Psychological Erectile Dysfunction: Causes and Treatments

Updated on September 28, 2021
Psychological Erectile Dysfunction

Around 20% of Erectile Dysfunction (ED) cases are what is known as Psychological Erectile Dysfunction. This is the name for the specific type of ED that is caused by psychological factors, rather than by your physical health. The effects and symptoms are the same, but unlike with physical ED, it’s not your blood vessels that are to blame.

Instead, psychological ED can be caused by a range of emotional, cognitive, or social causes and conditions. Chronic mental health conditions, including depression and anxiety, for example, can affect sexual function. Meanwhile, acute emotional difficulties such as stress can affect your sexual desire – and, as a result, can impact your sex life too.

Dr Earim Chaudry, Medical Director of men’s mental health platform Manual has explained the main causes of Psychological Erectile Dysfunction, and what men experiencing the condition can do to treat it. 

Causes of Psychological Erectile Dysfunction


Depression is a common medical condition that can cause low mood, a lack of interest, and an aversion to activity. Often associated with sadness, anger, low self-esteem, and other negative emotions, the psychological condition can affect many parts of your life – including your sexual activity.

According to one study, as many as 72% of men with depression experienced reduced sexual desire and libido, while a reduced ability to feel pleasure is a common symptom too. Understandably, these can combine to reduce your ability to achieve an erection.

Anxiety, Stress, and Erections

People who experience stress or anxiety can suffer different psychological and physical symptoms – from difficulty sleeping and digestive problems to irritability, anger, increased blood pressure, and muscle tension. Again, these symptoms can include ED.

Anxiety and stress are different medical issues. While stress is usually acute and is a response to external events, anxiety can be chronic and may not have a specific cause. However, the symptoms are similar and are caused by similar chemical changes in your body. For example, when stressed or anxious, your body releases cortisol, the hormone that speeds your heart rate and boosts energy. 

It is common for men with ED or other sexual problems to experience sex itself as stressful. That’s what we call performance anxiety – and this can make the symptoms of ED even worse.

Performance Anxiety

Performance anxiety is often triggered by worries about being able to achieve an erection, pleasing a partner, or ejaculating too early. One of the particular difficulties with psychological ED is that it can be self-reinforcing. If you experience ED once, it can knock your self-esteem and make you anxious about future sexual experiences. 

This way, it can contribute to performance anxiety, and may make future erectile problems more likely.

How to Treat Psychological ED

While psychological erectile dysfunction sounds scary, the outlook is better than you might think. There are ways to tackle the underlying causes of your sexual difficulties, and effective ED medications mean that it’s possible to have satisfying sex again.

Here are three things that can help to get you through psychological ED:

1. Talk to Someone

If you’re in a relationship, talking with your partner about how you feel is vital. Keeping your struggle to yourself may make any feelings of stress or dissatisfaction worse – and may compound your relationship issues.

2. Seek Professional Help

It sounds like a big step, but it shouldn’t be. Seeking help for psychological problems should be as normal as going to a doctor about any physical health condition or complaint..

A psychologist, counsellor, or psychiatrist can help you dig deep into the base causes of your condition – and they will be able to guide you toward a solution too. For example, they can help you gain greater control over your emotions through techniques like cognitive behavioural therapy (or CBT).

3. Try ED Medications

ED treatments, such as Viagra, Sildenafil (the active agent in Viagra), and Tadalafil (Cialis), are not only effective with the physical causes of erectile problems. Medication like these can help to reduce your performance anxiety – and to boost your confidence long-term.

If you are suffering from low libido or reduced desire, however, Viagra may not be effective. You will need to be aroused for these drugs to do their work.

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