A common problem among men characterized by the consistent
inability to sustain an erection sufficient for sexual intercourse or the inability
to achieve ejaculation, or both. Impotence can vary. It can involve a total inability
to achieve an erection or ejaculation, an inconsistent ability to do so, or a tendency
to sustain only very brief erections.
The risk of impotence increases with age. It is four-fold higher in men in their
60s compared with those in their 40s according to a study published in the Journal
of Urology (2000;163:460-463). Men with less education are also more likely to experience
impotence, perhaps because they tend to have less healthy lifestyles, eat a less
healthy diet, drink more and exercise less. Physical exercise tends to lessen the
risk of impotence.
Impotence can have emotional causes but most often it is due to a physical problem.
The physical causes of impotence include diseases (such as diabetes and hypertension),
injuries (such as from prostate surgery), side-effects of drugs (such as the protease
inhibitors used in HIV therapy), and disorders (such as atherosclerosis) that impair
blood flow in the penis. Impotence is treatable in all age groups. Treatments include
psychotherapy, vacuum devices, surgery and, most often today, drug therapy.
Advertising for drugs for the treatment of impotence has greatly popularized
the problem better known in the ads by its other name, erectile dysfunction.
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