A “cycle”, as you put it, can certainly become established after a man experiences a number of erectile failures and begins to lose confidence. Once the idea of attempting intercourse produces anxiety rather than excitement, it becomes less and less likely he will successfully produce a reliable erection. Pharmaceutical agents can bypass this cycle, but it can also be extremely important to learn to be less fixated on erectile ability and instead focus on pleasure. Learning it is possible to give and receive enormous pleasure without an erection can be a vital aspect of a return to sexual health. This knowledge can lead to a reduction of the pressure you mentioned, as well as to a lifetime of sexual confidence and enjoyment.
A 2013 study published in The Journal of Sexual Medicine evaluated 439 men for erectile dysfunction and compared ED causes and frequency in men 40 or younger to men over 40. They found that 26 percent of the younger men had ED. Although these men were healthier and had higher levels of testosterone than the older men, they were more likely to be smokers or to have used illicit drugs. In almost half of the younger men with ED, the ED was considered severe.

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“With the success of Viagra-type drugs, there has been a tendency to start all patients with ED on one of these drugs and not look much further for a medical cause. But we now know that ED may be an early warning for heart and blood vessel disease, so it is important to look for common risk factors. These include high blood pressure, diabetes, medications, smoking, drinking, and drugs,” said Dr. Wang.
Don’t approach sex like a race. If you struggle with losing your erection quickly, you might be used to speeding things up. That’s counterproductive, though. Work on slowing things down and don’t be afraid of what happens in your body. By slowing down, you’re retraining your body to expect something different from sex. Right now, your body probably expects to climax in a very short period of time. If that’s not what you want, you have to train your body to take a little longer.

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Depression. The profound sadness, emptiness, and hopelessness that characterize depression may also cause ED among younger men. “The biggest effect of depression is on a man’s desire for sexual relations, or libido,” says Drogo Montague, MD, director of the Center for Genitourinary Reconstruction in the Glickman Urological and Kidney Institute at the Cleveland Clinic. “To some extent, depression can affect a man’s ability to maintain an erection. It can be a chicken-and-egg situation. However, reduced libido is a common indicator of depression.”

Did you know that a cock ring can help you maintain an erection? This O-shaped toy fits around your penis and helps keep blood in the shaft, where you want it. A cock ring also helps prevent venous leakage, a form of erectile dysfunction where blood flows to your penis, but has trouble staying there. (Giddy, a new cock-ring-like gadget designed to treat ED, may also help guys with venous leakage maintain stronger erections.)

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UW Health urologists with advanced training offer medical and surgical treatment options for men and their partners affected by erectile dysfunction. There are several different ways that erectile dysfunction can be treated. For some men, making a few healthy lifestyle changes may solve the problem. Your urologist will help determine the most effective course of treatment for your condition. 
Evaluate surgical options. If the other treatments have not proven successful, your doctor may recommend a surgical procedure that will involve an inflatable penile prosthesis being implanted into your penis. Typically a pair of inflatable cylinders are inserted into the penis, which can be pumped up and deflated using a connected device that is inserted into the scrotal sac.
“With the success of Viagra-type drugs, there has been a tendency to start all patients with ED on one of these drugs and not look much further for a medical cause. But we now know that ED may be an early warning for heart and blood vessel disease, so it is important to look for common risk factors. These include high blood pressure, diabetes, medications, smoking, drinking, and drugs,” said Dr. Wang.
A 2013 study published in The Journal of Sexual Medicine evaluated 439 men for erectile dysfunction and compared ED causes and frequency in men 40 or younger to men over 40. They found that 26 percent of the younger men had ED. Although these men were healthier and had higher levels of testosterone than the older men, they were more likely to be smokers or to have used illicit drugs. In almost half of the younger men with ED, the ED was considered severe.

Is it OK to take viagra everyday?


Ask about transurethral pharmacotherapy. Your doctor may suggest you try this treatment, which involves placing a suppository into the urethra. The suppository contains alprostadil, which is then absorbed into the blood stream, relaxing blood vessels and improving blood flow into the penis. This treatment is thought to be less effective than the vacuum devices, or injection therapy.[16]

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