There are a number of medical conditions that make it physically difficult or impossible for a man to have an erection. These include injury or surgery to the spinal cord, certain chronic illness such as diabetes, nervous disorders, and a number of different drugs-tranquilizers, diuretics, antidepressants, barbiturates, drugs for high blood pressure, stomach ulcers and old age.
However, there is something of a debate in the medical profession as to whether most cases of impotence are due to such physical causes or whether they have a psychological origin because, while erections are certainly the result of a reflex, there is nothing automatic about them.
They can be helped by trust, relaxation and fantasy and they can become a problem because of guilt, sexual taboos and fears of inadequacy when there are no physical problems at all. In fact the psychological reasons for being unable to make love can be caused by a multitude of reasons including: mundane-job worries, money problems, depression, and fatigue. Some experts claim that 90 percent of cases are due to the mind, though others put the effect of physical causes much higher.