Inability to achieve or maintain an erection, usually caused by psychological factors, including concerns about performance or relationship difficulties. In about 1 in 10 cases, the cause is a physical disorder, such as diabetes mellitus, or a neurological disorder, such as damage to the spinal cord. Some drugs cause impotence as a side effect, but this reverses when the drugs are stopped. Treatment may include counselling or sex therapy for psychological problems. The drug sildenafil is used to treat both organic and psychological impotence, but side effects may occur. Other treatments include self-administered injections into the penis and a surgical implant, which can produce a sustained erection.


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