Impotence means that a man's penis doesn't get hard enough to have sexual intercourse. The man cannot get or maintain an erection. The medical term is erectile dysfunction (ED). 

ED is not the same as premature ejaculation. 

The major causes of ED include: 

• Vascular (blood vessel) disease — Erections happen when blood collects in the shaft of the penis. Vascular disease can limit the amount of blood flowing to or staying in the penis. Both can result in problems with erections. 
• Vascular disease is the most common medical cause of impotence. 
• Nerve damage — Nerves must be working normally for a man to get and keep an erection. Nerves can be damaged by diabetes, multiple sclerosis, prostate surgery or damage to the spinal cord. 
• Psychological factors — Psychological issues such as depression, anxiety, guilt or fear can sometimes cause sexual problems. At one time, these factors were thought to be the major cause of impotence. Doctors now know that physical factors cause impotence in most men with the problem. However, embarrassment or "performance anxiety" can make a physical problem worse. 
• Medications — Many medications cause problems with sexual function. These include drugs for high blood pressure, depression, heart disease and prostate cancer. 
• Hormonal problems — Abnormal levels of certain hormones can interfere with erections and sex drive. Hormonal problems, such as a low testosterone level, are an uncommon cause of impotence.

Symptoms

A man with impotence has either a problem getting an erection or difficulty maintaining one. This usually interferes with sexual activity. 

Impotence can happen suddenly or gradually. Some men slowly lose the firmness of their erections or how long the erections last. 

Diagnosis

Your doctor will ask you about your medical history. He or she will want to learn if any medical conditions might be causing the impotence. These may include vascular, neurological and hormonal disorders. 

Vascular disorders affect the entire body. Many men who have impotence because of vascular disease also have a history of heart disease, stroke or poor circulation in their legs. 

Neurological problems can contribute to impotence in men with a history of diabetes and spinal cord injury. They also can cause symptoms in other parts of the body. 

In men with abnormal hormone levels, a reduced sex drive often accompanies impotence. 

Expected Duration

How long your impotence lasts depends upon what causes it and how quickly your treatment starts to work. Impotence is treatable in all age groups. 

Treatment

There are many effective treatments for impotence. The most popular is a class of drugs called phosphodiesterase type 5 (PDE5) inhibitors. These include sildenafil (Viagra), vardenafil (Levitra), tadalafil (Cialis) and avanafil (STENDRA). These drugs are taken in pill form. They work in most men. But they are less effective in men with neurological causes of impotence. 

The PDE5 drugs are generally safe. But always review the risks with your doctor. PDE5 drugs can interact with other medications and cause dangerously low blood pressure. For example, you should not take PDE5 drugs if you use nitroglycerin or other nitrate medications.   This content was found at harvard.edu. read the full article here

There are also natural treatments such as VigRX Plus pills and VigRX Oil that work great for many men.

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