Impotence is a symptom of various pathological conditions which interferes with the normal course of the sex act. It is typically manifested as erectile dysfunction, which is a persistent failure to develop erections that are firm enough for sex, and is sometimes combined with premature or retarded ejaculation. Impotence may be organic or psychosomatic but regardless of its origin, the impact such a deficiency renders on the psyche of a man can be devastating. Sexual dysfunction affects all areas of a man's life – his sense of self-esteem; his relationships to his mate, other women, and other men; and even his job performance. The Catholic Church recognizes impotence as grounds for invalidating a marriage.
Temporary loss of erection due to stress anxiety or simple exhaustion is rather common. In 1993, an American study indicated that 52% of males between 40 and 70 had experienced impotence to some degree, rising from 5% at the age of 40 to 15% at the age of 70.
Estimates suggest that 5% of men at 40 years of age are completely impotent and 15% at 70 years of age. In addition, 10% have moderate to chronic impotence at age 40; the figure is 30% at 70 years. Men can ordinarily remain potent into their 90's.
In Europe an estimated 36 million men suffer from erectile dysfunction. In the USA, the number is 30 million, of which 15-20m are over 40. Around half of these have taken the drug Viagra since it was approved in 1998.
In Britain in 1998, 3m men suffer erectile dysfunction, and 1 in 10 men experience a sexual problem at some time in their life. 25% of the men over 40 who request medical assistance for impotence have been unfairly turned down by general practitioner doctors on the mistaken grounds that they are too old.