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Urology/Erectile dysfuncion with good morning erections


I'm a 36 years old male with an erectile dysfunction problem (I can have an erection but I lose it if I have no stimulation)
I have this problem from my first sexual relation attempt when I was 18 years old.

One year ago, my urologist made me all the test recomended(doppler, testosterone, etc)and the results are ok, he said that the results depicts no physical problem, I have consulted other urologist and he had the same opinion.  

I have used Viagra, It ever works with me with the minimum doses (25 mg), my urologist said that this also indicates that the structures of my penis are ok.  

I frequently wake up with erections in the morning and before sleep at any time of the day, they are steady and hard erections and if I have a woman beside me at this moment, I have no problem with this erection (all the times I have sex when I wake up the erection was fine)

But when I try to masturbate or have sex at night for example, I have problems to mantain erections, even if I don't feel anxiety or depression.  

My question is: it's possible to have a physical problem if I have good morning erections until today? or a deep physicological problem could be the cause of the lose the erection when Im 100 awake?

Sorry about my english but I'm from Argentina.


While anything in medicine may be possible, given the information provided, it is exceedingly unlikely your problem is purely physical.  A psychological issue such as depression, anxiety or nervousness is far more likely.  Since a very small dose of sildenafil works well for you, this might be an acceptable treatment for the time being.  Since your physicians have not found a physical cause, you might well be advised to check with a mental health professional who deals with sexual related problems just to determine if there is a treatable underlying problem.


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Stephen W. Leslie, MD


Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.


Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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