Smoking and Alcohol Use Heavy smoking is frequently cited as a contributory factor in the development of impotence, mainly because it accentuates the actions of other disorders of the blood vessels, including high blood pressure and atherosclerosis. Alcohol has also been implicated in causing impotence. In small doses, alcohol releases inhibitions, but in doses larger than one drink, it can depress the central nervous system and impair sexual function. In virtually every case of impotence there appear to be emotional issues that may seriously affect both an individual's self-esteem and relationships and may even cause or perpetuate erectile dysfunction. Many men tend to fault themselves for their impotence even if it is clearly caused by physical problems over which they have little control.
Anxiety is among the most frequently cited contributors to psychological impotence.
For many reasons, cultural as well as situational, anxiety over sexual performance may provoke an intense fear of failure and self-doubt on the part of the individual. Often called performance anxiety, these feelings can sometimes set off a cycle of chronic anxiety-induced impotence. When anxiety is experienced, the brain releases chemicals known as neurotransmitters that constrict the smooth muscles of the penis and its arteries. This constriction decreases the blood flow into and increases the blood flow out of the penis, resulting in impotence. Simple stress may promote the release of brain chemicals that negatively affect potency in a similar way.