5 Common Causes of Impotence

Key takeaways
The risk of impotence increases with age and is higher in males who have been diagnosed with heart conditions.
Other causes include endocrine diseases like diabetes, neurological disorders, certain medications, and lifestyle or emotional factors like depression and anxiety.
What is impotence?
Impotence occurs when you're unable to achieve an erection, maintain an erection, or ejaculate on a consistent basis. It's used interchangeably with ED. Several factors can contribute to the condition, including both emotional and physical disorders.
According to the Urology Care Foundation, an estimated 30 million Americans experience ED.
A 2007 study published in the American Journal of Medicine noted the risk of impotence increases with age. Research suggests it's even higher in men who have also been diagnosed with one or more cardiovascular risk factors.
Impotence can often have a negative effect on your sex life, and it can also cause depression, additional stress, and low self-esteem.
Impotence and erectile dysfunction symptoms
A common misconception about erectile dysfunction is that you cannot achieve an erection at all. This is not always the case. Erectile dysfunction can also include symptoms like:
being unable to achieve an erection
inconsistently being able to achieve an erection each time you have a sexual encounter
not being able to maintain an erection for the entire sexual encounter
Impotence can begin to affect your quality of life and relationships with your sexual partners over time. However, there are several treatment options available for many of the root causes of ED.
If you are experiencing any of these symptoms, consider talking with your doctor about what might be causing your ED and what treatment options might be best for you.
What causes impotence?
Understanding the most frequently diagnosed potential causes can help you identify why you may be experiencing the condition. Here are five common causes of impotence:
1. Endocrine diseases
The body's endocrine system produces hormones that regulate metabolism, sexual function, reproduction, mood, and much more.
One of the complications associated with chronic diabetes is nerve damage. This affects penis sensations. Other complications associated with diabetes include 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 you from achieving an erection.
Neurological disorders associated with impotence include:
Alzheimer's disease
Parkinson's disease
brain or spinal tumors
multiple sclerosis (MS)
stroke
temporal lobe epilepsy
If you've had prostate surgery, you can also experience nerve damage, resulting in impotence.
Long-distance bicycle riders can experience temporary impotence. Repeated pressure on the buttocks and genitals can affect nerve function.
3. Taking medications
Taking certain medications can affect blood flow, which can lead to ED. You should never stop taking a medication without your 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)
antihistamines, such as cimetidine (Tagamet)
beta-blockers, such as carvedilol (Coreg) and metoprolol (Lopressor)
chemotherapy medications
central nervous system (CNS) depressants, such as alprazolam (Xanax), diazepam (Valium), and codeine
CNS stimulants, such as cocaine and amphetamines
diuretics, such as furosemide (Lasix) and spironolactone (Aldactone)
selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) and paroxetine (Paxil)
synthetic hormones, including 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, you cannot achieve an erection.
Atherosclerosis, a condition that causes blood vessels to become clogged, can cause impotence. High cholesterol and high blood pressure (hypertension) are also associated with an increased risk for impotence.
5. Lifestyle factors and emotional disorders
To achieve an erection, you must first go through what's known as an excitement phase. This phase can be an emotional response. If you have an emotional disorder, it can affect your ability to become sexually excited.
Depression and anxiety are associated with an 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 also cause impotence. If you haven't been able to achieve an erection in the past, you may fear you won't be able to achieve an erection in the future.
You may find that you cannot achieve an erection with a certain partner. If you've been diagnosed with ED related to performance anxiety, you may be able to have full erections when masturbating or when sleeping, but unable to maintain an erection during intercourse.
Substance use disorder involving drugs such as cocaine and amphetamines can also cause impotence. Alcohol misuse or alcohol use disorder (AUD) can affect your ability to achieve or maintain an erection as well. See your doctor if you suspect that you may have a substance use problem.
Erectile dysfunction treatment
Treatments are available for impotence, including medical interventions, natural remedies, and lifestyle changes.
Medical interventions
There are a variety of medical interventions that can be used to treat impotence. Prescription treatments for impotence include:
alprostadil (Caverject, Edex, MUSE), which is available as an injection or as a suppository
avanafil (Stendra)
sildenafil (Viagra)
tadalafil (Cialis)
vardenafil (Staxyn, Levitra)
testosterone replacement therapy (TRT)
You may also want to consider vascular surgery (to improve blood flow in the penis) or penile implant surgery.
Find Roman ED medication online.
