Male sexual impotence or erectile dysfunction is the persistent inability to achieve or maintain an erection that allows a satisfactory sexual relationship.

You must differentiate yourself from other sexual problems, such as lack of desire, the alterations of ejaculation (delayed ejaculation, premature ejaculation and absence of ejaculation) or orgasm disorders.

Impotence or erectile dysfunction is a common condition which if untreated can affect relations with the couple, family, working and social environment. All men can have trouble having an erection in his life, especially if you are tired, have stress, a serious illness or are under the influence of alcohol and drugs.

Causes
Impotence or erectile dysfunction can be caused by:

Psychological causes

In these cases, the penis does not present any physical alteration, however, diseasessuch as the anxiety (often fear to not get an erection or to defraud the woman), depression, problems with the couple and even stress can affect the sexual act.

Also the excessive preoccupation with work, social or family problems imply that not dedicated attention to the sexual act. Fatigue, inappetence, lack of exercise, insomnia or a labour failure also unbalance sexual reflexes.
Vascular causes

This type is very common. The penis cannot accumulate the necessary blood so thatan erection is usually given because it does not arrive in sufficient quantity. Smoking, high blood pressure, diabetes, some heart diseases and increased levels of cholesterol in the blood can cause vascular disorders that hinder the erection.

Neurological causes

In these cases there is a cut in the transfer of messages from the brain to the penisbecause there is an injury to the nerves involved. This occurs with lesions of the spinal cord, after some surgical interventions or multiple sclerosis in the pelvis.
Hormonal causes

They are infrequent. They are usually due to a lack of male sex hormones.
Pharmacological causes

There are several medications that have side effect of reducing the ability to have an erection. Among them are some drugs to treat high blood pressure, heart diseaseand psychiatric disorders.

Symptoms
The main symptom of erectile dysfunction is a change in the quality of erection, both in terms of rigidity, as in the ability to maintain an erection.

If impotence is caused by physical causes, one of the main indicators in the inabilityto have or maintain an erection upon awakening in the morning.

On the other hand, if it is caused by psychological causes, impotence often occur during a specific time period (as long as the situation of stress, for example). If it persists for more than three months the patient must seek a urologist specializing in impotence.

Prevention
The main measure that men should take into account to prevent the emergence oferectile dysfunction is the modification of lifestyle to avoid any habit that negatively impact on the arteries and the veins, (check ed reverser review) such as smoking, alcohol and saturated fat consumption, sedentary lifestyle and stress.

Types
Today, some experts establish the following classification to distinguish the differenttypes of impotence:

Impotence impotentia: is the inability to maintain a sexual intercourse.

Impotence erigerandi: inability to achieve erection of the penis.

Impotence generandi: inability to procreate but there is penetration.

Psychological impotence: when the erection depends on mental and not physical problems.
Diagnosis
For the elaboration of a correct diagnosis, it is necessary that the patient undergo medical check-ups that allow you to develop a good clinical history.

An interview with the affected person may reveal psychological factors involved in the erection disorder. It is essential to rule out depression, which is not always apparent. The Beck Depression scale and the scale of Yesavage geriatric depression in theelderly are simple and easy to perform.

Personal relationships, if there are conflicts or difficulties of communication with your partner, should also be analysed by which an interview with a sexual partner of the affected can reveal details of utmost importance.

The general medical assessment should include a history of ingestion of drugs, alcohol, smoking, diabetes, hypertension, and atherosclerosis, an exploration of the external genitalia to discard presence of fibrous bands and an appraisal of the signs of vascular, hormonal or neurologic diseases.