Causes of Impotence:

DRUGS

Blood Pressure Medications
Beta blockers e.g. Propanolol
Diuretics e.g. Thiazides
Alfa blockers e.g. Prazosin
Vasodilators e.g. Hydralazine
Sympatholytics e.g. Clonidine
Calcium channel blockers e.g. Felodipine (cause less impotence than other blood pressure
medications)
Psychoactive Drugs
Antipsychotic Drugs
Antidepressants
Tricyclics
MAO Inhibitors
Seizure medications
Tranquilizers
Amphetamines
Cocaine
Heroine
Alcohol
Marijuana
Prostate Cancer Treatment
Estrogens
Antiandrogens
Gonadotropin-releasing hormone analog
Decongestants
Cholesterol Lowering Drugs
Ulcer Treatment
H2 Blockers
Hair Loss Treatment
Spironolactone
Finasteride
Heart Medication
Digoxin
Sedatives
Tobacco

PSYCHOLOGICAL

Excessive Feelings of:
Depression (Although decreased libido often makes potency moot)
Helplessness
Unworthiness (low self esteem)
Guilt
Shame
Anxiety (Particularly performance anxiety)
Rage
Paranoia
Fear of failure
Fear of contracting a sexually transmitted disease
Unresolved issues with one’s partner, like:
Anger
Dominance
Humiliation
Resentment
Fear
Inner conflict about one’s sexual identity or orientation

CARDIOVASCULAR

Diabetes
Atherosclerosis
Heart Disease

NEUROLOGICAL

Diabetes (With neuropathy)
Stroke
Multiple Sclerosis
Parkinson’s Disease
Alzheimer’s Disease
Tumors of the Brain and Spinal Cord
Temporal Lobe Disorders
Trauma

CANCER AND/OR SURGERY OF:

Prostate
Bladder
Rectum or Colon
TRAUMA TO PELVIC AREA OR GROIN
ENDOCRINE (Glandular or Hormonal)
Pituitary
Gonads
Thyroid
Adrenal

PEYRONIE’S DISEASE

The most common of all these causes are THERAPEUTIC DRUGS and ALCOHOL EXCESS.
(Wyngaarden and Smith, Cecil Textbook of Medicine, W.B.Saunders Co., Phila. 1985, p.2030)
The aging process with its increase in ATHEROSCLEROSIS, eventually becomes a major
cause; a quarter of all men over 70 have erection failure attributable to it alone. But DIABETES
with its blood vessel and nerve damage remains the most common disease causing impotence.
PSYCHOLOGICAL factors are always important: they can be a cause of the impotence or a
consequence of it. Patients who have physical illness may develop psychogenic impotence,
such as can happen after a stroke or heart attack. Up until the 1980’s it was thought that most
cases of impotence had a psychological cause. Now it is thought that physical sources are more
prevalent. Long term HEAVY USE OF TOBACCO is also a relatively common cause.

The rest of the causes are comparatively uncommon. Most endocrine disorders that are severe enough to cause impotence are easily recognized. Usually the connection of impotence with  trauma, surgery, major neurological disorders, and already diagnosed cancer is fairly evident. Sometimes however, a cancer (of prostate, say) has not been diagnosed and will be revealed in the work-up for impotence. Peyronie’s Disease, which is a localized disorder of the connectivetissue of the penis that leads to painful curvature, is rarely mistaken for anything else.

Therefore, in determining the cause of impotence, a man should think first of his intake of
medications, particularly blood pressure drugs and psychoactive drugs like anti-depressants or tranquilizers. Next he should consider his alcohol and/or tobacco usage. The next step is a
consultation with his physician about whether diabetes or hardening of the arteries could be the cause. Since impotence can be the first sign of these disorders and since they can lead to
coronary artery disease or stroke, it is quite important to check out these possibilities.