Sexuality in people is a process consisting of biological, psychological, and social factors. Being biologically healthy is not sufficient for the penis to get erected. Psychological factors are as effective as biological and organic factors in the erection mechanism. Since sexuality in men is mostly focused on performance and score, the fear of not being able to show the same performance all the time is called performance anxiety and is one of the common causes of erectile dysfunction.
Penis is an anatomically porous organ. These pores are filled with blood with sexual stimulation, and the penis enlarges and gets hardened. For the penis to get hardened with the sexual stimulation, depending on the signals sent from the central nervous system through the nerves, arteries expand and carry blood to the penis. Meanwhile, the veins narrow and do not carry the blood coming to the penis back and ensure that it is trapped in the penis. In other words, for a healthy erection, firstly the nerves and the vessels need to function healthily. Also, hormones play important roles during erection process.
The hardening of the penis (erection) is a complicated process in which hormones, nerves, vessels, and also psychological factors play a role. Erectile dysfunction may arise due to any problem in any stage of this process. Therefore, erectile dysfunction may result from biological/organic problems related to hormones, or from completely psychological problems.
Sometimes the psychological problems are added on the biological problems, causing the situation to get more complicated. To solve the problem in the right way, the underlying reason or reasons must be analyzed well.