instruction: i am 32 years old healthy male without any relevant medical history I am married since years and do not have kids till months ago I used to have weekly sex with my wife but now since last months I have been staying without her in some city so meet her only once a month I also masturbate once a day mostly in last 45 days we have met three times but I felt less confident in maintaining erection enough to have sex so I had my tadalafil and did intercourse comfortably but yesterday I had to take 10 my tadalafil and then also I was under confident kindly suggest if I have erectile dysfunction and need to take medicine if it is just psychological condition and need not worry or keep consuming 5mg 10 my tadalafil every time having sex but I am afraid this will be habitual and long term usage for next 15 20 years shall have side effects on my body and family planning or whatever you suggest is right thanks a lot
output: erectile performance and ejaculation can be influenced by many factors if you are anxious sad or stressed this can get lower performance if you are relaxed and happy you will have better performance because it is affected by neurotransmitters which is influenced by mood stress level etc the more relaxed happy and stress free you are the more levels of these neurotransmitters and better performance it is also influenced by emotional factors with your partner if any problem between them can lead to psychological erectile dysfunction which is common in young couples and when partners stay away they are not doing sex often and they get distanced in emotions and some level of anxiety builds up when they perform