It is estimated that nearly 5 percent of men become impotent by the age of 40, and 15 to 25 percent by the age of 65. Accurate risk factor identification and characterization are essential for prevention or treatment of erectile dysfunction. Like any learned behaviors, it can be unlearned. Secondary premature ejaculation occurs when, after years of normal ejaculation, the duration of intercourse grows progressively shorter. Secondary PE is due to physical causes, usually involving the penile arteries, veins, or both.
Some antidepressant medications cause erectile failure.
Organic impotence involves the penile arteries, veins, or both, and is the most common cause of impotence, especially in older men. When the problem is arterial, it is usually caused by arteriosclerosis, or hardening of the arteries, although trauma to the arteries may be the cause. Impotence is common in persons with diabetes. There are 5 million adult men in the US with diabetes, and it is estimated that half are impotent and the other half will become impotent in time. The process involves premature and unusually severe hardening of the arteries.