<s>[INST] My penis is always constricted - even during sleep. I can get erections sufficient for intercourse...but they are smaller than they were in the past because of the constriction not allowing the smooth muscle to fully expand. Urologist says its stress...but no idea how to reverse it. I have tried therapy, medications etc but I have so much focus on my penis that it has been conditioned to stay this way no matter what...any help out there please?? [/INST] HiT hank you for asking Chat Doctor. Stress can be a reason for loosing proper erections. In such case stress management like breathing exercise can be done. SSRIs like paroxetine or duloxetine may help in some. As you have done urologist consultation and confirmed an organic cause is unlikely. If you're not getting proper erection at all phosphodiesterase inhibitors like sildenafil may be helpful. A proper counselling and behavioral therapy by psychiatrist or sex therapist may benefit you also. Hope this may help you. Let me know if you have any further queries. </s>