“…[4][5][6][7] A wide range of psychosocial factors predispose (eg, restrictive upbringing, distorted parental attitudes to sex, disturbed parental relationship, and early traumatic sexual experiences), precipitate (eg, random failure, depression/anxiety, traumatic sexual experience, aging, and psychological reaction to organic factors), and maintain (eg, psychological responses to a sexual problem, attitudes, marital discord, inadequate sexual information, restricted foreplay, performance anxiety, fear of failure, partner demands, and guilt) sexual dysfunctions. [7][8][9][10][11][12] Factors such as acute and chronic stress, 13 poor relationships, 14 and cognitive interference and negative effect 15,16 are implicated as etiological factors for sexual dysfunctions in men. 7 Furthermore, erectile dysfunction (ED) can be caused by chronic diseases, such as cardiovascular disease, hypertension, dyslipidemia or hyperlipidemia, diabetes mellitus, arthritis, reproductive cancers, androgen deficiency, or lower urinary tract symptoms, and physical injury such as spinal cord injuries.…”