So, how do you distinguish between impotence caused by problems with your body and that caused by psychological factors? A simple stamp can help. Given the advances in medicine and nutrition research, however, it is no longer a scary thing. In these cases, all the plumbing is OK, but the otherwise healthy man is unable to achieve an erection. One of the most promising herbs is the purified extract of Tribulus terrestris. It does not work immediately.

His radio programs recommended expensive goat gland implants and "mercurochrome" injections as the path to restored male virility, including operations by surgeon Serge Voronoff. Furthermore, studies have shown that lack of testosterone leads to a range of other sexual performance problems, including premature ejaculation and low sex drive. The current diagnostic and statistical manual of mental diseases (DSM-IV) has included a listing for impotence.

Other studies have suggested that Tribulus also acts by increasing the level of dehydroepiandrosterone (DHEA), a naturally occurring substance in the body believed to be important for a healthy sex drive. These studies showed that Tribulus helps treat impotence caused by low testosterone levels or an imbalance in the body's level of sex hormones. It is estimated that between 50% and 60% of diabetic men are impotent. John Brinkley initiated a boom in male impotence cures in the U.S. It is estimated to affect between 10 million and 15 million men in the United States alone. Although middle-aged and older men are more likely to be impotent than younger men, impotence can strike at any adult age. These involuntary erections mean that everything is fine with the nerves, muscles and arteries involved in the erection process, and signals that the cause of impotence is elsewhere. Men with primary impotence have never had sufficient erections for satisfactory intercourse. Boredom, marital problems or negative feelings toward your partner may contribute to an impotence problem.