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The “Hard” truth about Erectile Dysfunction | Part 1

Sex Ed

The “Hard” truth about Erectile Dysfunction | Part 1

Although there are many various types of sexual dysfunctions, one of them is considered especially significant: erectile dysfunction, caused by an inhibition in the sexual excitement phase during the male’s sexual response. It is defined as a permanent, occasional or recurring inability to develop or maintain an erection required for one to successfully engage in sexual activities and complete sexual intercourse.

Freud classified impotence as a type of neurosis, and only with the arrival of Masters and Johnson, as well as Kaplan, did impotence receive a nicer name, free of pejorative meaning and negative self-evaluation, which is erectile dysfunction. Another discovery then was that not every man with sexual problems is necessarily neurotic, suffering from a personality disorder or another psychopathological disorder. One can be completely “normal” and be unable to develop or maintain an erection, without it meaning anything other than (most commonly) an inability to initiate or maintain sexual excitement during one of the phases of the sexual response cycle. Therefore, a satisfying erection cannot be achieved without positive sexual excitement, although, in rare cases, certain fears may lead to an erection (e.g. when men were forced to rape women at gunpoint during the war). Generally speaking, fears have an adverse effect on sexual functionality, although uncommon fears such as the fear of being discovered by others (e.g. while engaging in sensual contact in the bathroom at a friend’s party) may increase excitement.

The first research of all types of impotence was conducted by Kinsey et al. in 1948, when they established that there was a relatively high percentage of “total impotence”, both psychogenic and organic in origin, on a sample of over 6,000 men. They determined the percentage to be 2–4% at the age of 35 and 77% at the age of 80. More methodologically valid tests were subsequently conducted, indicating a percentage of 7‒10% (Hawton, 1985). In 1993, the National Institutes of Health found that there was a high prevalence of erectile dysfunction in the United States and that between 10 and 20 million men over the age of 18 suffered from this disorder.

The article proposes to discuss two examples of such:

An 85-year-old man, after abstaining from sex for 3 years following his wife’s death, experienced several failures with a woman who accepted to have sex with him (mostly due to financial aid on his part), and approached us, demanding that we enable him to have a hard penis when he takes off his clothes so that she could see that he is “ready to go” and a “real” man. He would not accept my suggestions that things did not work like that even in much younger men, but he still, somewhat foolishly, hoped that there was a drug that would “raise him from the dead”. Prejudices of this type are not uncommon in men, who often expect that their penis should function regardless of their psychophysical condition, and the pharmaceutical industry relies precisely on these myths when it produces drugs for potency. This perspective disregards any ideas about necessary conditions, good relations with the partner, erotic surroundings, etc., as unimportant.

Your partner may be Monica Bellucci or Claudia Schiffer, but if you are not “there”, are absent-minded, have not provided your necessary conditions, do not have a positive sexual excitement, are not in good relations with your partner, you will not have a satisfying erection. No drug can give you that.

Therefore, an erection only means that your penis is hard. Whether you really want sex, whether you are indeed a real man, whether you find your partner attractive, etc., depends mostly on your assessment, your feelings and current circumstances. It would certainly not be a good idea to want to act upon your erection caused by looking at your best friend’s daughter

(to be continued …)

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Josif Fidanovski

Josif Fidanovski has a B.A. in psychology. He is a cognitive-behavioral therapist, psychosexual therapist, member of the European Federation of Sexology (EFS) and a representative of the Seksin association in Belgrade( He runs a private practice, using psychosexual therapy as an integrative method to help clients improve intimacy with their partners, as well as their sexual functionality. He is a regular contributor to the Plodnost (Fertility) clinic from Novi Banovci, where he has worked for 5 years with Dr. Sava Bojovic in diagnosing and treating sexual dysfunction and has helped treat infertility.

He has a blog entitled “Sexual functionality”: where he writes and publishes texts about problems related to love and sex.

He was a regular guest of Dr. Bojovic on BN television on shows about contemporary education and communication in sex for the duration of 6 months. He also occasionally appears on TV channels in Serbia, Macedonia and Bosnia (TV Pink BH, TV Alfa, TV Galaksija, etc.) and writes articles for daily and weekly magazines with the aim of promoting sexual health and psychosexual therapy.

He participates and speaks at national and international congresses on psychotherapy, sexuality and fertility.


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