What Causes Impotence and Loss of Erection?

Impotence occurs when a man has difficulty with either getting an erection or keeping one for long enough to allow satisfactory sexual activity.

It's one of the most common sexual problems and affects around 2.3 million men in the UK. Half of all men over the age of 40 will experience it at some point in their lives. It becomes more common and severe as men get older. However, only about 10 percent of affected men seek help.

Causes

There are a number of reasons why you may have impotence. In around three-quarters of cases there are physical problems affecting the blood supply. However, there is a complex relationship between the physical and psychological aspects of sexual function. For instance, you may have physical health problems that cause psychological distress and this may have an additional effect on erection problems.

Physical health

A number of different conditions may cause impotence, including:

• diabetes
• multiple sclerosis
• Parkinson's disease
• if you have had surgery in your pelvic area
• hormone imbalances

Psychological

Psychological problems can influence your ability to get and keep erections. These include:

• feeling anxious, guilty or depressed
• stress at work
• conflicts with your partner
• unresolved issues about your sexual orientation

Lifestyle

If you drink too much alcohol, this can affect your ability to get and keep an erection (often called brewer's droop). In the longer term, it interferes with the production of the male hormone testosterone, which can reduce your sexual drive and desire (libido).

Smoking damages your blood vessels and so increases your risk of erection problems. Similarly, being physically inactive, which contributes to poor cardiovascular fitness, may raise the chances of you having impotence. Impotence may be an early warning sign that you are at risk of coronary heart disease (the arteries that go to your heart are narrowed).

Many men need greater tactile stimulation as they get older. You may want to consider a change in sexual foreplay and technique to ensure a sustained erection.

Medicines

The side-effects of some medicines such as those for high blood pressure and certain antidepressants can lead to impotence. Medicines can also affect your libido, or cause problems with ejaculation and orgasm. These can also have an effect on erections.