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About 10 to 20 percent of ED cases may be caused by psychological factors such as stress, anxiety, guilt, depression, low self-esteem, and fear of sexual failure. Other possible causes are smoking, which affects blood flow in veins and arteries, and hormonal abnormalities, such as not having enough testosterone in the body. Several new discount Erectile Dysfunction medicines are trying to create inroads within this market. All of them are currently waging a marketing war to try to convince doctors and patients that their product is the best.