Natural remedies
If you want to avoid prescription medication, there are a variety of natural remedies known to help treat impotence. It's important to note that the efficacy of these alternative remedies is not always tested or verified by the FDA so you may not see the advertised results of these products. Before you use any natural remedies, make sure you consult your doctor first.
Some alternative remedies for impotence include:
Penis pumps
Penis pumps are another option if you're looking for noninvasive, nondrug treatments. They may be most effective if you have moderate ED.
Lifestyle changes
Whether your impotence has a physical or an emotional cause, there are many cases where lifestyle changes can reduce problems with ED.
According to an article in the Journal of Restorative Medicine, examples of these lifestyle and behavioral changes include:
quitting smoking if you smoke
drinking alcohol in moderation
practicing supportive communication in a romantic relationship
exercising
eating a well-balanced, nutritious diet
reducing anxiety
You may also want to consider meeting with a mental health professional if you feel your ED is due to psychological causes.
How to increase blood flow to the penis naturally
Naturally increasing blood flow to the penis often requires a combination of lifestyle changes. Here are a few changes that you can consider trying:
If you smoke, consider quitting. Smoking can affect your blood flow and worsen erectile dysfunction.
Engage in regular physical activity. Exercise can help improve blood flow in your entire body and aid in maintaining a moderate weight, which also may reduce erectile dysfunction.
Try to choose heart-healthy foods. These include low sodium and low fat foods.
Consider seeing a physical therapist who specializes in pelvic floor physical therapy. It's important to start these exercises under the advice of a therapist as appropriately performed exercises can help erectile dysfunction, but inappropriately performed exercises can be problematic.
However, it's important to remember that some causes of decreased blood flow require medical treatments. If you try techniques at home to increase blood flow to your penis yet still experience erectile dysfunction, it's worthwhile to seek out medical attention.
When to see a doctor
While erectile dysfunction is commonly tied to aging, it is not an inevitable part of the aging process. Many people have been able to treat the condition, regardless of their age.
If you experience problems achieving or maintaining an erection, consider talking with a doctor. Both primary care professionals and urologists can help you create a treatment plan for erectile dysfunction. However, if your condition is related to an underlying medical condition, they may refer you to a specialist.
It's completely understandable if you feel self-conscious about speaking with a doctor about erectile dysfunction.
However, it's important to keep in mind that sexual health is an important part of your overall health and how you feel about yourself.
It's important that you are able to talk with healthcare professionals openly and honestly about your symptoms and to get help for any underlying medical conditions.
Frequently asked questions about the causes of impotence
How long can the average person with a penis stay erect?
There is not a specific answer for how long the average person with a penis can stay erect. What matters is if you are unable to maintain an erection for a long enough time to have satisfying sexual intercourse.
There is also an alternative where the penis stays erect for too long, a condition known as priapism. If your erection exceeds 4 hours, you should seek emergency medical attention.
What causes erectile dysfunction?
Erectile dysfunction can be caused by impaired blood flow, problems with the nerves in and around the penis, or nervous system changes that may affect sexual desire.
Sometimes, erectile dysfunction can occur as a side effect of taking some medications, including:
antidepressants
anxiolytics
muscle relaxants
diuretics
antihypertensives
What is the main cause of impotence?
For older people experiencing impotence, an estimated 70 to 80 percent of cases are related to a physical issue that affects blood flow to the penis.
In some instances, erectile dysfunction can be one of the earliest signs of blood flow problems in the body. Because erectile dysfunction can potentially signal underlying medical conditions like cardiovascular disease, it's important to talk with your doctor if you experience ED or impotence for several weeks.
Can impotence be cured?
If the underlying cause of impotence is treatable, impotence can be cured.
Treatment can include:
taking medications to improve blood flow
participating in talk therapy
changing medications that may contribute to impotence
Medications, such as sildenafil (Viagra) or tadalafil (Cialis) can also help to improve erectile dysfunction symptoms. However, it should be kept in mind that not all causes will have cures, and it may take time for a doctor to properly diagnose your specific issue.
Takeaway
Impotence can change your life and affect your self-esteem.
Though ED can have a negative effect on your sex life, it's ultimately a treatable condition. Many interventions exist that can help you regain your sexual function, including natural remedies, medications, and lifestyle changes.
Because impotence can signal an underlying health problem, it's important to make an appointment with a doctor if it becomes a consistent problem, even if you think it's just stress.

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