Psychological Distress and Erectile Dysfunction

What is Psychological Erectile Dysfunction?

There are 3 types of erections: reflexive (associated with physical stimulation), psychogenic (from visual or mental images), and nocturnal (occurs during sleep).

Psychological ED or psychogenic erectile dysfunction is the inability to achieve or maintain an erection during sex due to psychological factors such as stress, anxiety, depression, guilt, low self-esteem, or relationship issues.

Conversely, physical impotence can develop for no apparent reason, such as with age or after a diagnosis of a medical disease that reduces blood supply to the genitalia. Diseases of the circulatory and respiratory systems also fall into this category.

Therefore, psychological impotence is not a condition best solved by pharmaceuticals or pills; nonetheless, it is treatable if the root cause is addressed.

Sexual Performance Anxiety

A crippling worry of falling short in the bedroom and being unable to satisfy a partner during sexual interplay characterizes the experience of those who suffer from sexual performance anxiety. Surprisingly, the more you stress over such things, the more likely you are to develop ED. When the prospect of failure looms so large that the thought of trying at all seems impossible, you may be experiencing this phenomenon.

Hormones like adrenaline and cortisol are produced in the brain whenever there is any kind of stress or anxiety. This causes the body to stiffen up and the heart to beat faster. Sometimes it hinders you from getting an erection by decreasing blood flow to the penile arteries.

These chemicals set up the well-known "fight or flight" response, preparing us both physically and psychologically to flee from harm. In contrast, an erection is not the sort of physical response that is prioritized when your brain and body are focused on survival.

Can Erectile Dysfunction be mental?

Yes. Erectile difficulties are fairly common in men of all ages and should. How common, exactly? Studies suggest that up to 20% of men have experienced psychological erection problems at some point in their lives.

The reality is that this number is likely much greater than 20%. Men who are embarrassed about their ED issues may choose not to tell researchers about their experiences with erectile dysfunction.

How can you tell if your Erectile Dysfunction is Psychological?

The key to treating sexual dysfunction and erectile dysfunction is to identify the underlying psychological causes. Because most erectile dysfunction cases are caused by physiological issues your first step should be to talk to your doctor.

Some of the medical causes often linked to erectile dysfunction include diabetes, heart disease, high cholesterol, high blood pressure, obesity, hormonal disorders, and alcoholism. To rule out medical issues, your doctor may order laboratory testing. 

There are a few signs to look for that might suggest your erectile dysfunction is psychological. 

Ask yourself specific questions. 

• Do you experience morning erections?
• Are you under abnormal amounts of stress or anxiety?
• Are you able to achieve an erection while masturbating?
• Do you get nervous about pleasing your partner?

If you answer yes to any of these questions, this may be a sign that your impotence is due to psychological causes.

Psychology and Erectile Dysfunction

Stress Anxiety

The sensation of stress is familiar to us all, though many people feel it more regularly than others. Whether it's stress at work, a loss in the family, or money problems, life can throw a lot of curveballs. Whether you're experiencing worry, stress, or depression, all of these things can add up to a feeling of helplessness on the inside.

Having sex may be the last thing on your mind and body's mind while you're worried about being in danger. When under psychological distress, erectile dysfunction can often occur as a result of the body's stress response. Stress causes the release of hormones into the bloodstream, and an erection is impossible while these stress chemicals are present in the body.

Depression & ED

Depression can have a major effect on your sexual desire and performance. It can feel like an ongoing burden that you just can't get rid of, negatively affecting all aspects of your life.   Studies have shown that over 75% of men and women with depression issues also have problems with sexual performance.

Chemical and neurological system alterations have been related to depression. Your libido, erection problems, and sex drive can all be influenced by these factors.

Relationship Issues

Disputes between partners can make it hard to get and keep an erection. Depending on the severity of the dispute and the emotional disturbance caused, it can cause mental erection problems which can "spill over" to your intimate interactions. Effective communication is crucial to intimacy, and disagreements are a natural behavior of any relationship. When you and your partner both feel comfortable and close, you may have sex that satisfies both of your needs.

Pornography Dependency/Addiction

Getting an erection only from seeing porn might lead to impotence issues and "stage fright" when it comes to actual sexual performances. In particular, when it is employed to facilitate masturbation.

