Impotence

Persistent inability in a male to achieve or maintain a penile erection of sufficient rigidity to permit satisfactory sexual intercourse, in the absence of ejaculatory failure or reduced libido.

Causes

• Vascular causes

  • Cardiovascular disease

  • Atherosclerosis

  • Hypertension

  • Peripheral vascular disease

  • Diabetes-related vascular damage

  • Reduced blood flow to penile tissue

• Neurogenic causes affecting erection pathways

  • Diabetes mellitus with autonomic neuropathy

  • Multiple sclerosis

  • Spinal cord injury

  • Prostate surgery

  • Bladder surgery

  • Pelvic nerve injury

  • Pelvic trauma

  • Neurological disorders

• Hormonal and metabolic causes

  • Obesity

  • Low testosterone levels

  • Endocrine disorders affecting sexual function

  • Tobacco use

  • Excessive alcohol consumption

• Medication-related causes

  • Antihypertensive medications

  • Antidepressants

  • Antihistamines

  • Chemotherapy agents

  • Antiandrogen medications

  • Other medications affecting vascular, hormonal, or neurological function

• Psychogenic causes

  • Depression

  • Anxiety

  • Stress

  • Relationship conflicts

  • Performance anxiety

• Other causes

  • Peyronie's disease

  • Chronic kidney disease

  • Sleep disorders

  • Aging-related changes in vascular and hormonal function