Impotence is a widespread problem among men characterized by the inability to maintain an erection adequate for sexual intercourse or the incapability to attain ejaculation, or both. A penile erection is achieved due to the blood flowing in and being retained in sponge-like structure within the penis.

Impotence could have a range of causes that could be both physical and psychological. Physical causes of impotence include the following:

weakening of the arteries - this is a physical alteration which is widespread in elder men, including those having high blood pressure

smoking

diabetes

too much drinking

being overweight and in poor shape

side-effects of some drugs, particularly ones for depression and blood pressure

consequences of taking recreational drugs, such as cocaine

Major surgery of the abdomen - predominantly on the prostate gland.

injury to the spinal cord or brain

Hormonal imbalances

Erectile dysfunction is very likely to have psychological causes in the young if he:

Wakes up regularly with morning erections

Can get a good erection while masturbating.

Has feeling of guilt particularly if you're trying to have sex with somebody else's wife

Has relationship problems

Has latent gayness - for example, if he is fundamentally a gay guy, trying to have sexual intercourse with a woman

Exhaustion.

Depression

In many cases, ED turns out to be a result of a mixture of physical and psychological causes.

Impotence or Erectile dysfunction is a widespread problem in men. While most people are embarrassed to talk in the open about ED, it is important that once you have the problem tell your doctor about it so that the root cause can be identified and treatment started. Your physician would normally ask you some questions; do some physical examinations and some tests to identify the cause.

Treatment is primarily done by tackling the root cause of the problem, whether psychological or physical. Today there are many treatment options available that include: medicines injected directly into the penis or inserted into the urethra, Medicines taken orally, Surgery, Vacuum devices etc. Exercise, mainly aerobic exercise is a good remedy to erectile dysfunction.

Drugs such as sildenafil (Viagra) have been used very successfully in many cases to manage erectile dysfunction. In certain cases changes in lifestyle is prescribed to bring about changes in weight in order to decrease the risk of cardiovascular diseases.

In patients suffering from hypogonadism, testosterone treatment might improve erectile dysfunction and libido. Even though, there is no specific testosterone level to characterize hypogonadism, levels lesser than 250 nanograms per deciliter are thought to be low, and levels of higher than 350 nanograms per deciliter are considered normal.

Psychological methods of treatment might include some commonsense advice to both partners by your doctor and other methods like counselling, psychotherapy, and relationship counselling.

Erectile dysfunction can occur at any age. However it is uncommon among young men and is more common in the elderly. By the age of 45 most men have experienced erectile dysfunction at some point or the other. After the cause of the problem has been established, erectile dysfunction or impotence, can be easily treated these days - sometimes even without drugs.