Erectile dysfunction can result from the following mechanisms:
A patient with a heterosexual relationship is not able to initiate or maintain his erections. His condition has developed over several weeks. He has DM and uses captopril (ACE-inhibitor) and metformin. He has erections early in the morning and during sleep. Which is the most probable cause of his erectile dysfunction?
Extra info: The fact that he has erections in the morning and during sleep suggests that he is able to get erections and that the cause is not vascular or neurogenic. His medications do not induce erectile dysfunction. Therefore the cause must be psychological and the doctor should ask about such factors.