<s>[INST] Hello Doc,  so...I get an erection, and get really warm and get sweaty and get to a point where it feels like little needles  in my scalp, ( I shave my head) and then little drips of sweat release. I guess I also feel like a "hot flash" then loose my erection its something that Ive been noticing for about 3 months my blood work came back all good for things like prostrate cancer and low T.I've taken cialis the past month with improvements of getting an erection,  but mixed results on mainting it..And Ive been somewhat constipated recently as well. [/INST] DearWe understand your concernsI went through your details. From the given information itself it is almost clear that your ED is due to psychological factors than physiological. Smoking is a key cause of erectile dysfunction. Do you smoke? In any case, I suggest you to consult a specialist to diagnose.If you require more of my help in this aspect, please use this URL.  Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck. Take care. </s>