Psychogenic erectile dysfunction is the persistent inability to achieve or maintain an erection rigid enough for sexual performance, due primarily to psychological or interpersonal factors. Performance anxiety and relationship issues are common psychogenic causes.  sexual dysfunction sexual dysfunction refers to problems that prevent an individual or couple from enjoying and completing the sex act. The issue can occur during any point of the sexual response cycle—desire, arousal, plateau, orgasm, and resolution. Both men and women can experience sexual dysfunction.  pastuszak aw. Current diagnosis and management of erectile dysfunction. Curr sex health rep. 2014;6(3):164-176. Doi:10. 1007/s11930-014-0023-9 cleveland clinic. Erectile dysfunction. Updated october 14, 2019.

Erectile Dysfunction (ED): Symptoms, Causes, Diagnosis, and Treatment

To determine a cause and treatment options, physicians evaluate a patient’s detailed medical history and look for obvious causes such as medications known to be linked to erectile dysfunction. Physicians then take into account the patient’s lifestyle, such as smoking and illicit drug use, which can affect a man’s ability to obtain an erection. Other health conditions are addressed as well. Medical history is important. For example, a man who has a history of decreased sex drive may have deficient production of the male hormone testosterone. Testosterone is the hormone responsible for the physical transition into manhood. It helps with gaining muscles, facial hair, and a deeper voice.

What causes an erection?

Old age -as men age there is a natural slowing down of many bodily functions. From a sexual viewpoint, this may occur as decreased firmness of erections, shorter lasting erections or a longer "recovery time" in between erections these changes may be caused by a decreased production of testosterone, decreased blood flow or other diseases that are more common in men as they age. Most commonly, the sexual changes associated with old age are due to a combination of the factors discussed in more detail below. Decreased bloodflow - a decrease in the blood flow to the penis will affect the quality of erections.

). By preventing the hydrolysis of cgmp, these drugs promote the cgmp-dependent smooth muscle relaxation that is essential for normal erection. Although vardenafil and tadalafil are more selective for the penile vasculature than sildenafil, clinical responses and adverse effects of these drugs are similar. In comparative clinical trials, these drugs show comparable efficacy (60 to 75%). All pde5 inhibitors cause direct coronary vasodilation and potentiate the hypotensive effects of other nitrates, including those used to treat coronary artery disease. The concomitant use of nitrates and pde5 inhibitors can be dangerous and should be avoided. Patients who only occasionally use nitrates (eg, for rare bouts of angina) should discuss the risks, selection, and proper timing of possible pde5 inhibitor use with a cardiologist.

Your brain, blood vessels and nerves all play a part in helping you get and keep an erection. Hormones and muscles do, too. Physical, psychological and environmental factors can cause problems with any of these.

"ed is commonly caused by temporary stress or chronic cardiovascular conditions that reduce blood flow to the penis. But, low testosterone can contribute to issues with forming and maintaining an erection," says dr. Starke. "your doctor can help you understand if your testosterone levels are low and whether starting testosterone treatment may help alleviate your ed symptoms. "though testosterone replacement is not recommended as a first-line, single treatment for ed, your doctor may recommend it or try it in combination with another ed treatment option, depending on your individual symptom profile.

Premature ejaculation. This is the inability to keep an erection long enough for mutual pleasure due to climaxing too soon. Performance anxiety. This is most often caused by stress. Depression. Being depressed can affect your ability to get an erection. Some antidepressants cause erection problems, too. Organic impotence. This involves the arteries or veins in the penis. It is the most common cause of ed, especially in older men. It can be related to hardening of the arteries throughout the body. Injury or a venous leak in the penis may also cause ed. Diabetes. Ed is common in men with diabetes.