There are many psychological conditions that can lead to impotence. Fear of sexual failure is a very common factor in impotence. Impotence may also be caused by the drugs used to treat disorders such as depression. As men get older, changes to the circulation or, very occasionally, lowered levels of testosterone, may cause impotence. Other physical causes include smoking, excessive alcohol consumption and drug abuse.
Impotence can occur in any age group and has a wide variety of causes.
The problem may occur every time sexual activity is attempted, or its occurrence can be very variable depending on the circumstances. For example, a man may have a good erection on awakening but fail to get one when he tries to have sex. A man experiencing impotence often responds by trying to hide the problem from his sexual partner. He may manipulate events to avoid situations in which sexual contact, and especially penetrative intercourse, may occur. This is a common response to the problem but usually only makes it worse.