❤️ Performance Anxiety vs Organic Cause Differential Simulator

Situational vs Global ED — First Branch Point

Placeholder: partner-specific or situational ED suggests a psychogenic driver.

• Psychogenic: Situational ED (Placeholder short note)
• Organic likely: Global ED (Placeholder short note)
• Context-dependent?: Key question (Placeholder short note)
• Morning erections: Next clue (Placeholder short note)

Situational pattern recognition

Placeholder: masturbation and partner variability suggests anxiety-linked cause.

Placeholder: situational cues shift differential toward psychogenic branch.

Morning Erection Presence — Second Branch Point

Placeholder: presence of morning erections implies intact vascular/nerve axis.

• Psychogenic: Erections present (Placeholder short note)
• Organic likely: Erections absent (Placeholder short note)
• NPT monitoring: Test used (Placeholder short note)
• Moderate: Sensitivity (Placeholder short note)

Nocturnal penile tumescence logic

Placeholder: REM-linked erections bypass cortical anxiety inhibition.

Placeholder: absent morning erections raise organic suspicion.

Psychogenic Anxiety Pathway — Anticipatory Failure Loop

Placeholder: performance anxiety triggers sympathetic override of arousal.

• Elevated: Cortisol spike (Placeholder short note)
• High: Sympathetic tone (Placeholder short note)
• Sudden: Onset pattern (Placeholder short note)
• CBT responsive: Response to therapy (Placeholder short note)

Anxiety-driven vasoconstriction loop

Placeholder: fear of failure activates norepinephrine-mediated smooth muscle constriction.

Placeholder: breaking the anticipatory loop restores function.

Vascular and Neurologic Organic Pathway

Placeholder: endothelial dysfunction and nerve damage impair rigidity mechanically.

• Reduced: Endothelial NO (Placeholder short note)
• Impaired: Nerve conduction (Placeholder short note)
• Gradual: Onset pattern (Placeholder short note)
• Doppler US: Workup (Placeholder short note)

Vascular and neural mechanical deficit

Placeholder: impaired inflow or nerve signaling limits corpus cavernosum filling.

Placeholder: gradual global ED flags vascular/neurologic workup.

Endocrine Organic Pathway — Hormonal Axis Disruption

Placeholder: low testosterone or thyroid/prolactin abnormality suppresses libido and rigidity.

• Low: Testosterone (Placeholder short note)
• Elevated: Prolactin (Placeholder short note)
• Abnormal: Thyroid axis (Placeholder short note)
• AM hormone panel: Workup (Placeholder short note)

Hormonal suppression of erectile capacity

Placeholder: HPG axis disruption reduces libido and nocturnal erection frequency.

Placeholder: endocrine panel confirms hormonal organic cause.