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If performance anxiety is deemed the root of your ED problem, then sex therapy might be suggested. Hypoxia from decreased corpora cavernosal oxygenation can cause a decrease in prostaglandin E1 levels, which normally inhibit pro fibrotic cytokines, such as transforming growth factor 1 TGF 1 43. Meaning, if you fear that you may not get an erection as you are about to have sex, you may simply not get an erection.

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