Yes, psychological factors such as stress or anxiety can certainly impact the ability to sustain an erection, even when using medications like Malegra 25 mg (which contains sildenafil, a PDE5 inhibitor commonly used to treat erectile dysfunction). While Malegra 25mg can help improve blood flow to the penis and facilitate an erection, it doesn't directly address psychological factors. Stress and anxiety can interfere with the normal physiological processes involved in achieving and maintaining an erection. They can increase levels of cortisol, which is a stress hormone, and affect neurotransmitters involved in sexual arousal. Additionally, anxiety about performance or other personal concerns can create distractions that make it difficult to maintain focus on sexual activity. If stress or anxiety is impacting your ability to sustain an erection, it's important to address these underlying factors. This might involve techniques such as relaxation exercises, mindfulness practices, therapy to address specific anxieties or stressors, or lifestyle changes to reduce overall stress levels. It's also helpful to communicate openly with your partner about any concerns or feelings of pressure, as this can alleviate some of the psychological barriers to sexual performance.