Our expert says:
You may be right, if you are able to obtain an erection in some circumstances and not others, then it often is a sign of a psychological issue rather than physical. Given the dangerous nature of the conditions that ED can be indicative of, however, I would STILL want to exclude those (I err on the side of caution and then rest easy if all is ok).
I forgot to mention last time also that, if relevant, alcohol intake may negatively effect erections!
At age 40 your erection is not likely to have sustained significant negative age-related changes yet. Just to clarify though - some men complain of erection difficulties in the second or third 'round' of sex, having had a firm erection on the first 'round'. If this is relevant to you, you need to know that the refractory period (length of time after ejaculation before another erection can be achieved) increases with age and so you may begin to experience normal difficulties in obtaining subsequent erections.
HOWEVER, if none of these apply, it may be that your main issue indeed is psychological - eg. concerns about the relationship, conflict related to your high sex drive, sexual problem in your partner (e.g. sexual pain, anorgasmia), concerns about not pleasing her. These would need to be explored and can still be addressed the ways I discussed in my earlier response.
Hope that's helpful.
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