Patient's question:
Detailed medical condition and consultation purpose: Suffering from ED for over a year, high work pressure, frequent social engagements, smoking and drinking. How should the doctor treat it?Duration and persistence of the current illness: Over a year
Current general condition: Morning erections occur occasionally, almost none during the day, and there is almost no libido.
Medical history: No other medical history
Previous diagnoses and treatment history and effectiveness: No treatment has been administered.
Ancillary tests: None
Doctor's answer:
Hello: Impotence can be classified into primary impotence and secondary impotence based on the history of its occurrence. Primary impotence refers to cases where the penis has never been erect or has only been slightly erect once without being able to insert into the female vagina. Secondary impotence refers to cases where erections can occur during non-sexual activities (such as upon waking up from sleep, in dreams, or with a highly full bladder), or where there has been a successful sexual experience in the past, but impotence occurs later due to other reasons. Primary impotence accounts for a very small proportion of the population, and most impotence cases are secondary impotence.Impotence can be categorized based on its causes into organic impotence, psychogenic impotence, and iatrogenic impotence. Organic impotence refers to impotence caused by insufficient sexual ability in an individual. This insufficiency is due to physical factors, such as physical weakness, prolonged illness, or factors like excessive alcohol consumption and medication. Psychogenic impotence refers to impotence caused by emotional tension. Iatrogenic impotence refers to erection difficulties caused by improper medical treatment.
To diagnose whether someone has impotence, various situations must be analyzed. Occasional inability to achieve an erection due to excessive fatigue or alcohol consumption in men cannot be considered impotence. Only if this condition persists repeatedly can a conclusion of impotence be drawn.
Additionally, impotence and premature ejaculation share similarities. If a person can achieve a short erection but prematurely loses sexual fluid, causing the penis to become soft and unable to complete the entire sexual act, this should be classified as premature ejaculation rather than impotence.
Furthermore, sexual failure requires specific analysis and should not be solely attributed to the male. Factors such as female vaginal spasm or thickened hymen can also make sexual intercourse difficult.
Sex psychologist Masters and Johnson once proposed