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Erectile dysfunction (ED), sometimes called “impotence,” is the repeated inability to get or keep an erection firm enough for sexual intercourse. The word “impotence” may also be used to describe other problems that interfere with sexual intercourse and reproduction, such as lack of sexual desire and problems with ejaculation or orgasm.

Erection begins with sensory or mental stimulation, or both. Impulses from the brain and local nerves cause the muscles to relax, allowing blood to flow in and fill the spaces. The blood creates pressure making the penis expand. It helps trap sustaining erection. When muscles in the penis contract to stop the inflow of blood and open outflow channels, erection is reversed.

In older men, ED usually has a physical cause, such as disease, injury, or side effects of drugs. Any disorder that causes injury to the nerves or impairs blood flow in the penis has the potential to cause ED. Incidence increases with age of 40-year-old men and 65-year-old men experience ED. But it is not an inevitable part of aging. Experts also believe that a psychological factor such as stress, anxiety, guilt, depression, low self-esteem, and fear of sexual failure causes ED.
Advances in medical treatment have been expanding the options for men seeking treatment and may offer a long-lasting therapeutic approach for ED. These advances have also helped increase the number of men seeking treatment.