Impotence is a condition that affects a man's ability to achieve or maintain an erection.
There can be several contributing factors to impotence. These include both emotional and physical disorders. According to The Merck Manual, an estimated 50 percent of men age 40 to 70 experience some erectile dysfunction (ED). Understanding the most common potential causes can help a man identify why he may be experiencing the condition.
1. Endocrine Diseases
The body's endocrine system produces hormones that regulate metabolism, sexual function, reproduction, mood, and much more.
Diabetes is an example of an endocrine disease that can cause men to experience impotence. Diabetes affects the body's ability to utilize the hormone insulin.
One of the side effects associated with chronic diabetes is nerve damage. This affects penis sensations. Other complications associated with diabetes are impaired blood flow and hormone levels. Both of these factors can contribute to impotence.
2. Neurological and Nerve Disorders
Several neurologic conditions can increase the risk for impotence. Nerve conditions affect the brain's ability to communicate with the reproductive system. This can prevent a man from achieving an erection.
Neurological disorders associated with impotence include:
brain or spinal tumors
temporal lobe epilepsy
Men who’ve had prostate gland surgery can also experience nerve damage that causes impotence.
Long-distance bicycle riders can also experience temporary impotence. This is because repeated pressure on the buttocks and genitals can affect the function of the nerves.
3. Taking Medications
Taking certain medications can affect blood flow, which can lead to ED. A man should never stop taking a medicine without his doctor's permission, even if it's known to cause impotence.
Examples of medications known to cause impotence include:
alpha-adrenergic blockers, including tamsulosin (Flomax)
beta-blockers, such as carvedilol (Coreg) and metoprolol (Lopressor)
cancer chemotherapy medications, such as cimetidine (Tagamet)
central nervous system depressants, such as alprazolam (Xanax), diazepam (Valium), and codeine (found in various brand-name drugs)
central nervous system stimulants, such as cocaine or amphetamines
diuretics, such as furosemide (Lasix) and spironolactone (Aldactone)
synthetic hormones, such as leuprolide (Eligard)
4. Cardiac-Related Conditions
Conditions that affect the heart and its ability to pump blood well can cause impotence. Without enough blood flow to the penis, a man can't achieve an erection.
Atherosclerosis, a condition that causes the blood vessels to become clogged, can cause impotence. High cholesterol and high blood pressure (hypertension) are also associated with increased risks for impotence.
5. Lifestyle Factors and Emotional Disorders
To achieve an erection, a man must first go through the excitement phase. This phase can be an emotional response. If a man has an emotional disorder, this affects his ability to become sexually excited.
Depression and anxiety are associated with increased risk for impotence. Depression is a feeling of sadness, loss of hope, or helplessness. Fatigue related to depression can also cause impotence.
Performance anxiety can be another cause of impotence. If a man wasn't able to achieve an erection in the past, he may fear he won't be able to achieve an erection in the future. A man may also find he can’t achieve an erection with a certain partner. A man with ED related to performance anxiety may be able to have full erections when masturbating or when sleeping, yet isn't able to maintain an erection during intercourse.
Abuse of drugs like cocaine and amphetamines can also cause impotence. Alcohol abuse and alcoholism can also affect a man's ability to achieve or maintain an erection. See your doctor if you suspect you may have a substance abuse problem.
Impotence can change a man's life and affect his self-esteem. Note that aging isn't one of the biggest causes of impotence. ED isn't considered a natural part of aging. Many interventions exist that can help a man regain his sexual function.