From the author: Why a man “doesn’t want to.” Horror stories and the truth about impotence. What partners need to know and remember. Impotence: uncomfortable questions Advertising for a urological office is usually announced with the slogan: “Everything you didn’t know about impotence, but were afraid to ask.” But doctors view impotence rather as a death sentence, which only applies to very rare cases of organic nature. We'll talk about everyone else. Our guest is Lyubov Zaeva, sexologist, psychoanalyst, specialist of the European Confederation of Psychoanalytic Psychotherapy. - What is impotence? - Firstly, the word impotence itself has already ceased to be used among specialists. For a man, it sounds like a death sentence; in addition, it is extremely unfortunate, because there are many reasons for problems with potency. Impotence means the end. It's as if we compare it to the state of a car that suddenly won't start. But this does not mean the end. This means that you just need to show it to a mechanic and diagnose it. That’s why they now say “erectile dysfunction.” Although sexologists are unhappy with this word too. This is due to the fact that a man goes through several stages from the moment he gets an erection until he ejaculates. The sexologist looks at at what stage the failure occurs. When the term “erectile” is used, this means that we are talking about the stage of blood filling - stood up / didn’t stand up. But there are also other stages. - What are the causes of erection problems? - The first thing we need to talk about in this vein is the concept of sexual constitution. It is a combination of physiological and psychological components, something that does not change throughout life. There are ten types of sexual constitutions. Three types of weak, three medium, three strong and one very strong. 5-7 ejaculations per day are normal for the latter. The type of constitution is determined by a specialist during a special interview. Literally everything matters here, including: at what age did erotic desires appear, at what age did you begin sexual activity, how many ejaculations occur per day per month, etc. Doctors also use calculations of a certain coefficient for complete accuracy of the length of the legs. The longer a man's legs, the less likely it is that he has a high sexual constitution. This is due to the closure of bone growth plates, and bone growth is related to hormone levels. That is, at a certain age, the level of hormones has not yet reached that intensity when bone growth has stopped. Doctors use this coefficient; psychologists need a smaller number of parameters. Unfortunately, not all men know their sexual constitution. Because men's sexuality is formed in different conditions. If a man has stereotypes of his friends or brothers, he could identify himself with them, and compare himself with them, and consider himself inferior to them. And when we talk about the sexual constitution - this is very important - there is no concept of better or worse. Who is better, who is two meters tall or who is fifty meters tall? It's all very relative. And if a man begins to live not according to his natural sexual constitution, then sooner or later this will lead to such a state of brokenness, problems with sexual life. Men have a pattern in their heads that they must live by demonstrating a strong male sexual constitution. By nature, such a man may belong to a completely different group. But this does not mean that he is a bad lover, because if he finds a woman of his sexual constitution or approximately his own, they will be guaranteed to be satisfied with each other. But the likelihood that a woman with a very weak constitution and a man with a very strong constitution will form a couple is very small. They simply will not understand each other from the beginning, they will not agree on the level of temperament. Most often, people form a couple at the junction of two neighboring types of sexual constitutions. Another cause of problems with sexual function is the influence of pornography. Now they even talk about pornophilia. When a real woman doesn't cause such arousal becauseit turns out that she is far from what the man sees on the monitor. Because he needs to get involved emotionally with her, but he either doesn’t want to get involved emotionally, or can’t, or doesn’t know how, or isn’t ready. - There is a stereotype that after 50, most men “can’t” anymore, and if they can, it’s very rare. Is it so? - No, of course, that's not true. And at 80 years old a man can be very active in sex. Although, of course, each age level has its own sexual behavior. And after 50, a man can provide such emotional fulfillment that a woman may not need three hours of sex at all. She may be pleased with him, he himself may be this very “great phallus” for her. After all, potency is also a psychological characteristic. It’s just that as a man ages, he must be realistic about his capabilities and use more the emotional component of sex rather than the physiological one. Expecting that at 50 years old you will have an erection like at 30 means driving yourself into a corner. Nature will definitely remind such a man of reality. You can be a good lover at any age if a woman is filled with emotions after communication, if a man finds the keys to her, learns the secrets of her body, and combines tenderness and passion. There are happy partners for 50-year-old men with weak sexual constitution, and unhappy partners for 35-year-old men with high potency. And impotence is a folk horror story. There are not so many real cases when there are reasons for the end of a relatively young man’s sexual life. Everything else is a state when a man is emotionally exhausted, driven into a corner, does not hear himself or his partner does not hear him. - What about organic, physiological reasons? In most cases, the organ cannot be to blame. It is just a performer and an indicator of something. An organic reason, especially if the man is young, is one case out of 1000. Everything else is purely psychological reasons, primarily various fears. The easiest way to check whether organic matter is involved in the problem of potency is to find out whether a man masturbates. If there is, this is a 100% psychological factor. Although the older the man, the greater the likelihood of an organic cause. Here they usually look at the condition of the blood vessels - does the man have atherosclerosis, problems with sugar, what kind of lifestyle does he lead, how active is his lifestyle. To prevent atherosclerosis, a common cause of sexual dysfunction, you need to monitor cholesterol levels, eat healthy foods, and not smoke. - Are problems with potency somehow related to social stereotypes? - It is very important to say that a man has the right not to want sex. In our country, a man experiences at least awkwardness, and often deep shame, when he is forced to deny his wife or girlfriend sex. He's a man - how so. But he may simply be very tired at work, simply be overwhelmed with problems, and not experience sexual desire in this situation - it’s very natural. It’s another matter if work serves as a permanent “cover” - here you need to understand each specific case separately. In general, sex is a couple function. That is, we are not currently considering sex with a partner from a bar for one evening. If he didn’t succeed with such a woman, this does not mean at all that he has problems with sex. Maybe he didn’t have an internal need for sex with her, he just needed, for example, to relax. If such a problem arises in a permanent relationship, then through this state of “half past five” a man can show that he does not want something. The problem of potency is, in the vast majority of cases, not a problem of “I can’t”, but of “I don’t want to”. The question is what he doesn't want. This could be an unconscious protest against anything. A man may not want sex with this particular woman; he may thus unconsciously demonstrate his anger, resentment, anger at his partner, whatever. But more often than not, this is a relationship problem - something went wrong in the relationship, so