Brief Answer: ED can occur due to several causes Detailed Answer: Hello, I appreciate your efforts for medical consultation in so much distress. You appear to have erectile dysfunction (ED). It is important to is to identify cause of the problem. It can be a result of a psychological or physical problem or structural problem. Psychological causes: Most common cause in young patients. These include performance anxiety, emotional weakness, inferiority complex, stress, marital or relationship problems, low mood, and the effects of a past sexual/emotional trauma. Physical causes: Include neurological disorders, alcoholism, smoking, hormonal imbalances, diabetes, hypertension, blood vessel disease and chronic diseases. Let me know if you have any of these problems so that we can discuss it accordingly. Important thing in your case that you are having ED problem mostly in winter months (Nov 2011 and Now). It can be related to stress of cold, cold intolerance or seasonal variation in stress in life. In the meanwhile the following steps will help you: 1. Talk to a therapist/Psychiatrist: Make an appointment to rule out anxiety, stress and depression in your case. Medical professional like psychiatrist can also help you to investigate medical cause of ED. 2. Be open with your partner. Talking with your partner about your anxiety can help ease some of your worries. Trying to reach a solution together might actually bring you closer as a couple and improve your sexual relationship. 3. Get intimate in other ways. There are many ways to be intimate without actually having sex. Give your partner a sensual massage or take a warm bath together. Take turns pleasing each other with masturbation so you don't always have to feel pressured to perform sexually. 4. Exercise. Not only will working out make you feel better about your body, but it will also improve your stamina in bed. Start aerobic exercise (like: Jogging, skipping and cycling) daily for 30 Minutes. It will increase blood flow all over body and will reduce stress. 5. Distract yourself. Try putting on some romantic music or a sexy movie while you make love. Think about something that turns you on. Taking your mind off of your sexual performance can remove the worries that are stopping you from getting excited. 6. Take some multivitamins like Cobadex CZS 2 times a day. 7. Do not consume excessive caffeine (present in tea/coffee and cold drinks) as caffeine increases stress and anxiety. Stop smoking (if present). 8. Get check up for medical causes of ED. I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups. Wish you good health. Regards, http://bit.ly/Dr-Ashish-Mittal

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