Key Facts about Psychological Erectile Dysfunction

Written by
The Manual Team
Medically approved by
Dr Earim Chaudry
Last updated
4th May 2021

In 30 seconds

Sometimes erectile dysfunction – or ED – is all in your head. But that doesn’t make it any less real, or any less difficult to manage. Psychological erectile dysfunction, the name we give to ED when it’s caused by psychosocial or emotional, rather than anatomical causes, can be a huge blow. Particularly when it comes with other psychological issues, too.

Psychological ED can be the result of mental health issues including depression, anxiety, and stress. Past negative sexual experiences, including abuse, can contribute too. Meanwhile, the particularly difficult thing about the condition is that, once you have experienced it once, it can be hard to shake off.

However, it is far from impossible. While psychological treatment – such as talking to a counsellor or psychologist – will help in the long term, ED medications can give you your confidence back when you need it most. The best options are Sildenafil and Tadalafil.

What Causes Erectile Dysfunction?

Erectile dysfunction is really common. Most men will experience an episode at some point in their life.

For the majority, the causes will be physiological. ED can occur in isolated cases when we’ve had a bit too much to drink, for example. Or, it can be the result of more long term problems in your blood flow – such as those caused by high cholesterol, heart disease, or other medical conditions.

Those causes make up about 80% of cases of ED – and they tend to get the vast majority of attention. However, 20% of men experience erectile problems of a different nature. In those cases, the cause is psychological.

Psychological erectile dysfunction is the name we give to this condition. And in this article, we’ll give you all the crucial info you need – from the specific causes of psychological ED to treatment options. Let’s take a look.

What is Psychological Erectile Dysfunction?

Psychological ED (or psychological impotence, as it’s sometimes known) 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 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, your sex life too.

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.

Some Common Causes of Psychological ED?

Separating the physical from the psychological is never a neat process. Just as physical pain has a psychological impact, some psychological problems are never only psychological. Stress, for example, can affect your skin, your digestion, and your heart rate. And, yes, your erections too.

In this way, psychological conditions are no less real than physical illness. And, as such, these possible causes of psychological ED deserve more attention. We know these things can hurt. But however you are feeling, know that you don’t have to feel this way forever. 

Depression and ED

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 all 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.

Unfortunately, the experience of ED can make feelings of depression stronger. Meanwhile, antidepressant medications can sometimes reduce libido even further. Yet, as you’ll see below, there are ways to treat the symptoms.

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. However, cortisol has also been found to impair arousal and sexual response.

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.

Be aware though that performance anxiety in young men in their earliest sexual experiences is very common – with ED and premature ejaculation the likely consequence. If this happens the first time, don’t sweat it. It’s normal and will most likely pass.

Relationship Problems

Again, a possible cause and a possible consequence of psychological ED, relationship issues are one of the most commonly overlooked causes of ED. If your relationship is not at its best – if you’re struggling to communicate, for example, or to trust each other – this can affect what happens in the bedroom.

Just like with stress, these difficulties can get in the way of optimal erections, and ED can make those relationship issues more difficult.

If you went through negative relationships or sexual experiences in the past – including abuse or trauma – ED may become more common too. In this case, it is even more important to address any underlying psychological issues. 

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 root 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 any other doctor.

A psychologist, counsellor, or psychiatrist can help you dig deep into the root 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, generic unbranded Sildenafil (the active agent in Viagra), and Tadalafil (Cialis), are not only effective with the physical causes of erectile problems. Rather, these drugs can help to reduce your performance anxiety – and to boost your confidence in the long run.

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.

Cialis (Tadalafil)

The weekend pill

Known as the “weekend pill” because it is effective for up to 36 hours, Tadalafil is the generic, unbranded version of Cialis. Clinically proven to help you get an erection when you need it.


Best for
Weekend use
Effective in
Effective in 8 out of 10 men
Dosage
2.5mg, 10mg, 20mg

Key Takeaways

Psychological erectile dysfunction is a condition that is hugely difficult for many men. Don’t lose hope, though: it can and will get better. 

Talk to someone you trust, and visit a doctor. They can help you through any mental health issues that are contributing to your ED. But, in the short term, medicines like Viagra and Cialis can help. And they might give you back the confidence you need to overcome its symptoms.

While we've ensured that everything you read on the Health Centre is medically reviewed and approved, information presented here is not intended to be a substitute for professional medical advice, diagnosis, or treatment. It should never be relied upon for specific medical advice. If you have any questions or concerns, please talk to your doctor.

Further reading

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