Causes of Impotence: Here’s What to Consider

Causes of Impotence: Here’s What to Consider
Kristin Hall, FNP
Medically reviewed by Kristin Hall, FNP Written by Our Editorial Team Last updated 9/11/2020

Men don’t sit around and talk about their inability to achieve an erection. It just doesn’t happen. 

But they could, as the problem is far more common than the shame associated with it would lead you to believe. 

Impotence, a fairly outdated term, refers to the inability to get or stay hard. 

It’s also known as erectile dysfunction. It’s common. Very common. 

But researchers suggest as many as 69 percent of men deny it when it happens to them, and wait more than two years to seek treatment for this highly treatable condition. 

What’s causing your ED could be as simple as your fear of ED. But it could also be as complex as an undiagnosed medical condition. Addressing it head-on can get you back in the game as soon as possible, with minimal damage to your self-esteem.

What Is Impotence? 

Impotence, more often called erectile dysfunction (ED), is the inability to obtain or keep an erection hard enough for sexual activity. 

For some men, this means getting hard sometimes, but not every time you want to. For others, it means getting hard, but not staying hard long enough. 

And for some, it means never being able to get hard. It can be an occasional problem, a short term problem or one that lasts for years.

ED is common. Very common. One estimate, from researchers with Johns Hopkins Bloomberg School of Public Health, puts the number at 18 million men in the U.S. alone, or roughly 18 percent  of those over the age of twenty. 

In other words, nearly one in five men in the U.S. More than likely, you’re not the first of your friends to experience it. 

Erectile dysfunction can be a symptom of other problems and it can cause other problems, such as strained relationships, depression, anxiety, low self-esteem and inability to have children, to name a few.

While it can be difficult to talk about your struggles with ED, it’s important. Understanding the potential causes will drive home the possible seriousness of the condition. 

Physical Causes of Erectile Dysfunction 

It was once believed that all cases of erectile dysfunction stemmed from psychological causes. Now, it’s understood that as many as 80 percent of cases have a physical origin. 

These physical causes run the gamut and can signal very serious health concerns — some of which you may be aware of before you experience ED, and others for which ED could be your first noticeable symptom: 

  • Kidney disease 
  • Hardening of the arteries/atherosclerosis
  • High cholesterol
  • Diabetes
  • Multiple sclerosis
  • Parkinson’s disease 
  • High blood pressure 
  • Radiation therapy
  • Injuries to the penis, spinal cord, prostate, pelvis or bladder
  • Peyronie’s disease 
  • Obesity
  • Metabolic disorder
  • Sleep disorders
  • Alcoholism and drug abuse 
  • Smoking
  • Certain prescription drugs including blood pressure medications, antiandrogens used for prostate cancer treatment, antidepressants, appetite suppressants, ulcer medications, sedatives and tranquilizers 

Psychological Causes of Erectile Dysfunction

Obviously your brain plays an important role in your ability to get and maintain an erection. Yes, you have to think with both your brain and your, uh, unit, when it comes to sex. 

It all starts with sexual thoughts, whether triggered by something (or someone) you see, or from your imagination. 

Any number of things can interrupt the messages from your brain to your penis, or stop your brain from getting excited altogether. 

Psychological causes of erectile dysfunction may include: 

  • Depression
  • Anxiety 
  • Other mental health issues 
  • Stress
  • Relationship problems
  • Fear of failure or inability to perform
  • Low self-esteem
  • Guilt surrounding your sexual performance

 Reading through these, it’s easy to see how the feelings associated with erectile dysfunction can become a vicious cycle. One bad experience where you couldn’t get hard can lead to gripping performance anxiety, which may increase the risk of experiencing this nightmare situation again. 

As one group of researchers put it: “Men who cannot achieve or maintain an erection as a result of anxiety lose sexual confidence and generally develop greater fears leading up to the next sexual encounter, which increases the likelihood of failure and reinforces the pressure to perform during future encounters.”

Impotence Risk Factors 

Similar to causes, risk factors are things that can increase the likelihood of your developing erectile dysfunction. Or, in research, they’ve found an association with these things and the risk of ED: 

  • Some medical conditions like diabetes and heart disease
  • Overweight and obesity 
  • Medical treatments including certain surgeries or cancer radiation treatment 
  • Tobacco use 
  • Injuries 
  • Certain medications
  • Depression, anxiety, stress and other psychological conditions
  • Drug and alcohol use 
  • Age: ED is more common in older men

What Can You Do about Impotence? 

The short answer to this is: get help. It’s hard to ask for help for erectile dysfunction, but failing to do so can cause unnecessary stress and strife. 

Erectile dysfunction can lessen your quality of life, cause increased stress and anxiety, and cause you to withdraw from relationships and intimacy. What begins as an inability to get hard can result in far more serious problems, left untreated. 

There is help out there, including simple medications to help you perform and get back to the old you. Don’t feel ashamed about such a common occurrence, and don’t wait to seek help. 

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.