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November 18, 1983

Causes of Impotence

Author Affiliations

St Louis University Medical Center

JAMA. 1983;250(19):2604-2605. doi:10.1001/jama.1983.03340190018017

To the Editor.—  The report by Slag et al (1983;249:1736) entitled "Impotence in Medical Clinic Outpatients" indicated that 14% of the patient study group had impotence of psychogenic origin. Final diagnosis for each of the patients was made at the conclusion of history taking, physical examination, and elaborate endocrine laboratory studies. Those with psychogenic impotence were said to have normal physical examination and normal endocrine study findings. The rest of the patients were classified into their diagnostic categories based on drug history and abnormal laboratory test results and physical findings. The most frequent cause of impotence was drug effects. Medication effect was prominent in those with hypertension. Some antihypertensive medications such as methyldopa, β-blockers, and reserpine could cause depression. Impotence per se, whatever its cause, is anxiety provoking for many. Both depression and anxiety have profound effects on sexual performance.The impression one gets from reading the study is that