Can Erectile Dysfunction (ED) Arise From Psychological Causes?

Erectile dysfunction (ED) is a prevalent sexual health condition affecting men from all backgrounds and all ages. Having ED means you might find yourself having difficulties producing or keeping an erection hard and long enough for sex – or the complete and total lack of erections.

ED doesn’t only affect older men as most people think. ED affects one in four men below one age of 40 – and rates are increasing globally.

 

Certain factors such as age, underlying health conditions, prescription drugs, or habits such as smoking, recreational drug use, and alcohol abuse may increase your likelihood of developing ED. 

But do psychological factors cause ED, too? Let’s find out.

 

What are some common psychological causes of ED?

 

Most erectile dysfunction cases arise from physical causes. However, a significant number of psychological or emotional issues can also lead to ED.

Psychological ED or psychological impotence has no single cause or trigger. Rather, multiple issues can all cause psychological ED, including the following:

 

• General or sexual performance-related anxiety
• Guilt about engaging in sexual activity
• Chronic or sex-related stress
• Mood disorders and depression
• Relationship or intimacy problems
• Low self-esteem
• Watching copious amounts of pornography

 

Certain medicines used to treat psychological conditions, such as antidepressants, may increase the likelihood of developing ED.

Such psychological ED triggers are closely related, and it’s possible to experience several factors simultaneously. Let’s go on a deep dive into each potential cause and how they can lead to psychological ED.

 

 

Anxiety and stress

 

Anxiety and stress are closely related to ED.

For instance, chronic stress can cause anxiety, triggering heightened stress levels, consequently creating a vicious chain reaction that can take a toll on your mental and sexual health.

More importantly, stress and anxiety play an even larger role in erections than we care to admit. Erections, whether caused by physical stimulation, responses to visual or mental images, or as a bodily reflex while sleeping, involve a variety of your body’s systems. This includes your endocrine, nervous, circulatory, and psychological systems. If any of these systems are under any sort of compromise, they can all contribute to or lead to ED.

 

A 2015 study demonstrated a link between anxiety or depression and ED. Out of 64 subjects, 15 had been diagnosed with anxiety disorders, while 8 had been diagnosed with depressive disorders. Both disorders predated their ED, suggesting that anxiety and depression contributed to their sexual dysfunction.

 

Relationship issues

 

Cultivating a healthy relationship with your partner takes time, effort, and understanding. And if you and your partner have underlying relationship issues that need to be addressed, they might very well affect your sex lives.

It’s entirely possible that your ED problems are at the root or a major contributing factor to relationship problems, which demonstrates the chain reactions that ED might set off, affecting various aspects of your life.

Therefore, open communication and professional counseling may help you and your partner understand both of your sexual needs and improve your intimacy with each other.

 

Depression

 

Depression wears down your mind and body, interfering with every aspect of your life, with corresponding mental and physical consequences. The most common depression symptoms may include the following:

 

• Persistent sad or aimless mood
• Feelings of pessimism, anxiety, and hopelessness
• Reduced or complete and total lack of interest in your usual hobbies or routine
• Feelings of guilt and worthlessness
• Changes in appetite
• Sudden weight gain or weight loss
• Difficulty sleeping or sleeping too much
• Forgetfulness, distractedness, or difficulty making decisions
• Suicidal thoughts or risky behavior
• Random pains and/or digestive issues without an identifiable cause

 

Obviously, depression symptoms can make it hard to enjoy anything, much less sex. A study published in the Psychosomatic Medicine journal in 1998 demonstrates a clear link between ED and depression in middle-aged men, indicating a relationship that affects all ages and demographics.

In certain cases, excessive porn consumption may also worsen depression and ED. More on this in just a bit.

 

Sexual performance anxiety

 

Worrying about satisfying your partner in bed becomes a self-fulfilling prophecy since performance anxiety and nerves can lead to ED issues in the bedroom.

Performance anxiety is often caused by negative thoughts and worries about satisfying your partner, inability to get hard enough, or ejaculating too soon.

Negative sexual experiences may also persist in your mind, interfering with your confidence and ability to fully relax while having sex.

 

Feelings of guilt and low self-esteem

 

Guilty feelings in men with ED about not being able to please their partners can worsen their sexual dysfunction. Persistent guilt or shame can add another link to the ongoing negative chain reactions ED can cause. Such emotions are often linked to depression and other mental health concerns that can bleed into the bedroom.

