Physical causes of impotence include damage to the arteries and veins that allow blood to flow into and out of the penis, damage to the nerves that send signals from the body's central nervous system to the penis, and, more rarely, a deficiency in testosterone or other hormones. Some medications can contribute to impotence, as can some operations and radiotherapy treatments.

In the past, doctors considered impotence to be a mainly psychological problem, caused by performance anxiety or stress. Now, however, doctors know that most cases of impotence have a physical cause, which can be treated. In fact, according to Impotence World, physical causes contribute to about 75 per cent of cases of impotence.

Most men experience a failed erection at some time in their lives, but if you find that you can't achieve and maintain an erection in at least 3 out of 4 attempts, you should ask your doctor about impotence.Impotence, also known as erectile dysfunction or ED, is a condition in which a man is unable to achieve or maintain an erection long enough to have a satisfactory sex life.

Causes of impotence

- Impaired blood flow to the penis

- Impaired blood flow out of the penis

- Diabetes

- Prostate cancer

- Peyronie's disease

- Diseases of the nervous system

- Depression

- Hormones

- Injury and accidents

- Surgery

- Smoking

- Excessive alcohol use

- Illicit drug use

- Prolonged exercise

Psychological causes of impotence

- Stress and anxiety

- Fear of failure

- Problems with your relationship

Some people may wonder why they need to take medicines for a condition that doesn't have symptoms and doesn't appear to affect their quality of life. Your doctor is aware of this and will try to avoid treatments that make you feel bad or interfere with your lifestyle. Although taking medication may seem like a chore, it is being prescribed to prevent serious illness or even death. Always take medicines according to instructions, and do not stop taking them abruptly as this can cause problems. If you have any questions about your medicine, always ask your doctor.

Impotence can nearly always be treated - 95 percent of men find a suitable treatment. The simplest are talking therapies, such as cognitive behavioural therapy, and medicines.If the cause is mainly because you are anxious or are having relationship difficulties, then talking to a counsellor or psychosexual therapist will probably be most helpful for you.