Impotence, or erectile dysfunction (ED), is a common problem that profoundly negatively effects quality of life. Published estimates suggest that at least 20 million American men are affected by this condition. As with many disease processes, erectile dysfunction has a spectrum of severity. The most frequent symptom that we see is the inability to achieve any penile erection at all. Commonly, however, one may experience partial erection with either incomplete rigidity or loss of rigidity before ejaculation.
The causes of erectile dysfunction are many. Physicians in the past attributed ED to psychogenic causes. We now know that psychogenic impotence is responsible for less than 10% of cases of serious erectile dysfunction. Common causes of ED include failure of chemical mediators within the penis, arterial blockage due to atherosclerosis, peripheral nerve damage due to diabetes, pelvic fracture, and spinal cord injury. Chemical mediator problems appear to be the most common cause of erectile dysfunction, but are only now being understood. Identifying the exact cause of erectile dysfunction is often difficult. Fortunately, determining the specific cause of erectile dysfunction is usually not necessary.