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32 years
I get erections while I'm asleep or watching porn. I lose them fast or do not get any when I am with a woman. Physical or psychological?
Feb 4, 2015

Dr. Zakia Dimassi Pediatrics
This condition is known as erectile dysfunction, and could be caused by physical or psychological factors, or a combination of both.
The most common organic risk factors for erectile dysfunction are:
age over 50
diabetes
high blood pressure
high cholesterol
smoking
cardiovascular disease
All of the above listed factors may interfere with the blood flow to the penis, hence interfering with normal erection.

The psychological factors that could lead to erectile dysfunction include: stress, depression, or anxiety about sexual performance (performance anxiety).

The medical teachings stress that possible organic causes that may alter blood flow before proceeding to ruling out a psychological element. In your case, and despite the fact that the problem is most likely to be the result of stress or anxiety, since you do not experience it in all circumstances, it is still advisable that you seek medical attention by a urologist who may do a Doppler ultrasound to make sure the blood flow is normal. Afterwards you should seek help on how to relieve performance anxiety.
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