Marital sexual dysfunction: erectile dysfunction.

All clinicians are occasionally consulted by men complaining of impotence. The history is the most important step in the differential diagnostic process for this symptom. Answers to four basic questions enable the physician to recognize classic psychologic and organic patterns. In addition, these questions provide clues as to the cause of the dysfunction. Physical and laboratory examinations are usually required to identify the specific organic cause. Traditional prevalence figures for impotence may no longer be valid. This topic awaits epidemiologic data that reflect current diagnostic sophistication. Individual treatment approaches to both organic and psychologic impotence must counteract the adverse influence of performance anxiety.