The development and maintenance of an erection requires mental or physical stimulation of the penis, which causes blood to rush into a structure called the corpus cavernosum. The blood is then trapped by tissue called the tunica albuginea to maintain the erection. Any defect in this process can lead to male impotence, also known as erectile dysfunction.
Identification
Male impotence is a condition in which men have trouble achieving and maintaining an erection that is firm enough for sexual intercourse. Although most men will have periods of time where their erections are insufficiently firm, the Mayo Clinic defines erectile dysfunction as problems with maintaining and achieving an erection on a consistent basis, coupled with a decrease in sexual desire.
Physical Causes
There are a number of things that can physically cause male impotence, the National Institute of Diabetes and Digestive and Kidney Disorders explains. Anything that damages the fibrous tissue, nerves, blood vessels or smooth muscle can cause erectile dysfunction. Conditions such as high blood pressure, diabetes, heart disease, nerve problems, atherosclerosis and multiple sclerosis can all cause impotence in men. Pelvic surgery can also cause nerve damage, leading to erectile dysfunction. Certain medications, such as antihistamines, antidepressants, blood pressure drugs and cimetidine can also cause erectile dysfunction.
Psychological Causes
In addition to physical causes of male impotency, there are a number of psychological factors that can play a role. According to the Mayo Clinic, psychological problems such as depression and anxiety can lead to impotence. Fatigue and stress can also make it difficult for a man to achieve an erection. The Patient Education Institute explains that anxiety about achieving an erection can also contribute to impotence in a man.
Diagnosis
A basic physical exam and blood tests can be used to identify causes of erectile dysfunction, the Patient Education Institute explains. To distinguish between physical and psychological causes of impotence, patients may wear a special device during the night to detect erections that occur while the patient is sleeping. Ultrasound can be used to determine if there are any problems with penile blood flow leading to trouble achieving or maintaining an erection.
Treatment
There are multiple drugs that can be taken to treat erectile dysfunction. Sildenafil, vardenafil and tadalafil all increase the blood flow to the penis, the National Institute of Diabetes and Digestive and Kidney Disorders explains. Some medications, such as alprostadil, can be injected into the penis to generate an erection. Vacuum devices can be used to pull blood into the penis. Finally, surgery can be performed to repair any damaged nerves or blood vessels that are causing impotence.
