Dear service user, Thank you for writing to HCM. I can understand your concern about erectile dysfunction. Extreme changes in temperature (hot or cold) will affect the blood vessels to the penis and spongy tissue in penis. Erection will be affected in this situation. This is normal thing. One should avoid genital exposure to extreme temperatures. Wear cotton undergarments with comfortable fitting. Cause of erectile dysfunction should be ruled out for proper treatment. Mostly it is due to stress and anxiety. Situational reasons like fatigue tension or own pressure to perform rather to enjoy is very common. Let me know whether you achieve and maintain a good quality of erection in sleep, in the early morning, during masturbation but not at the time of coitus? If you are able to achieve and maintain erection in any one of the above mentioned situations than your problem is more likely to be psychological rather than physical. I recommend you to discuss with your psychiatrist. He will assist you to find out reason for this problem in your case. Long standing heartburn and acid re flux suggests acid peptic disease. Stress worsens it. There are effective and safe medications as well as behavior therapies for erectile dysfunctions. Psychiatrist will identify the best suited for you after knowing your history. I hope this will help you. If you have any further questions I will be happy to help. Wish you good health.