• Impotence is the inability to maintain a sufficiently erect penis to perform sexual intercourse. Erections in the penis occur because or proper blood supply (arterial) to the penis. Proper balance of nerve conduction to the smooth muscles that control outflow of blood from the penis (i.e., keep blood in the penis so it stays erect) is essential, and the contraction of other muscles (bulbocavernosus and ischiocavernosus muscles) help to maintain an erection. Organic (actual medical problems) causes are more common than psychological causes of impotence.

• Inability to get an erection
• Inability to maintain an erection
• Lack of morning erections indicates organic disease
• Presence of morning erections indicates probable psychological origin

• Arterial insufficiency (including coronary artery disease or atherosclerosis disease with diabetics being at highest risk)
• Diabetes
• Testicular disease
• Pituitary disease
• Hypothalamic disease
• Medications
• Psychological
• Thyroid disorders
• High Blood Pressure
• Trauma to pelvic area
• Alcoholism

- Complete blood count, lipid profile, serum glucose, Prolactin, testosterone levels

• Viagra is an oral medication that is effective for many individuals. Individuals who are taking nitroglycerin medications should not use Viagra because it could cause the blood pressure to drop dangerously low.
• Testosterone injections in those found to have low testosterone levels
• Vacuum constriction device is a cylindrical vacuum device that induces an erection. A rubber band is placed at the base of the penis to maintain the erection.
• Injection therapy -- medications that induce erections (e.g., Prostaglandin-E synthase) are injected directly into the penis.
• Penile prostheses are devices implanted into the penis that either maintain an erect state or are inflatable to create an erection.
• Vascular surgery is required for those with disorders of the arterial system or venous system.