In order to understand impotence causes and treatment it is important to review the erection process first. An erection involves a certain sequence of so erectile dysfunction (ED) occurs when one or some of these processes is upset. Impulses in the penis, brain and spinal column, response in tissues, muscles, veins and in the area of the corpora cavernous- these are the order of processes resulting into erection.

There is a great range of physical factors which can result into impotence. The most wide-spread reason of ED is damage of nerves, arteries, muscles and fibrous tissues. Such diseases as diabetes, kidney problems, multiple sclerosis, alcoholism, vascular disease, atherosclerosis, and neurological disease make the main part of impotence cases.

Some surgeries can also injure nerves in the area of the penis resulting into ED. Traumas to the penis, spinal cord, bladder, pelvis and prostate can produce impotence because they affect the work of smooth muscles, tissues and arteries. Besides many medicines can lead to ED. For example while using drugs for blood pressure, antidepressants, tranquilizers; suppressants of appetite men can get ED as a side effect.

Additionally, sexual desire is lowered if there are some hormonal disorders. Inflammatory diseases of the urinal bladder, testicles, urethra and prostate can also be a reason of sexual failures. Harmful habits such as smoking can also become a cause of ED as it affects blood flow. Scientists claim that psychological problems such as stress, anxiety, depression, low self-esteem account for 10-20 % of impotence cases. There are certain centers in the brain that stimulate sexual arousal as well as suppressing it. And the frequent reason of it is stresses, tense rhythm of modern life, family quarrels or dissatisfaction with work.

Treatment of an ED depends on the cause of the problem, which may be psychological, physical or a combination of both. Problems with erection usually have one or two physical factors and as a rule they are combined with psychological disorders. Naturally it makes the problem worse and as a result the treatment needed becomes more complicated and complex.

First of all, different analyses and examinations should be performed to define the possible physical cause of impotence. Sometimes consultations of various specialists and complex tests are necessary. In some cases, discovering and then eliminating medications that may be causing the problem is needed (if it's not a risk for a man's life and health).

If there is a hormonal abnormality a doctor can make a decision to use a substitutive therapy. Vacuum devices are used in order to improve blood flow in the area of the penis. Medications that are injected or inserted into the penis and penile implant surgeries are also used if needed. In cases of diseases of the spinal cord and brain, erection recovery depends on the peculiarities of these problems. Traumas, growths, epilepsy are hard to cure and as a result impotence caused by these diseases is also difficult to treat.

Oral medications have revolutionized the treatment of erection problems, and they are commonly tried first before other medication or surgery. Though medications for ED have a few side effects they still can be dangerous for some groups of men. For example, there are certain drugs that can't be taken with medications used for erection problems treatment. So, before using these or those medications a man should always consult with his doctor.

Counseling (also called psychotherapy) or behavioral therapy may be appropriate even if an erection problem has a physical cause. It may be offered if a doctor suspects psychological issues play a role in erection problems. Discussions on psychological topics, tests and special games are used to help a person in solving his inner psychological problems.

The main thing people suffering from ED should remember is that impotence is treatable at any age. Greater number of men seeks help and returns to normal sexual activity because there are improved, successful treatments for ED nowadays.