• Psychological factors
    • One may be surprised to note that in about 80% of young adults with impotence, the cause is usually a psychological one. Most of the time impotence reflects disturbed relationship between the partners and  that may very well be due to lack of understanding between the couple or due to a disturbed marriage. The psychological factors are:
      1. Performance anxiety, i.e. fear of failure during sexual act is one of the commonest psychological cause.
      2. Interpersonal factors like marital discord: It has been found through research that even a trivial domestic problem like a fight with the spouse (impotence may be expressed as hostility towards partner) or stress at the office can affect the sexual performance.
      3. Person’s self esteem, his past sexual experiences and his understanding towards sex.
      4. Person’s sexual and non sexual relationship with partner.
      5. Availability of time and space.
      6. Presence of stress, anxiety, depression, etc.
      7. Fear of pregnancy.
      8. Homosexual impulses can affect heterosexual performance.
  • Physical factors  
    • Increasing Age: Men do not recognize the fact that some decrease in erectile function is a normal part of aging and should not expect to have same sexual vigor which they enjoyed years ago.
    • Injury to a part or component of penis like nerves, arteries or muscles can cause impotence. The injuries may be  due to different ailments including diabetes, kidney disease, liver disease, hypertension, heart problems and atherosclerosis. Direct injury may occur due to trauma or due to the surgical procedures like prostate surgery. Trauma to spine and the nerves supplying penis can also cause impotence.
    • Drug abuse: Alcoholism and smoking are frequently associated with impotence.
    • Drugs for high blood pressure, allergies, depression, anxiety and other medical problems can also cause impotence.
  • One or more combinations of any of the above causes can lead to impotence