Impotence is a persistent condition through which a man has problems achieving or maintaining a penile erection adequate for sexual activity. According to the American Urological Association (AUA), about 30 million American men beyond age 50 have some form of impotence. Three factors may contribute to impotence, including loss of sexual drive, erectile dysfunction and ejaculation problems. Many types of disorders can cause impotence. Determining the cause of impotence is the first step toward successful treatment.
Brain and Nerve Disorders
Physical sexual response depends on a complex interplay of messaging between the brain and the local nerves of the genitalia. Damage or interference with the brain or genital nerves may cause impotence, notes the University of Maryland Medical Center. Specific brain and nerve disorders that may cause impotence include stroke, spinal cord injuries, multiple sclerosis and Parkinson's disease. Surgery or radiation treatments for prostate cancer or benign prostatic hyperplasia (BPH) may cause nerve damage leading to impotence.
Hormone Imbalances
Normal male sexual function requires balanced sex hormone levels. The Mayo Clinic points out that a low level of testosterone may cause impotence. Similarly, some medications used for the treatment of BPH interfere with male sex hormones and may cause impotence. The American Society for Reproductive Medicine notes that excessive levels of the pituitary hormone prolactin can also cause impotence.
Vascular Disorders
Disorders that interfere with the blood vessels in and around the genitalia are a common cause of impotence. The online professional endocrinology reference book "Endotext" notes that high blood pressure, atherosclerosis and traumatic blood vessel injuries of the pelvis are possible causes of impotence. The AUA points out that smoking is a significant contributing factor to the development of atherosclerosis; as such, smoking may contribute to the development of impotence.
Drugs
Many prescription, over-the-counter and illicit drugs can interfere with normal sexual function, according to the AUA. Commonly used antidepressants, blood pressure medicines, diuretics, narcotic pain relievers, decongestants and antihistamines are among the many types of medications that can cause impotence. Notably, recreational drugs can also cause impotence, including cocaine, barbiturates, amphetamines, heroin, marijuana and alcohol.
Chronic Diseases
Chronic diseases frequently cause impotence. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) reports that 35 to 50 percent of men with diabetes mellitus experience impotence. Chronic kidney, heart and liver disease may also lead to impotence.
Psychological Problems
According to the AUA, psychological problems are the primary cause of impotence in about 25 percent of men with the condition. Depression, self-esteem and relationship problems, guilt, anxiety disorders, fear and excessive stress may interfere with normal sexual response, the NIDDK explains. Notably, men with a physical disorder that causes impotence often experience psychological problems in response to the condition.
References
- National Institute of Diabetes and Digestive and Kidney Diseases: Erectile Dysfunction
- American Urological Association: Erectile Dysfunction, Causes, Risks and Talking with Your Doctor
- American Society for Reproductive Medicine: Hyperprolactinemia
- Endotext.org: Classification of Erectile Dysfunction
- Mayo Clinic: Erectile Dysfunction, Causes
