psych or ven. leak: Performance anxiety would be the most likely cause in the early 40s. However venus leak may also be the cause. The erectile cylinders or corporal bodies relax to allow bloodflow in but may leak out in certain individuals not allowing the penis to remain erect. With any erectile performance concerns one should always assess cardiovascular risk which goes in line with small vessel disease, such as the coronary arteries in the heart.
Answered 4/29/2018
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