Low self-esteem can also lead to psychologically-induced ED. Lack of confidence or insecurity about your attractiveness or sexual performance can lead to sexual dysfunction.

A study found that ED can cause significant distress to men, and the latter can seriously diminish their confidence and the quality of their personal relationships.

 

Excessive consumption of pornography

 

Watching porn isn’t a bad thing. But anything in excess is, and so is excessive porn consumption because it can affect erectile function and sexual well-being.

Watching and jacking off too much porn may lead you to develop unrealistic expectations about sex and your sexual partners.

Porn-induced erectile dysfunction is when such expectations distract you from maintaining an erection and can affect your pleasure from engaging in real-life sex.

 

How to determine if your ED is psychological

 

The age-old myth that sexual dysfunction is but a normal part of aging has been debunked by modern medicine and changing attitudes towards sex since ED can be treated and men can enjoy a healthy sex life at any age.

The first step to making progress with psychological ED if you’re otherwise in good health is to consult your healthcare provider.

 

They will discuss your medical history, subject you to a physical exam, ask questions and run tests to exclude potential underlying medical reasons for your ED, such as cardiovascular disease, high blood pressure, low testosterone, renal disease, multiple sclerosis, or trauma or damage in your pelvic region.

You may also be asked questions about your sex life, such as your libido, your current state of erectile function, orgasm, ejaculation, and overall sexual satisfaction.

 

Based on your results and answers, your healthcare provider might refer you to a psychological evaluation to determine if mental issues are causing your ED. And if you suspect your ED issues are caused by a diagnosable mental health issue such as major depressive disorder or generalized disorder, speak to a health professional and let them know.

 

What are the treatment options for psychologically-induced ED?

 

All forms of erectile dysfunction can be treated in most cases, whether they have physical or psychological causes.

However, treating psychological ED isn’t as simple as popping a sildenafil (generic Viagra) tablet before having sex.

Most ED medications belong to the PDE5 inhibitor class of drugs that enhance blood flow to the soft penile tissues that absorb the blood to cause an erection, bypassing physiological ED causes such as poor circulation or nerve damage.

PDE5 inhibitor drugs include tadalafil (generic Cialis), vardenafil (Levitra), and avanafil (Stendra).

 

While these ED drugs have enjoyed great success treating ED for millions of men worldwide, they aren’t developed to affect your thoughts, emotions, or moods. 

Therefore, they might be unable to manage psychological issues such as low self-confidence, depression, or anxiety.

Addressing the root of the problem is the best way to treat psychological ED, whether caused by mental illness or negative feelings.

Psychotherapy such as cognitive behavioral therapy (CBT) has been widely used to treat anxiety and depression, and research suggests that it could help treat psychological issues linked to ED.

 

This treatment helps you determine and correct unhealthy mental and behavioral patterns that might be causing your ED or other sexual dysfunctions.

The idea behind CBT is based on the notion that your reactions to outside stimuli are what causes your problems (such as the inability to produce or keep an erection) rather than the situation itself.

 

 

Learning to understand and manage your thought patterns may help you change them and cope with them in a positive manner to solve your problems.

Sex therapy might be another approach you can take to treat psychological ED. This involves counseling designed to help you and/or your partner to identify and determine solutions to your relationship problems that may be causing your ED.

However, if you aren’t mentally ready to talk to a mental health professional about your psychological ED yet, you can try meditation or breathing exercises to improve your depression and anxiety symptoms. 

You may have a lot on your plate if you suffer from the effects of psychological ED. That said, it’s totally understandable if you feel overwhelmed about the idea of sharing your problems with your healthcare provider.

 

However, you must come to terms with acknowledging, communicating, and being honest about your ED problems with your partner and healthcare provider is an inseparable part of the healing process. Trust us – you’ll feel better for doing so.

Offering an opportunity for your partner helps them understand and work towards solutions to help you get in the mood for sex, manage expectations, or get assistance when you start running into erectile dysfunction when having sex.

 

Treat your ED today

 

Erectile dysfunction can happen to anyone, anytime, due to physical or psychological reasons. 

Consult a qualified healthcare provider if you’re suffering from ED symptoms and suspect psychological factors causing it. They will be able to determine what’s causing your ED symptoms and work with you to determine a suitable approach to treating it, whether through medication, therapy, or a combination of both.