Q&A Forum - Best of Elise

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But even Tobias admits that Viagra can sometimes be the answer even when a psychological problem is the primary cause of a failed erection. Take the case of a man with performance anxiety -- perhaps the most common psychological cause of erectile dysfunction. If you increase performance by prescribing Viagra, then the anxiety part of the equation disappears.

But, Tobias says, Viagra is not a fix-all -- perhaps especially when the problems involve younger men. "Younger couples need to work with someone because the issues are quite often buried -- issues of power, dominance, virility. Often ED is just a symptom of a conflict that exists between a couple."

Psychologist Warren Edwards, PhD, remembers the days when erectile difficulties were thought to be connected to males' too-early viewing of a vagina. "In the early 1960s, we talked seriously about that stuff. Now we're more recognizing that things have changed -- and we're once again going back to the idea there's some organic component in most men's erectile dysfunction."