When an erection problem occurs suddenly, then the question that usually torments men is 'what was it that triggered the onset of the problem'. Various conditions can trigger the first blockage in the erection (Althof SE. Et al. Journal of Sexual Medicine; 2010). The most common are the following:

1. a night with a lot of alcohol where the man did not respond sexually
2. when using a condom, where the man found it difficult to place it correctly
3. a period with various problems, e.g. financially, where sexual desire is reduced
4. concern about the size of the penis and the reaction of the woman when she sees him naked
5. when the couple tries to have a child, with planned intercourse, without pre-existing sexual desire
6. in contact with an unexpectedly provocative woman, where the man is anxious about his performance

a night with a lot of alcohol where the man did not respond sexually
when using a condom, where the man found it difficult to place it correctly
a period with various problems, e.g. financially, where sexual desire is reduced
concern about the size of the penis and the reaction of the woman when she sees him naked
when the couple tries to have a child, with planned intercourse, without pre-existing sexual desire
in contact with an unexpectedly provocative woman, where the man is anxious about his performance.

Thus, a vicious cycle begins that often leads the man to avoid sexual moments and situations that could potentially lead to sexual intercourse (Nobre P et al. Sexual and Relationship Therapy, 2010). Factors that sustain the problem for months or even years are:

1. performance anxiety
2. unrealistic expectations for sexual performance (eg the man must always be ready for sex even if he has no desire)
3. tension with the partner and low quality relationship
4. sexual dysfunction in woman. Often, the man's problem triggers sexual problems in the woman (eg decreased sexual desire and arousal difficulties)
5. stressful everyday conditions, e.g. the couple does not find time for enjoyable activities together and especially for intimacy
6. stress and depressive symptoms maintain and aggravate the erection problem

While the doctor is solely responsible for diagnosing whether the causes of the problem are psychogenic or organic, some information from the patient may indicate that the problem is psychogenic. When the onset of the problem is sudden (instead of gradual and over a long period of time), when there are fluctuations in the quality of the erection (that is, the problem does not always appear), when there are morning or night erections, , when there are no diseases and medications related to erectile dysfunction, when there are relationship problems and symptoms of depression or intense stress (especially during intercourse), then the likelihood that the erection problem comes from psychogenic causes.

Prevention instructions

• Be sure to have sex when you feel sexual desire​.
• Constantly focus your attention on sexual stimuli.
• Focus on your personal enjoyment.
• Use all your senses (sight, touch, hearing, smell, and taste).
• Avoid sex when the time available to you is not enough and when the space is not suitable.

Source: imop.gr