Psychological Causes of Erectile Dysfunction

Wednesday 26 May 2021
Erectile Dysfunction
4 minute(s) read
By Anonymous
Dr.Heather Bartlett

Medically reviewed by

Dr Heather Bartlett, MD

on 23 November 2022

Table of Contents 

I. Is it all in my head?

II. Causes of Psychological Erectile Dysfunction 

III. Anxiety and Depression

IV. Relationships and ED

V. Pornography and ED

VI. Treatment Options

For many couples, sex is an important part of a healthy relationship, so by all means, invest in having a fulfilling sex life. While erectile dysfunction symptoms are unlikely your favorite topic of choice, it’s an impactful problem that is worth discussing. It’s important to know what erectile dysfunction is if you suspect that you may be experiencing symptoms.

Is it all in my head?

Psychological ED may be “all in your head,” but try not to be too self-critical. After all, you didn’t choose your mental health struggles. However, you can choose to address or ignore them. While traditional notions of masculinity often tell us that it’s better to bottle up emotions, if you want a healthy relationship and a fulfilling sex life, you should address your ED concerns.

What are common psychological causes of ED?

Childhood sexual abuse and trauma may be the cause of some cases of ED. If you can relate to this, first, understand that the sexual abuse was not your fault, and try not to blame yourself for any existing sexual issues. You likely have mental health challenges to address, so we strongly encourage you to seek professional help from a qualified psychiatrist or psychologist who has been trained in this area. Other possible causes of psychological ED include:

  • Anxiety and depression, including performance anxiety
  • Problems in your relationship
  • Pornography (research remains inconclusive but ongoing)

Anxiety and Depression

Lots of psychological ED issues stem from an anxious mindset. Anxiety affects sexual functioning by inhibiting the autonomic nervous system response. Interestingly, when people expect to perform well sexually, they tend to perform well; when they expect failure, they tend to experience failure.

Negative thinking (often associated with mood and anxiety disorders) may be another cause. Avoidance, self-criticism, and past negative experiences may also lead to ED. Anxiety.org recommends the following actions if you believe your sexual troubles stem from an anxious mindset:

  • Search, identify, and address key negative thoughts and attitudes towards sex. It may help to talk these over with a mental health professional.
  • Shift your focus from being successful in bed to simply having a good time with your partner. Sex is not just about orgasms and lasting long. Enjoy the physical and emotional intimacy.
  • Do not avoid your fears. This will only prolong your anxiety. Instead, try to expose yourself to them so that you develop a tolerance for distress.
  • Communicate with your partner (we’ll talk more about this next).

Relationships and ED

ED is obviously not just one man’s problem. If ED leads a man to avoid sex or have less-than-satisfying sex, their partner may also feel frustrated and unsatisfied. They may also perceive themselves to be unattractive to their partner, thereby ushering in feelings of anger, guilt, and poor self-esteem.

If you think your ED may be caused by underlying relationship issues, you may want to discuss these issues with your partner, a trusted friend or relative, or a mental health professional. Don’t expect good sex to fix the problem; avoiding the problem will likely make things worse.

Talking to your partner about ED isn’t easy, but it may also help dispel any misunderstandings and prevent future conflicts. Keep the following tips in mind:

  • Don’t blame your partner for your psychological difficulties. Emphasize that your ED is not their fault.
  • Use “I” statements, such as “I feel self-conscious when I can’t get hard” or “I feel like I’m letting you down when I can’t get it up.
  • Tell your partner what you’re doing to address the problem, such as scheduling doctor visits or mitigating your pornography use.

Remember, relationships aren’t easy, so pat yourself on the back for openly and maturely addressing the negative events in yours.

Pornography and ED

While there are conflicting views regarding today’s Internet pornography and its impact on sexual health, many people claim from experience that abstaining from pornography can help with ED. They believe that pornography can cause someone to be desensitized to normal stimulation.

There are tests you can try to see if your ED is due to pornography or performance anxiety. However, please note that although they are insightful, a do-it-yourself test is no replacement for consulting with a doctor. A professional health-care provider can perform more sophisticated and accurate tests like the nocturnal penile tumescence (NPT) test.

Treatment Options

Remember: psychological issues are not the only possible cause for erectile dysfunction! Before doing anything else, confirm with your doctor if there are underlying physical causes. Medications, diabetes, alcohol, and other health conditions may be to blame.

Your doctor may prescribe you ED medications like Sildenafil and generic Cialis. (These medications can be found at substantially lower prices than typical American pharmacies at licensed and accredited Canadian Pharmacy referral service.)

Next, remember that the foundation of any good relationship is communication. Leaving things unsaid will only breed distrust and misunderstanding. Asking for help doesn’t mean you’re weak. It means you’re taking responsibility.

Lastly, also remember that sex is not restricted to penetration. The focus of sex should be pleasure, so as long as you’re both enjoying it, you’re doing it right.

DISCLAIMER: 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.