Viralis RX Impotence then refers exclusively to problems of penile erection, so it must be differentiated from other disorders of ejaculation and problems of orgasm. Many men may have an initial problem of mild impotence due to a vascular injury, which can be aggravated by feeling stress for fear of failing in the sexual act. Therefore, the causes must be analyzed from different points of view. Causes and risk factors of impotence Under normal conditions the penis remains flaccid or not erect, since the small arteries that lead the blood to the penis are contracted reducing the entrance of blood.