Physical erectile dysfunction may gradually develop over the years. Some causes of physiological Erectile Dysfunction are as follows: Vascular disorders, Diabetes, Neurological diseases, deficiencies in the Endocrine System, some Prescription medications, smoking, Chemotherapy/Radiation therapy, Substance Abuse or pelvic Surgery.

Impotence Treatments
The most successful and effective impotence treatments are:

1. Impotence vacuum pumps: Impotence vacuum pumps create an erection by using a plastic cylinder which is placed around the penis. A manual or electronic pump gradually withdraws the air from the cylinder, creating a vacuum and drawing blood into the penis. Once the penis is rigid, the cylinder is removed and an elasticized band (often referred to as a "tension ring") is applied to the base of the penis to prevent blood from flowing back into the body and to maintain the erection during intercourse.
2. Impotence injections: Drugs such as papaverine, when used in impotence injections, dilate and relax the blood vessels and enable the penis to engorge with blood, thereby creating an erection.
3. Penile implants: Penile implants are surgically implanted prostheses that are not externally visible. Penile implants are normally the final course of action when other impotence treatments have failed.
4. Urethral suppositories: Consist of a small specially designed plastic plunger that inserts a small pellet, the size of a grain of rice, into the urethra. The ingredient is Alprostadil, which is absorbed by the erectile tissue in the penis. Alprostadil is one of the active ingredients used in impotence injections.
5. Viagra: Viagra belongs to a group of drugs that contain PDE-5 inhibitors, which work by relaxing the blood vessels and allowing blood to flow into the penis. The result is a natural erection. Viagra has successfully produced erections in between 65% and 75% of impotent men, even those who have had severe and long-term impotence. Recently, new PDE-5 inhibitors have been introduced that work in the same way as Viagra.

Choosing the right impotence treatment is a personal decision, based on what feels comfortable for the affected person. The options should be discussed with the doctor and partner.

Remedies that promise to increase virility, cure impotence and increase penis size, all in one "easy to swallow tablet" in all probability won't do any of those things.