1. Medication use (especially antihypertensives)
2. Smoking
3. Hormonal deficiency caused by disease ( diabetes ) or injury
4. Liver disease , usually caused by alcoholism
5. Circulation problems ( arteriosclerosis , anemia , or vascular surgery)
6. Neurological problems (injury, trauma, disease)
7. Urological procedures ( prostatectomy, orchiectomy, radiation therapy )
8. Penile implants (or prostheses) that are not functioning properly
9. Depression , anxiety , fatigue , boredom, stress , fear of failure
10. Mood-altering drugs, alcohol , medications
11. Fear of infection
12. Fear of recurring heart problems
13. Deep-seated psychological problems

Note: There may be other causes of impotence. This list is not all inclusive, and the causes are not presented in order of likelihood. The causes of this symptom can include unlikely diseases and medications. Furthermore, the causes may vary based on age and gender of the affected person, as well as on the specific characteristics of the symptom such as quality, time course, aggravating factors, relieving factors, and associated complaints. Use the Symptom Analysis option to explore the possible explanations for impotence, occurring alone or in combination with other problems.