Brief Answer:
We need to identify cause first

Detailed Answer:
Dear XXXXXXX,
Thanks for using healthcaremagic.

I read your query and understand your concern.

Presence of erectile dysfunction in middle age could be due to multiple factors which includes psychological to organic problems.

Before we can make any conclusions I request you to provide following details so an impression can be made about the cause of problem.

1. How long you are facing this problem ?
2. How the problem started whether it was sudden in onset or build up slowly over the months or years
3. Frequency of the problem in a week ?
4. In a typical month out of what number of sexual interactions/masturbations ?
5. What are the factors that increase the problem?
6. Factors that relieve the problem- thoughts, situations, partner, place etc
7. Do you get early morning erection?
8. If yes how frequent
9. Your relationship status and partner details- Is she very critical, demands sex more than what can you think, does she feel superior to you or bothers you in some other regards
10. Effect on your relationship so far
11. Details of medical illness, if any
12. Medications you are receiving currently, if any
13. Medication you received in past and their effect?
14. Do you have any psychiatric illness?
15. Investigations done till date and reports of most latest investigations?

I must assure you that treatment is possible only after through evaluation of problem.
I look forward to see more details.
Thanks and regards

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Brief Answer:
We are close to identify the cause

Detailed Answer:
Dear XXXXXXX,
Thanks for reverting back to me with required details.

I have evaluated your history and like to inform you that the cause for your erection is psychological and there is no possibility of any serious problem.

In medical language it is called psychological erectile dysfunction.

Since the problem is psychological following course of action is required.
Meet a psychiatrist in your city and start treatment for Erection problem (counselling).
See a counselor to get couple therapy.
Use of viagra is beneficial but it is not a permanent solution. Presence of morning time erection strongly indicates that all the blood and nerve supply to your penis is intact and there is no problem with them.

I hope this helps you.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386

Thanks and regards

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