Don't hate me for chiming in here. But exercise and (plant based) diet will do a lot!! The only time I've seen guys truly not be able to solve this one is guilt from cheating on their spouse. Which is rare but it does happen. Which brings me to the emotional side of things. Have you looked at it deep down, taken a breath, and asked your higher self what's going on? Since I've learned to 'talk' with my subconscious, I've gotten a lot of answers. yes, you can talk with yourself this way. Quiet the mind, breathe, and ask in your head why it's happening.. wait 30 seconds to a min for yourself/higher self to reply- often a one word answer will come from god, or, you. You can also do this with trapped emotions in the body- sending your consciousness to different areas, areas of pain, asking why the pain is with you etc, and asking it to be released.
If that doesn't work, sometimes the answers can be found via talk therapy (which I can't recommend enough,) or, alternatively, even a guided mushroom journey can give insights.
Most of my clients that face this are hella stressed! So, with compassion, there's my 2 cents. Hope you find some answers and not just quick fixes. <3<3
SJ.~