for allergies, anxiety, colds, depression, hypertension, lethargy, panic or personality disorder, restlessness, and sleeplessness.
A good book to read about the lack of desire and arousal in men is The Sexual Male — Problems and Solutions, by Richard Milsten and Julian Slowinski. It was published in 1999 by W.W. Norton & Company in New York.
