Impotence
Impotence - known as erectile dysfunction - is the inability to attain or maintain an erection sufficiently vigorous to allow penetration and successful intercourse. There are many causes including diabetes mellitus and atherosclerosis(affecting the blood supply); the side effect of drugs (such as many of those used to treat high blood pressure); alcohol (either as an acute effect of over-indulgence or the consequence of long-term abuse), and diseases such as renal failure. By far the commonest cause however is stress and anxiety, particularly over whether or not performance will come up to scratch.
Such patients usually find (as is normal) that they wake with an erection but are unable to produce one when required. Until recently there were no reliably effective remedies available to take by mouth, though there were treatments involving injections or vacuum devices which some found useful. The discovery of medicines which enhance the action of the agent responsible for increasing the blood flow in the penis - nitric oxide - has revolutionised the management of this disorder, and probably saved much marital disharmony.
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