Impotence - NU Hospitals

Impotence is when a man is not able to have an erection firm enough nor able to maintain it for a long enough time to have successful sexual intercourse. Many men experience short episodes of impotence. Temporary impotence can be caused by stress or drinking too much alcohol. But overall, one in ten men are continually unable to have an erection firm enough for successful sexual intercourse.

What is impotence ?

Impotence means that a man is not able to have an erection firm enough, nor can he maintain it for a long enough time, to have successful sexual intercourse.

Many men experience short episodes of impotence. Temporary impotence can be caused by stress or drinking too much alcohol. But overall, one in ten men are continually unable to have an erection firm enough for successful sexual intercourse.

Facts about impotence ?

Many men become sexually impotent, but never admit it to themselves. Sadly, this denial prevents them from enjoying sexual activity on a regular basis. Up to one in ten are impotent, but only 5% of them have ever been treated for it.

Ignoring the problem was normal behavior years ago, but sexual well being is now moving to the forefront as a key indicator of total health. As more men are living longer, they have an interest in treating impotence. The pride factor is not the block to treatment that it once was. Today, both surgical and non-surgical methods are available and are effective treatment modalities. But, the first step is to admit the problem.

We begin by defining what impotence is:

Impotence is the chronic inability to have an erection that is rigid enough and to maintain it long enough to complete sexual intercourse at least half the time.

If your erections do not become firm enough to allow vaginal penetration, you are impotent. If your erections have the necessary rigidity, but are only firm briefly, you may have an impotence problem. If your erection loses its strength upon penetration, you probably have the problem. If any of these scenarios fit you, it may be time to admit it, and begin to move towards a treatment that can change your life.

When and how does erectile dysfunction occur?When and how does erectile dysfunction occur ?

Erectile dysfunction can occur at any age. According to studies by the National Institute of Health, 5% of men have some degree of erectile dysfunction at the age of 40, and approximately 15%-25% at age 65 or older. Erectile dysfunction affects all races, and crosses all ethnic and economic boundaries.

What causes Impotence ?

A man’s inability to get and maintain an erection can be caused by many disorders. The causes can be either physical or psychological. For many years, it was believed that 90 percent of impotent men had a psychological cause for their problem; but as a result of recent medical research, it is now known that at least half of the men suffering from impotence can actually trace its origin to a physical problem. For most men, the cause of impotence can now be fairly easily identified. Once identified, proper treatment can be recommended to help them return to a satisfactory sex life.

Of all the conditions men face, impotence is the most personal. But it is also very common. The overall incidence of impotence in men with diabetes is two to five times higher than it is in the general male population. This does not mean impotence is inevitable or permanent.

The purpose of this booklet is to provide a better understanding of impotence, also referred to as erectile dysfunction, why it occurs, and what treatment options are now available.

What are the types of impotence ?

There are two types of impotence:

hysical impotence and psychological impotence.

Physical impotence may result from damage to the nerves or the blood vessels that control blood to the penis. It may also be caused by problems with hormones – substances in the bloodstream that affect or control the activity of some organs.

Psychological impotence can be the result of fear, stress, worry, anger or frustration. Often, this type of impotence develops from “performance anxiety”, a man’s fear that he won’t perform well during sexual intercourse. Stress caused by problems on the job, marital problems, or financial difficulties also can lead to this type of impotence.

How is impotence diagnosed ?

A first step in diagnosis is to determine whether the impotence is physical or psychological. The physician may start by asking how the impotence developed.

After asking questions about the impotence, the physician conducts a thorough general examination. The physician usually does tests to find the cause of impotence.

Doppler study of the penis can determine if blood flow to the penis is impaired. Still others will tell if hormone problems are causing impotence.

How is impotence treated ?

Several treatment options are available. Depending on the cause of impotence, the physician may recommend counseling or therapy like oral medications, hormone injections, a change in your regular prescribed medications (if that drug is known to cause impotence), self penile injection of medication to cause erections, or an external vacuum device.

You should also discuss the option of surgical treatment. The most common surgical procedure to treat impotence is that of penile prosthesis implantation. For a few select candidates, a surgery to correct a blocked artery or a leak in the pelvic veins may also be an option.

In many cases, several of these treatments may be appropriate to restore sexual potency. The patient may then choose the treatment method with which he feels most comfortable. It is also very important to involve your sexual partner in this decision making process. Couples who participate together in treatment planning are almost always happy with the results.


Impotence, whether it is due to diabetes or some other cause, does not have to be permanent. Virtually every patient with impotence can be helped. And, in many cases, couples may choose between several effective treatment options.

Ask your physician for recommendations concerning the steps to take to have your problem evaluated and treated.