Ginkgo biloba increases arterial blood flow, which may have a positive effect on male sexual function, writes Dr Bhatti.

Erectile dysfunction or impotence is the term used when a man can't achieve or maintain an erection that is sufficient for satisfactory sexual intercourse. Having an erection is quite a complex process with a lot of psychological and physical aspects. Although not discussed very often, erectile dysfunction is one of the commonest male sexual problems.

Many men wrongly accept erectile dysfunction as a normal part of the ageing process. This is not true and men suffering with this problem should immediately talk to their doctor.

Psychological reasons alone account for about a third of ED cases, with the rest being due to physical conditions or lifestyle. ED is a very sensitive issue and can create a lot of anxiety in men. It can also put a lot of stress on the relationship.

Physical causes of ED include diabetes, high blood pressure, prostate surgery, multiple sclerosis, spinal injury and Parkinson's Disease. Any condition in which the nerve or blood supply to the penis is damaged can potentially cause ED.

In men, testosterone plays a role in maintaining sexual desire and affects nerve signalling within the brain and nervous system, but a lack of testosterone alone is very rarely the cause of erectile dysfunction. Some medications cause ED, so it is essential to mention to your doctor if you suddenly develop the problem after starting some kind of new medication. Smokers also have an increased risk of developing erectile dysfunction.

The presence of erectile dysfunction, for any reason, will almost always cause a man to worry about his ability to have sex, which will lead to anxiety and possible even further problems sustaining an erection. This is known as 'performance anxiety'. Most men have experienced this from time to time. It is quite common and extremely normal. The worst thing to do is to worry. Relaxing and accepting that it is a passing experience will help tremendously. Relationship difficulties may bring on ED as can bereavement. Depression is another common cause of this condition. Something as simple as tiredness and stress can also cause ED.

Erectile Dysfunction is highly treatable and there are a range of methods including medication, counselling, physical devices and surgery.