For the vast majority of men the notion of masculine power is directly related to how well they can perform in bed (not to mention how big their penis is). Still, most men will experience erection problems at different stages in their lives, and such problems can have very negative effects on a man's psyche.

Male erection is comprised of three main stages and if something is wrong at any of them, the erection won't take place:

1. Sexual stimulation and arousal, resulting from imagination or physical contact.

2. The brain transmits signals to the penis, causing increased blood circulation in the area.

3. Blood vessels in the penile area relax letting more blood to flow into the cavernous bodies in the penis, resulting in firm and durable erection.

If there's something interfering with any of these processes the chances that erectile dysfunction will take place increases significantly. The positive side of the story is that psychological issues account only about 20% of all erectile dysfunction cases. This means that the patient has psychogenic ED.

Most often psychological aspects that may induce erectile dysfunction include depression, anxiety, relationship problems, stress, sexual inhibition, mental illness, loss of interest in the current sexual partner.

The most common psychological issues are anxiety and depression. A clinical study has observed that depressed men are twice as likely to experience erectile dysfunction than those who do not have depression.

Still, remember that even if erectile dysfunction has purely physiological causes behind it, there are still psychological issues involved. For example, if impotence is caused by diabetes the patient will probably be depressed about it, aggravating his condition with an additional mental condition.

Long term erectile problems can induce performance anxiety, which can be even more devastating for a man's sexual abilities. When such things take place a patient can even lose interest in sex, being afraid that he won't be able to perform adequately and choosing not to perform at all.

With such a state of affairs the psychological problem can turn out to be quite worse than the actual cause of ED. And to treat the condition effectively you will need to deal both with psychological and physiological problems, rather than just pop Viagra and expect immediate results.

Quite often, a man can have a good erection and able to orgasm while masturbating, while having problems with erection during an intercourse with a partner. It was believed that it was the evidence that excessive masturbation can lead to impotence. However, the main reason for this is that masturbation delivers less tension to the penis than intercourse, and the man can fear unpleasant sensations during sex, which eventually leads to anxiety and ED.

Sexual education can also be a serious cause for erectile dysfunction in men. Feeling guilt about masturbation can lead to depression or anxiety and that alone can be a cause for erectile problems. Buying Viagra online won't change the way you perceive your sexuality, so you'll have to take some time to reevaluate your activities and feel at more ease with yourself about things like masturbation or sex.

In cases of psychogenic impotence it's best to consult with a qualified psychotherapist rather than ask your family doctor for a generic Viagra prescription. The problem can be solved by simple discussion or cognitive therapy.