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What Causes Psychological ED?

Tuesday 9 June 2020
Erectile Dysfunction

Table of Contents:


I. What is Erectile Dysfunction?

a. What Causes an Erection?

II. Psychological Erectile Dysfunction

a. How the Brain Affects Erections

b. Stress and Depression

c. Performance Anxiety

d. Relationship Problems

III. Treating Psychological ED


What is Erectile Dysfunction?

Erectile Dysfunction, or ED, is a common condition that can affect men of all ages. ED is the inability to get or maintain an erection firm enough for sexual intercourse. It affects around 30 million Americans. This number may be higher as some men may not see a physician about their condition. Luckily, there are many medications out there like Viagra (sildenafil) can help improve your symptoms. [1]

Erectile dysfunction can be caused by physical or psychological factors. As men age, it is more likely that ED will be a result of a physical cause. 90 percent of ED in men over the age of 50 is caused by a physical condition [2]

Psychological erectile dysfunction is more common in younger men. Around 90 percent of teenagers and young adults suffer from psychological ED, but it is usually short-term. Keep reading to learn about the psychological causes of erectile dysfunction and what can be done to help.

A group of young men walking down a street

a. What Causes an Erection?

The process of getting an erection is very complicated. Erections occur when a male is sexually stimulated, through either physical stimulation to the penis or sexual thoughts. Once a male is sexually aroused, the brain sends a signal to the penis to relax the penis muscles. Once these muscles have relaxed, blood can flow through the arteries of the penis, filling two chambers. The increased amount of blood inside the penis causes it to become larger and firmer. Once the penis is firm, another signal tells the blood vessels to close off so that an erection is maintained throughout sexual intercourse.

After ejaculation, or once the male is no longer sufficiently stimulated, blood vessels re-open so that blood can leave the penis.

Psychological Erectile Dysfunction

a. How the Brain Affects Erections

Psychological erectile dysfunction can be caused by several different things.

These factors can cause erectile dysfunction by preventing the brain from sending the correct and appropriate signals to the penis. Without these signals, the penis muscles may not relax so that sufficient blood can enter to cause an erection. Alternatively, incorrect signals may cause blood vessels to relax so that an erection is not maintained. The most common causes of psychological ED are explained in more depth below.

b. Stress and Depression

Stress is a common cause of erectile dysfunction. For middle-aged men, personal and professional stress is the primary cause of ED. [3] Stress-related ED is often caused by big life events, including financial issues, job problems, or the loss of a loved one. These matters may cause ED to be persistent over the course of weeks or months. However, stress-related erectile dysfunction can also be a short-term problem caused by an upcoming exam or presentation. [4]

Depression can affect ED in a similar way. Additionally, antidepressant medications are often prescribed to treat depression. Many antidepressants cause sexual conditions, including erectile dysfunction, lowered libido, and premature ejaculation as a side effect.

A man sitting on a couch, holding his head

c. Performance Anxiety

Anxiety can also cause psychological ED. This can be a result of issues in daily life or sex-related anxiety. Anxiety about daily life can be similar to stress-related ED. It can be caused by problems with work, finances or personal relationships.

Sexual performance anxiety or ‘stage-fright’ is common in younger males. Anxiety or fear about any aspect of sexual intercourse may cause erectile dysfunction. This includes penis size and pressure to please their partners. If a male has suffered from erectile dysfunction previously, they may also feel the pressure of not being able to get or maintain an erection. This can cause more stress and anxiety, resulting in a vicious cycle.

Performance anxiety may also cause the inability to orgasm, lowered libido or premature ejaculation. [5]

d. Relationship Problems

Relationship trouble can be another cause of erectile dysfunction. Like stress and anxiety, this cause can also create a vicious cycle. Often, relationship problems may worsen other causes of psychological ED. When relationship problems result in erectile dysfunction, communication is key. Research shows that when a man’s partner is involved in treatment, ED is resolved more than half of the time. [6]

Treating Psychological ED

Often when treating psychological erectile dysfunction, doctors may try to focus on improving mental health. Once stress, anxiety or depression has been alleviated, erectile dysfunction should also improve. Useful treatments include counselling and therapy.

Prescription medications are also available to treat ED. Popular medications include Viagra (sildenafil), Cialis (tadalafil), and Levitra (vardenafil). These medications work by directly relaxing the muscles in blood vessels so that blood flow can flow into the penis. Erectile dysfunction medications do not automatically trigger an erection and they will not cause an erection without sexual stimulation.

Two men talking, while one makes notes

The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical condition, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis, or treatment.