On October 7, 1999 a book (and later, movie) by Gaby Hauptmann entitled "Suche impotenten Mann f'rs Leben" (In Search of an Impotent Man) came out with an interesting premise: maybe the perfect man is an impotent man. At least that's what the protagonist of the novel, Carmen, believes. The sexy, successful thirtysomething real estate maven is tired of being ogled, pawed, and cheated on by the men in her life. By removing the sexual aspect of the relationship, it could leave room for a caring, monogamous relationship. So with the help of her friends Elvira and Laura, Carmen embarks on a crazy quest to find a sensitive, intelligent man with a good sense of humor...but he must be impotent. After posting a personal ad online, Carmen eventually meets the impotent man of her dreams: David, a handsome architect with California surfer-boy looks. But when she finally gets what she thought she wanted, Carmen realizes that she wants to express her love for David in a physical manner. Laura tells Carmen,"You wanted an impotent man, and you've got the impotent man of your dreams and now you want to turn him into a potent superman."

While I wasn't very impressed with the movie, it did make me think---in real life, how can an impotent man find a partner in the sex-crazed world we live in?

Impotence, or erectile dysfunction, is a condition characterized by the repeated inability to obtain or maintain an erection. Erections are managed by two different mechanisms, the reflex and the psychogenic erection. Reflex erections are achieved by directly touching male shaft. Psychogenic erections are achieved by erotic or emotional stimuli. Erectile dysfunction can be caused by psychological issues, stress, alcohol abuse, smoking, hormonal deficiency, or diseases like diabetes and cardiovascular disease. While there are no formal tests being done to specifically diagnose it, several tests are helpful in determining if there is an underlying medical or psychological condition causing it. When the cause is determined, the proper course of treatment will then be prescribed. Patients will have the option to take either testosterone injections, oral prescriptions, direct injections to the shaft, vacuum pumps, surgery, or in cases of psychological issues, counseling. Apart from those there are other, more unconventional treatments available, like herbal medicine, acupuncture, or experimental medicine. However, since the brain controls the libido, the placebo effect cannot be dismissed as a possible cause for the treatment's efficacy.

It is unfortunate that men view sex and the ability to obtain an erection as an integral part of their masculinity. Thus, erectile dysfunction will cause the sufferer to feel performance anxiety every time he has sex, and the anxiety will further affect his ability to maintain the erection. Its up to their partners to ensure that their sexual relationship remains mutually satisfying regardless of the condition. One key aspect to this is improving communication between the couple. A spirit of fun and openness will go a long way to ensure that the relationship remains healthy during the toughest times.