This is because pornography can "teach" the brain to anticipate and require it to experience sexual excitement. Further, exposure to porn might cause one to overthink one's own sexual and bodily potential, which can lead to nerves before a performance and emotional disturbances.

Guilt

If your feelings of guilt are particularly intense, they may interfere with the messages sent to and from your brain, preventing you from achieving an erection. It's as if your subconscious retaliates against you for feeling guilty by making you feel less pleasure. Men who believe sex is shameful due to their religious or cultural beliefs, or those who are victims of sexual trauma or sexual abuse, may experience impotence due to guilt — both of which are psychological causes of ED.

Low Self Esteem

Erectile dysfunction and low self-esteem are a vicious cycle compounding psychological erection problems. According to a study of Brazilian guys, 95% of those with ED also had low self-esteem or a negative body image. It's common knowledge that issues with your sexuality or your ability to maintain an erection can lead to feelings of low self-worth.

Sexual Indifferences

Many things can cause men to lose interest in sexual activity, more so if they feel like there is monotony and tension in their partnership, but, what kind of neurology underlies this phenomenon?

A surge of dopamine—a chemical in the brain associated with pleasure, excitement and motivation—is released in response to sexual thoughts. When it comes to getting an erection, it's just as important as any other factor. The lack of excitement and interest in sex might lead to mental erectile dysfunction in men.

How to Beat Psychological ED

Therapy

Cognitive Behavioral Therapy (CBT) is an effective treatment for erectile dysfunction (ED), especially when linked to performance anxiety, low self-esteem, and reduced sexual arousal. This proactive therapy focuses on changing thoughts and behaviors to achieve positive outcomes.

When it comes to the impact of mental ED, feelings of guilt, shame, fear, or inadequacy may contribute to erection problems and can be effectively addressed through therapy.You can reduce the negative impact of your mental health conditions or relationship problems on your sexual performance by working through them with a mental health professional.

Therapy is a good way to ask for professional medical advice from your physician and lay out your medical history to help you with your erectile dysfunction problem.

Trust your Partner

Communication is key. Although it may be difficult, people with erectile dysfunction shouldn’t hide it from their sexual partner, or to avoid discussing it out of embarrassment or shame. Remember, your partner may be just as confused and upset by this as you are, so try initiating a frank and open discussion on the issue.

Communication is vital for increasing emotional intimacy between you, which can help to enhance your sex life.

Guided Imagery

The use of guided imagery in the treating psychological impotence has shown promising results. Seventy percent of males treated using Guided Imagery were able to overcome their psychological ED issues and improve their sexual performance dramatically.

Many people who have tried guided meditation have also found guided imagery therapy helpful. In this therapy, the patient is instructed to close his eyes, calm down, and perform a series of visualizations designed to help his mind regain control of his body.

You can conduct guided imagery with a trained therapist in a clinic or in the comfort of your own home by listening to audio recordings that walk you through the steps.

Meditation

Lifestyle changes like practicing meditation for just fifteen minutes a day will drastically reduce anxiety and stress. There are many options, from meditation groups to mediation apps, that you can access.

How to Reverse ED & When To See a Doctor

Men who experience symptoms that get worse or appear more frequently over time should also see a doctor.

Doctors may do a physical examination or blood tests to help identify any underlying health conditions causing ED and may ask questions about the man’s mental health and stress levels. A physician from a Urology Clinic in Sacramento can also give you an idea about what hypogonadism is since it may be one of the underlying causes of your Erectile Dysfunction.

Doctors may also have recommendations for managing performance anxiety and Erectile dysfunction.  [/vc_column_text][vc_column_text]In Summary[/vc_column_text][vc_column_text]Psychological ED is a problem that can happen to both younger and older men, regardless of their physical health or sexual history. In modern medicine, there are tons of sexual medications that you can take for your ED and will help you satisfy your sexual partners.

Instead of focusing on the negative outcome, it may help to identify what stressor or worry influenced the symptoms of Erectile dysfunction. The cause may be simple, such as an upcoming project at work or planning a family trip.

Shifting the focus to the cause, rather than the symptoms, may help a person reduce the pressure to perform sexually well every time, especially during times of increased stress.

Sources
Corona G, Rastrelli G, Vignozzi L, et al. Emerging medication for the treatment of male hypogonadism. Expert Opin Emerg Drugs 2012;17:239-59. 10.1517/14728214.2012.683411

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