When a man can't get an erection to have sex or can't keep an erection long enough to finish having sex, it's called erectile dysfunction. Erectile dysfunction is also called impotence. Erectile dysfunction can occur at any age, but it is more common in men older than 65. It is estimated that nearly 5 percent of men become impotent by the age of 40, and 15 to 25 percent by the age of 65. Accurate risk factor identification and characterization are essential for prevention or treatment of erectile dysfunction.

Erectile dysfunction doesn't have to be a part of getting older. It's true that as you get older, you may need more stimulation (such as stroking and touching) to get an erection. You might also need more time between erections. But older men should still be able to get an erection and enjoy sex.

The following are some of the different types and possible causes of impotence:

• premature ejaculation (PE)
  Premature ejaculation is the inability to maintain an erection long enough for mutual satisfaction. Premature ejaculation is divided into primary and secondary forms:
• primary premature ejaculation
  Primary premature ejaculation is a learned behavior that begins when a male first become sexually active. Like any learned behaviors, it can be unlearned. This form of primary PE is psychogenic (as opposed to organic or physical) impotence. (Congenital venous leak is a subset of primary PE and is caused by a congenital venous leak in which the venous drainage system in the penis does not shut down properly.)
• secondary premature ejaculation
  Secondary premature ejaculation occurs when, after years of normal ejaculation, the duration of intercourse grows progressively shorter. Secondary PE is due to physical causes, usually involving the penile arteries, veins, or both.
• performance anxiety
  Performance anxiety is a form of psychogenic impotence - usually caused by stress or anxiety.
• depression
  Depression is another cause of psychogenic impotence. Some antidepressant medications cause erectile failure.
• organic impotence
  Organic impotence involves the penile arteries, veins, or both, and is the most common cause of impotence, especially in older men. When the problem is arterial, it is usually caused by arteriosclerosis, or hardening of the arteries, although trauma to the arteries may be the cause. The controllable risk factors for arteriosclerosis - being overweight, lack of exercise, high cholesterol, high blood pressure, and cigarette smoking - can cause erectile failure often before progressing to affect the heart. Many experts believe that when veins are the cause, a venous leak or "cavernosal failure" is the most common vascular problem.
• diabetes
  Impotence is common in persons with diabetes. There are 5 million adult men in the US with diabetes, and it is estimated that half are impotent and the other half will become impotent in time. The process involves premature and unusually severe hardening of the arteries. Peripheral neuropathy, with involvement of the nerves controlling erections, is commonly seen in persons with diabetes.
• neurologic causes
  There are many neurological (nerve problems) causes of impotence. Diabetes, chronic alcoholism, multiple sclerosis, heavy metal poisoning, spinal cord and nerve injuries, and nerve damage from pelvic operations can cause erectile dysfunction.
• drug-induced impotence
  A great variety of prescription drugs, such as blood pressure medications, anti-anxiety and antidepressant medications, glaucoma eye drops, and cancer chemotherapy agents are just some of the many medications associated with impotence.
• hormone-induced impotence
  Hormonal abnormalities such as increased prolactin (a hormone produced by the anterior pituitary gland), steroid abuse by body-builders, too much or too little thyroid hormone, and hormones administered for prostate cancer may cause impotence. Rarely is low testosterone responsible for impotence.

Your doctor will probably start by asking you some questions and doing a physical exam. Samples of your blood and urine may be tested for diseases and disorders. Other tests may also be needed. Your doctor will determine which tests are right for you.

How erectile dysfunction is treated depends on what things are causing it. After your doctor checks you for medical problems and medicines that might cause erectile dysfunction, he or she may have you try a medicine to help with erectile dysfunction. Some of these medicines are injected into your penis. Other medicines are taken by mouth. Not everyone can use these medicines. Your doctor will help you decide if you can try them. You may first try natural remedies for impotence such as ProSize.

ProSize is a safe all-natural supplement which, in time, improves blood flow to penis and enables stronger erections, helping fight impotence if it is caused by vascular problems due to stress, old age, diabetes or heart problems Some of the ingredients in ProSize act as an aphrodisiac, increasing your sexual desire and therefore hightening nerve stimuli from your brain which also play crucial role in erection and may benefit sexual helath if ED is caused by mood swings and depression.