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Impotence or Erectile Dysfunction, in medicine, condition in which a man is unable to attain an erect penis that is rigid enough for sexual penetration or sexual satisfaction. Impotence should not be confused with premature ejaculation, loss of libido, or absence of orgasm; in all of these cases, satisfactory erection may be obtained. Impotence is a common problem; in the United States between 10 and 15 million men suffer from severe erectile dysfunction. The incidence of this problem increases with age. Less than 1 percent of the male population under 30 years of age is affected, 3 percent under 45 years, 7 percent between 45 and 55 years, 25 percent at age 65, and up to 75 percent in men 80 years old. Impotence appears to be on the rise, but this may be due to increasing life span. Impotence is classified as either primary or secondary. Primary impotence is expressed early in adolescence as a fundamental inability to achieve erection; secondary impotence is more common and consists of an onset of erectile inability during adulthood, after a period of normal erectile ability. Normally, when a man becomes sexually aroused, his penis increases in size, becoming erect and rigid, enabling sexual penetration. An average penis is between 7 cm (about 3 in) and 10 cm (about 4 in) long; when it is erect it increases in length to between 13 cm (about 5 in) and 18 cm (about 7 in). An erection occurs when the penis fills with blood. An erect penis contains six or seven times the blood volume of a flaccid penis. During erection, the rate of blood flow into the penis is greater than the rate at which the blood drains out, which leads to an accumulation of blood within the corpus cavernosum (cavernous spaces) of the organ. The process of erection is controlled by the autonomic nervous system.
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