Dear service user, Thank you for writing to Healthcaremagic. I understand that you are disturbed a lot regarding erectile dysfunction. There are several causes of insufficient erections. The common reasons are 1. Diabetes (nerve damage and vessels narrowing) 2. Some medicines like anti depressants and anti psychotics 3. Performance anxiety (the most common reason) 4. Psychiatric disorders (depression, anxiety) 5. Alcohol use (nerve damage and testicular injury) 6. Smoking (vessels narrowing) 7. after some surgical procedures (nerve damage). 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 psychological rather than physical. An occasional episode of erectile failure due to functional or situational reasons like fatigue, tension or own pressure to perform rather to enjoy is very common. This seems more likely in your case. First erectile failure due to any reason leads one to be worried about next sexual encounter. One focuses constantly on how do i perform . This leads to anxiety and difficulty in erection in subsequent sexual activities. One’s anxiety goes on increasing with every ‘failure’. What you need to do is to consult a psychiatrist well versed with psycho sexual therapies. He will definitely assist you to come out of this problem. I hope this will help you. If you have any further questions I will be happy to help. Wish you good health.