Impotence is also known as erectile dysfunction and it refers to the inability of getting and maintaining an erection while performing a sexual intercourse. Hence impotence refers to a total inability to get or sustain erection for a brief period of time. Impotence in older men can occur due to injury, disease and even side effects of certain medications. The incidence of impotence increases with age. The impotence factor increases by about 5 percent in case of 40 year olds and about 15 to 25 percent after people attain the age of 65. However people are becoming more aware of the fact that impotence can be treated at any age.
       
A precise sequence of events leads to impotence and impotence is said to occur when there is a problem in any of the events. The sequence of events includes impulses in the nerves followed by impulses in the spinal column and the area around the penis. Then there is a response in the muscles as well as the fibrous tissues and the veins near the corpora cavernosa.
 
The major cause of impotence includes either damage to the nerves or smooth muscles or fibrous tissues surrounding the penis. These symptoms are caused due to diseases of the kidney and even diabetes and consumption of too much alcohol. In fact 70% of the impotence cases are due to neurologic disease and 50% cases are due to diabetes.

Surgery for treating prostate cancer can also damage the arteries and nerves near the penis leading to impotence. Also the side effects of common medications for treating blood pressure such as antihistamines, tranquilizers and antidepressants may lead to impotence in many cases. However psychological factors such as too much depression, stress, anxiety, low self esteem, guilt and even fear of sexually satisfying the opposite partner accounts for about 20% cases of impotence. There are other possible causes as well such as smoking which may affect blood flow in the veins and arteries around the penis.

The doctors will recommend certain treatments which vary from least invasive treatments to most invasive treatments. The type of treatment suggested by the doctors varies from case to case. Doctors normally ask the patient as to which medications he is currently taking for any of his disorders. If he finds out that a certain medication is causing side effects such as impotence, he may advise the patient to cut back on the medication. The doctor may also suggest alternative medication. Doctor may also suggest psychotherapy to the patient followed by drugs that are injected. Serious cases of impotence will have to be treated by using vacuum devices and surgery. Surgery of the veins and arteries may be considered as well.