A 26-year-old man with no medical history presented with complaints of being unable to maintain an erection for the past year. Although he is able to achieve an erection, he is not able to sustain it when intimate with his wife. He has been married for 5 years and has 2 children. He denied drug use and decreased libido and said he does not have this issue during masturbation. Of note, he does report some relationship stresses, and occasionally he stays with his parents due to relationship issues. He also reported feeling more fatigued than normal over the past few months. His primary care physician already obtained a complete blood count and a metabolic panel, both of which were normal.

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