Hi, 1. If the main can obtain an erection on his own by masturbation, but not with his wife during intercourse or cannot sustain it, then the cause is definitely psychogenic. 2. Other causes which need to get evaluated as the probable or hidden cause of ED are: - Any use of hypertensive or psychiatric drugs - Any medical condition like overweight, diabetes, high blood pressure / cholesterol] - Any psychological issue [stress, depression or anxiety] - Any substance abuse [addiction] Please consult a urologist for necessary examination Serum Testosterone and FSH / LH level] and investigation. Till then: (i) Start with perineal exercises: while urinating, stop the flow of urine, start again, stop & start again 4-5 times. (ii) Take: milk and milk products, ghee, cheese, curd, black grapes, pears, raisins, dates, almonds, walnut, pomegranate, carrot, banana, apricots, muskmelon, gooseberry, coconut, pistachio, turnip, potato, onion, lady finger, radish, old brown rice, peas, garlic, and bottle gourd. iii) Avoid sour and cold substances, tobacco [in any form], brinjal, tandoori roti, red chilies, heavy and food which require long hours to digest, jaggery and its items, deep fried food. PS. Before prescribing medication especially for ED, the patient should be evaluated for any cardiovascular diseases, thus have an appointment with a cardiologist for any potential risk of a cardiovascular event. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Munish Sood, Ayurveda Specialist