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.