Skip to main content
NCBI home page
Postgraduate Medical Journal logoLink to Postgraduate Medical Journal
. 1971 Aug;47(550):562–571.

Sexual inadequacy in the male

John Bancroft
PMCID: PMC2467249

Abstract

The adequacy of sexual functioning in the male depends on a complex interaction between psychological, hormonal and neurophysiological factors. Disturbance of any one of these factors may lead to sexual inadequacy. In the majority of cases no gross abnormality is found but the absence of gross hormonal or neurophysiological abnormality does not necessarily imply a purely psychological cause. Individual variations in the pattern of response of the autonomic nervous system or in the ability to learn control of autonomic responses such as erection or ejaculation may be sufficient to account for some cases of inadequacy and in others may increase the susceptibility to psychological factors. Further research is required to clarify these undoubtedly important psychophysiological relationships.

Treatment has been most successful when it has taken into account both psychological and physiological factors. The advances made by Masters & Johnson (1970) in this area have partly depended on their earlier physiological and anatomical studies of sexual response (Masters & Johnson, 1966).

It may be that in some cases the use of anxiety-reducing drugs or androgens will be all that is required but further work is required to identify such cases. The placebo effects of such preparations should not be overlooked particularly as many cases of sexual inadequacy are based on lack of confidence or ignorance and require little more than good advice or reassurance.

Considerable advances in our understanding of these problems have been made in the past 20 years and techniques of endocrine, physiological and behavioural assessment are now available which should enable further progress to be made in the near future.

Full text

PDF
562

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BIERER J., VAN SOMEREN G. A. Stilboestrol in out-patient treatment of sexual offenders; a case report. Br Med J. 1950 Apr 22;1(4659):935–936. doi: 10.1136/bmj.1.4659.935. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. BRUHL D. E., LESLIE C. H. Afrodex: double-blind test in impotence. Med Rec Ann. 1963 Jan;56:22–passim. [PubMed] [Google Scholar]
  3. Bancroft J., Mathews A. Autonomic correlates of penile erection. J Psychosom Res. 1971 Jun;15(2):159–167. doi: 10.1016/0022-3999(71)90003-1. [DOI] [PubMed] [Google Scholar]
  4. Bancroft J. The application of psychophysiological measures to the assessment and modification of sexual behaviour. Behav Res Ther. 1971 May;9(2):119–130. doi: 10.1016/0005-7967(71)90069-6. [DOI] [PubMed] [Google Scholar]
  5. Bartholomew A. A. A long-acting phenothiazine as a possible agent to control deviant sexual behavior. Am J Psychiatry. 1968 Jan;124(7):917–923. doi: 10.1176/ajp.124.7.917. [DOI] [PubMed] [Google Scholar]
  6. Brener J., Kleinman R. A., Goesling W. J. The effects of different exposures to augmented sensory feedback on the control of heart rate. Psychophysiology. 1969 Mar;5(5):510–516. doi: 10.1111/j.1469-8986.1969.tb02853.x. [DOI] [PubMed] [Google Scholar]
  7. Burnap D. W., Golden J. S. Sexual problems in medical practice. J Med Educ. 1967 Jul;42(7):673–680. doi: 10.1097/00001888-196707000-00006. [DOI] [PubMed] [Google Scholar]
  8. Cooper A. J. 'Neurosis ' and disorders of sexual potency in the male. J Psychosom Res. 1968 Aug;12(2):141–144. doi: 10.1016/0022-3999(68)90021-4. [DOI] [PubMed] [Google Scholar]
  9. Cooper A. J. Clinical and therapeutic studies in premature ejaculation. Compr Psychiatry. 1969 Jul;10(4):285–295. doi: 10.1016/0010-440x(69)90004-2. [DOI] [PubMed] [Google Scholar]
  10. Cooper A. J., Ismail A. A., Smith C. G., Loraine J. A. Androgen function in "psychogenic" and "constitutional" types of impotence. Br Med J. 1970 Jul 4;3(5713):17–20. doi: 10.1136/bmj.3.5713.17. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Cooper A. J. Outpatient treatment of impotence. J Nerv Ment Dis. 1969 Oct;149(4):360–371. doi: 10.1097/00005053-196910000-00006. [DOI] [PubMed] [Google Scholar]
  12. Friedman D. The treatment of impotence by brietal relaxation therapy. Behav Res Ther. 1968 Aug;6(3):257–261. doi: 10.1016/0005-7967(68)90060-0. [DOI] [PubMed] [Google Scholar]
  13. GASTAUT H., COLLOMB H. Etude du comportement sexuel chez les epileptiques psychomoteurs. Ann Med Psychol (Paris) 1954 Dec;112(2 5):657–696. [PubMed] [Google Scholar]
  14. GOLLA F. L., HODGE R. S. Hormone treatment of the sexual offender. Lancet. 1949 Jun 11;1(6563):1006–1006. doi: 10.1016/s0140-6736(49)92095-4. [DOI] [PubMed] [Google Scholar]
  15. HARRIS G. W. SEX HORMONES, BRAIN DEVELOPMENT AND BRAIN FUNCTION. Endocrinology. 1964 Oct;75:627–648. doi: 10.1210/endo-75-4-627. [DOI] [PubMed] [Google Scholar]
  16. Hierons R., Saunders M. Impotence in patients with temporal-lobe lesions. Lancet. 1966 Oct 8;2(7467):761–763. doi: 10.1016/s0140-6736(66)90361-8. [DOI] [PubMed] [Google Scholar]
  17. Ismail A. A., Harkness R. A. Urinary testosterone excretion in men in normal and pathological conditions. Acta Endocrinol (Copenh) 1967 Nov;56(3):469–480. doi: 10.1530/acta.0.0560469. [DOI] [PubMed] [Google Scholar]
  18. JOHNSON J. SEXUAL IMPOTENCE AND THE LIMBIC SYSTEM. Br J Psychiatry. 1965 Apr;111:300–303. doi: 10.1192/bjp.111.473.300. [DOI] [PubMed] [Google Scholar]
  19. Laws D. R., Rubin H. B. Instructional control of an autonomic sexual response. J Appl Behav Anal. 1969 Summer;2(2):93–99. doi: 10.1901/jaba.1969.2-93. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Margolis R., Sangree H., Prieto P., Stein L., Chinn S. Clinical studies on the use of Afrodex in the treatment of impotence: statistical summary of 4000 cases. Curr Ther Res Clin Exp. 1967 Apr;9(4):213–219. [PubMed] [Google Scholar]
  21. SEMANS J. H. Premature ejaculation: a new approach. South Med J. 1956 Apr;49(4):353–358. doi: 10.1097/00007611-195604000-00008. [DOI] [PubMed] [Google Scholar]
  22. Shapiro D., Tursky B., Gershon E., Stern M. Effects of feedback and reinforcement on the control of human systolic blood pressure. Science. 1969 Feb 7;163(3867):588–589. doi: 10.1126/science.163.3867.588. [DOI] [PubMed] [Google Scholar]

Articles from Postgraduate Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES