Erectile Failure and Male Impotence

Erectile failure is common in men. It's associated with stress and depression and a variety of medical illnesses. What is good news, is that it's commonly treatable.
The first case I encountered as a country family physician responded to Testosterone injection. Testosterone is the male hormone and there are a variety of reasons for decrease in male hormone which are beyond the scope of this note. The good news is that there is replacement therapy. Testosterone can be delivered by injection or more commonly by "patch".  It's commonly seen in 'male menopause' when older men produce less testosterone, much the same as older women produce less estrogen.  In both sexes 'replacement therapy' is indicated. Because of a mild increased risk of prostate cancer PSA, the blood test marker for prostate cancer is measured at first and every 6 to 12 months of treatment.
Viagra, Cialis are principal treatments for erectile failure but they don't necessarily address male 'potency'.  Male potency is improved by a number of things including fr instance being winked at by Angelina Jolie or Nicole Kidman.  Winning lotteries and promotions can also increase male potency.  Similarly depression can reduce male potency and decrease male sexual desire.
Male sexual function is divided into the 'general interest', specific 'sexual desire', "erection", and "ejaculation".  DSMIV , the diagnostic and statistical manual of American Psychiatric Association separates the disorders of male sexual function into Sexual Desire Disorders, Sexual Arousal Disorders, Orgasmic Disorders and Sexual Pain Disorders.  These can be 'acquired' or life long.
Depression commonly affects 'sexual desire'.  Many medications and injuries can affect sexual desire. However, it's been said that rarely would a woman on a stretcher try to chat up a male  on the way to the operating room for a gunshot room whereas female and male nurses and doctors have experienced this with men.  Part of this may be 'socialization'.  Men are supposed to be 'ready and willing' and the 'pursuer' where as women are supposed to be 'coy' depending on culture, age and circumstance.
Sociobiology is the study of social behaviour as seen through the lens of biological function.  The distinction here is that sex has a pleasure aspect and a reproductive aspect. These aspects as played out socially can be a product of biological function.  Male 'reproductive' strategy might support multiple sexual partners whereas female sexual strategy might support one.  Sexual desire can be increased in men relative to the relationship of sex to reproduction.  "I'd like to have your baby," therefore could 'turn off' some men, and 'turn on others'.
Diabetes is a disease that can like smoking affect small vessel function and hence the nerves that feed off them. Similiar a variety of nervous and cardiac conditions can affect sexual desire, arousal and performance.
Always a physical assessment and assessment by a medical doctor is considered the first thing if sexual problems arise. Many a marriage could be saved by thus.