Contrary to the age-old myth that psychological factors are responsible for impotence, more than 85% of the cases of erectile dysfunction are attributed to physical reasons scientifically.

Occurrence and Prevalence:
According to the figures maintained by the National Institute of Health, around 30 million Americans suffer from chronic erectile dysfunction. The report also says that 22 in every 1000 Americans meet physicians with complaints of erectile dysfunction. The occurrence of the dysfunction increases with age. Chronic erectile dysfunction affects 5% of men in their forties, while it affects an estimated 25% of men in their sixties. 50% of the male population between the age of 40 and 70 suffer from a mild form of erectile problem. People with diabetes and kidney related problems have high chances of getting this disorder.

Causes:
A number of physical/organic conditions and psychological factors can cause erectile dysfunction. Physical conditions that prevent the flow of blood to the penis and other neurological disorders are responsible for around 85% of the erectile dysfunction cases while the rest are attributed to psychological reasons like stress and depression.

Physical:

• Vascular disease: the hardening and constriction of the arteries called arteriosclerosis is responsible for around 50% of the ED cases in men above 60. Smoking, high blood pressure and high cholesterol are the risk factors of arteriosclerosis.
  
  
• Drugs: the use of many prescription as well as illegal drugs can result in erectile dysfunction. Antidepressants, sedatives, tranquilizers, medications for high blood pressure and heart problems and a host of other over the counter drugs along with alcohol can cause impotence.
  
  
• Diabetes Mellitus: the high sugar level in the blood has the possibility of wrecking the blood vessels and nerves essential for erection. 60% of men with this medical condition face erectile problems.
  
  
• Neurological Conditions: nerve damage due to the injury to the brain or spinal cord can give erectile problems. Brain injuries like stroke and paraplegia, and neurological disorders like multiple sclerosis, Parkinson’s disease and Alzheimer’s disease could also result in ED.
  
  
• Venous Leak: due to injury the penis might not be able to restrict the flow of blood from it, failing to produce an erection.
  
  
• Peyronie’s Disease: scarring is caused on erectile tissue due to this disease. The scarring may result in painful erection resulting in erectile dysfunction.
  
  
• Surgery, Trauma and Therapy: surgery of the colon, prostrate, rectum and bladder may damage the nerves necessary for erection. Impotence also results from trauma to the pelvic region or the spinal cord. Radiation therapies like cystectomy and prostatectomy can also lead to ED.
  
  
• Hormone Disorders: erectile dysfunction can result from hormone imbalances like deficiency of testosterone and excess of the prolactin hormone.

Psychological:
Psychological factors are secondary causes of erectile dysfunction. But when it adds to the physical conditions, the erectile problem can become very grave. Stress, depression, anxiety, guilt, worry are some of the mental conditions that can hinder your libido. If a person undergoes the erectile dysfunction experience once, it is likely to cause him lots of worry when he wants to have sex the next time. When a person is trapped in this vicious cycle of mental disturbances and a low libido, he would get erectile dysfunction.

Diagnosis:
The medical examination of a person would be required to identify the cause of erectile dysfunction. The medical test will indicate the nature of the physiological cause, whether it is vascular, hormonal or neurological. A history of smoking, alcohol abuse and other illicit drug use can also be ascertained through the test. Some of the standard methods of diagnosis are:

• Complete Blood Count (CBC)
• Liver and Kidney Function Tests
• Thyroid Function Tests
• Urinalysis
• Duplex Ultrasound
• Digital Rectal Examination
• Bulbocavernosus Reflex Test
• Snap Gauge
• Vasoactive Injection
• Penile Biothesiometry
• Nocturnal Penile Tumescence

Treatment:
In sync with the belief in the popular myth that erectile dysfunction is a reason of psychological conditions, people believed that the cure lies in the mind of the person. But times they are a changing, and the outlook on the treatment of erectile dysfunction too has changed with the times. With the breakthroughs in the medical world, lots of prescription drugs, herbal medicaments and alternatives, and out of the box psychological therapies have been introduced to cure erectile dysfunction. The prominent methods of treatment are:

• Sex and Mind Therapy
• Penile Implants
• Vacuum Therapy
• Vascular Surgery
• Hormonal Therapy
• Herbal Alternatives
• Prescription Drugs like Viagra, Cialis, Levitra and Yohimbine
• Penile Injection Therapy using Prostaglandin and Phentolamine
• Urethral Suppositories like Muse® (Medicated Urethral System for Erections)