In younger men the cause is usually physical or emotional. Herbal remedies abound, among the most promising being: the herb ginkgo biloba, commonly taken as a memory booster, presumably acts by enhancing blood flow and seems relatively free of side effects; other herbs including the stress reliever Panax ginseng and the Brazilian herb Muira puama; and a derivative of the African tree bark yohimbe, which may may correct impotence and possibly heighten libido. Pharmaceuticals also include: the plant-based drug papaverine, which dilates the blood vessels and can be injected into the penis to produce an erection permitting normal ejaculation; the hormone supplement DHEA, which may provide benefits in men (and women) who have low levels of this hormone; and the amino acid arginine, which also enhances blood flow.
Other treatments for impotence include vacuum pump devices, insertion of capsules into the urethra, surgical implants or medication, including pre-sex pills, and various forms of alternative medicine (acupuncture, homeopathy etc). Emotional causes of impotence are best treated by rest and counselling for mental and emotional health.
Age-associated impotence is frequently tied to chronic illnesses, such as arteriosclerosis ("hardening of the arteries"), hypertension, diabetes, and depression.