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For older adults, slower titration is often appropriate

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Neurological & Structural Causes Spinal cord injury or nerve damage Multiple sclerosis, Parkinson's disease Pelvic surgery (prostatectomy, colorectal surgery) Pelvic radiation therapy Peyronie's disease (scar tissue in the penis) Psychological Causes Performance Anxiety The most common psychological cause, creating a self-reinforcing cycle where fear of failure leads to failure