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Psychological ED: causes, signs and options
Psychological factors can contribute to erection difficulties, but “psychological” does not mean imaginary. Anxiety, stress, depression, low self-esteem, relationship factors, and cognitive distraction can affect sexual response.
Psychological vs physical is not always either/or
Many people have mixed contributors. Situational erections, morning erections, or erections during masturbation can provide clues, but they are not a substitute for clinical evaluation.
Approaches
Depending on the cause, options may include counseling, cognitive behavioral therapy, stress reduction, lifestyle changes, medical treatment, or combinations of these approaches.