Trouble maintaining strong and good erections

Patient

Q: I'm trying to find out if this is psychological or medical.
I've had no problems getting and maintaining strong erections. I'm 37. Recently my wife left me. Before and after this I had no issues. but about a month ago I began to experience problems.
I continue to experience morning erections, but I don't seem to have the sex drive I did. It feels like my mind just isn't into it. Now, when sex comes up, I'm experiencing strong lasting erections about half the time. When I don't I can basically maintain one with constant effort and stimulation, but it is difficult. Other times I experience no issues.

Not sure what could be the cause.
Thanks in advance for any advice.

Doctor

A:   We empathize with your current situation. Looking at certain life events you have gone through, the stress of it is understandable and it is likely to influence your functioning in many areas – sexuality is one of them. The morning erections indicate it is more likely to be psychological. Sustainability related problem could be related to stress, your anxiety for strong and sustained erection and we call it “spectatoring”, which can interfere with arousal and stimulation. However, keeping in mind your age and in view of stress you are going through, it is better to rule out diabetes, hypertension etc. Please do consult your family physician. Psychological counseling can be of immense help. Please try.

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