Once identified, proper treatment can be recommended to help them return to a satisfying sex life. Psychological impotence is impotence caused by a man's anxiety or fear that he will not be able to perform well sexually. This is often referred to as performance anxiety or fear of failure . A man who is worried about getting an erection cannot relax and probably will not be able to get an erection. Persistent psychological impotence often can be triggered by one incident of sexual failure caused by drinking too much alcohol, fatigue, anger, worry, guilt or any number of other emotional factors.
Emotional stress can lead to impotence just as it can lead to many forms of illness or exhaustion.
Physical impotence is impotence caused by a physical disorder such as injury, a disease, a hormone imbalance or an operation. Examples of physical disorders which can cause impotence include arteriosclerosis, or hardening of the arteries, high blood pressure, diabetes, brain or spinal cord injuries, surgical removal of the prostate gland, bladder or rectum due to cancer, and radiation treatments to the pelvis. Such substances as alcohol, tobacco, drugs and certain medications also can interfere with erections and cause physical impotence. The medications that most frequently hinder sexual performance are those used to treat high blood pressure and depression. The first step toward overcoming impotence is to determine whether the problem is psychological or physical.