Physical factors include drugs (alcohol, nicotine, narcotics, stimulants, antihypertensives, antihistamines, and some psychotherapeutic drugs); injuries to the back, problems with an enlarged prostate gland, problems with blood supply, nerve damage (as in spinal cord injuries); or disease (diabetic neuropathy, multiple sclerosis, tumors, and, rarely, tertiary syphilis); failure of various organ systems (such as the heart and lungs); endocrine disorders (thyroid, pituitary, or adrenal gland problems); hormonal deficiencies (low testosterone, estrogen, or androgens); and some birth defects. Sexual desire disorders or decreased libido can be caused by a decrease in normal estrogen (in women) or testosterone (in both men and women) production. Other causes may be aging, fatigue, pregnancy, medications (such as the SSRIs) or psychiatric conditions, such as depression and anxiety. Sexual dysfunctions are more common in the early adult years, with the majority of people seeking care for such conditions during their late twenties through thirties. The incidence increases again in the geriatric population, typically with gradual onset of symptoms that are associated most commonly with medical causes of sexual dysfunction. The problem of an inadequate erection is probably one of the biggest issues a man confronts. Most men experience erectile problems on occasion, but impotence, also called erectile dysfunction, is defined as "the persistent failure to develop and maintain erections of sufficient rigidity for penetrative sexual intercourse." Of course, men have other kinds of sexual problems including lack of desire and problems with ejaculation, yet impotence is the most common and troubling. Many medications cause problems with sexual function, including drugs for high blood pressure, depression, heart disease and prostate cancer.
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