We used to break down erectile dysfunction into two groups—psy­chogenic or physical. We now know, however, that almost all cases involve at least some component of each. Importantly, whereas we formerly believed a majority of cases to be psychologically based, we now know the opposite is true. Most men who experience difficulties with erections have underlying physical problems. Overcoming these physical limitations can yield results that can permanently restore sexual satisfaction.

Finally, many of you will wonder what the difference is between erec­tile dysfunction and impotence. There is none. The term erectile dysfunc­tion arose in the early nineties to counteract the negative connotation of the term impotence. Impotence literally means “without power,” so some people felt it presented patients in a negative light. Erectile dysfunction became popularized when it entered the lay lexicon in association with the marketing campaign for Cialis. You will note that I use the terms some­what interchangeably throughout this book. Although the politically correct term erectile dysfunction is the preferred term, the less cumbersome impo­tence is more commonly understood. Its familiarity to the public and con­ciseness are the reasons it was chosen for the title of this book. For the same reasons it will be used in many circumstances that we will explore.

The disadvantage of cialis will be the same as its advantage—it may last too long. For men who are unlikely to go back for a repeat performance the following night (or day), this will be overkill. However, for the man taking his wife to New York for the weekend, it could be just the right thing.