The continuing disability to achieve and/ or maintain a penile erection sufficient to complete agreeable intercourse is called impotence or erectile dysfunction. In 1992, the National Institute of Health defined erectile dysfunction as the inability to attain or sustain an erection adequate for satisfactory sexual intercourse. Impotence should not be confused with male infertility. They are two very separate conditions; a man unable to maintain an erection may be perfectly normal in every other way as well as capable of fathering a child. Experts believe that impotence affects between 10 and 15 million American men. About half of the adult men in the US suffer from occasional impotence while 1 in 8 American men suffer from chronic impotence.

• A change in the quality of an erection
• The inability to experience or maintain an erection upon waking up in the morning
• Persistence of the Malfunction of mind or body for over three months

Although this condition increases progressively with age, it is not an inevitable consequence of aging and steps can be taken to minimize the risks of erectile dysfunction:

The most common causes of impotence are:

• Diseases like diabetes, kidney disease, chronic alcoholism, multiple sclerosis, atherosclerosis and vascular disease can cause impotence because they damage the arteries, smooth muscles and fibrous tissues that are essential to attain and maintain an erection.
• Surgery (prostatectomy, orchiectomy, radiation therapy or penile implants) may injure nerves and arteries near the penis leading to impotence.
• Medications like high blood pressure drugs, antihistamines, antidepressants, tranquilizers, appetite suppressants, and cimetidine can also induce impotence as a side effect.
• Smoking
• Hormonal deficiency caused by injury
• Excessive consumption of alcohol
• Psychological factors like stress, boredom, anxiety, depression, fear of sexual failure or low self-esteem
• Neurological problems (injury, trauma or disease)

There are numerous methods of diagnosing this condition:
Physical Examination:the physician will question you about your past and present medical problems, medications that you are taking and any history of psychological problems, including stress, anxiety, or depression. Knowledge about your sexual history concerning nature and onset of dysfunction, frequency, quality and duration of any erections is imperative to the physician in order to make a correct diagnosis. He will examine the genital area and will perform a digital rectal examination to check for prostate abnormalities. He will also look for other medical conditions like hypertension, diabetes, atherosclerosis and nerve damage.
Diagnoses with erectile function treatments:a man is injected with sildenafil and his erection observed. The physician examines the erectile response, curvature of the penis, and response after erection.
Blood tests-testosterone and prolactin levels can be measured to determine the presence of this condition. The physician may also screen for thyroid and adrenal gland dysfunction.
Snap-gauge testmeasures the man’s ability to achieve an erection during sleep. A RigiScan monitor makes repetitive measurements of rigidity around the base and tip of the penis.
Penile Brachial Index measurementcompares blood pressure in the penis with the blood pressure taken in the arm. Problems with the arterial flow to the penis can be detected using this method.

• Home impotence tests can Enhance in determining whether impotence is psychologically caused or has an organic source. These tests are set up prior to sleeping and determine if any erections occur during sleep. If there are no erections during sleep then there may be a mechanical or organic cause present. Seek medical attention (urologist) if this is the case. However, if you discover that erections do occur during sleep, but you still experience impotence when awake, then the problem has a psychological basis and a counselor may be consulted.
• Discuss your problem with your partner. Express your feeling and insecurities, especially if you have negative feelings toward your partner.
• Relaxation techniques like yoga, bio-feedback, etc. are effective in counteracting the negative effects of stress and tension.
• It has been suggested that exercising right before sex directs blood away from the penis and may hinder an erection.
  

The key factors in impotency are life style stop smoking and using hard liquor. Take alternating hot and cool showers to increase circulation.

• Impotence is psychological in nature; sex counseling or physiotherapy may be Enhanceful, although it is vital that you choose a good therapist.
• Avoid traditional methods of psychotherapy, as it has not enjoyed a great deal of success in treating impotence.
• If alcoholism is a factor, proper Favorable Effects is necessary.
  

Saw palmetto is a herb that provides its positive effects on erection and different sexual troubles. ^{1, 2, 3, 4, 5, 7, 8} Sarsaparilla Root shows its beneficial effects on impotence and infertility. ^{1, 2, 3} Male Response is a food supplement that contains a blend of herbs, minerals and vitamins. This supplement contains herbs like Muira Puama and Sarsaparilla Root. Muira Puama exhibits its favorable effects on erection and different sexual problems. ^{2, 4, 5} Sarsaparilla Root exhibits its wholesome effects on impotence and infertility. ^{1, 2, 3} Male Response also has zinc which is an essential mineral that shows its positive effects on reproductive functions and infertility. ^{2, 4, 5, 6, 7} Horny Goat Weed is a herbal supplement that exhibits favorable effects in improving sexual functions and stimulating sexual desire. ^{4, 9, 10}

These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, cure, mitigate, treat, or prevent any disease.