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How to Overcome the Psychological Effects of Erectile Dysfunction

Overcoming the Psychological Effects of 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).

Some men have trouble getting or keeping an erection; this condition is known as psychological impotence. Anxiety, particularly performance anxiety, can be triggered by stress, melancholy, guilt, a negative body image, difficulties in relationships, mental health concerns, sleep disorders, or other stresses.

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 are included in this category.

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

Sexual Performance Anxiety

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” reaction. The act of doing so prepares 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.

How many men are affected by Psychological Impotence?

Erectile difficulties are fairly common in men of all ages and should. How common, exactly? Studies suggests that up to 20% of men have experienced psychological ED 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 which are often linked to erectile dysfunction include diabetes, heart disease, high cholesterol, high blood pressure, obesity, hormonal disorders, and alcoholism.  In order to rule out medical issues, your doctor may order laboratory testing. 

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

Asking 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.

Psychological Erectile Dysfunction causes

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. It doesn’t matter if 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. 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. This 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 due to the fact that pornography can “teach” the brain to anticipate and require it in order to experience sexual excitement. Further, exposure to porn might cause one to think excessively highly of one’s own sexual and bodily potential, which can lead to nerves before a performance and emotional disturbances.


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 may experience impotence due to guilt, one of the psychological causes of ED.

Low Self Esteem

Erectile dysfunction and low self-esteem are a vicious cycle. According to a research of Brazilian guys, 95% of those with ED also had low self-esteem. 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 erectile dysfunction in men.


How to deal with Mental Erectile Dysfunction


Although erectile dysfunction is a private issue that most men don’t like talking about, it can be discussed with a therapist in a secure, confidential setting during psychotherapy.

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 issues or relationship problems on your sexual performance by working through them with a mental health specialist.

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, it’s best for people with erectile dysfunction not to 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 treatment of 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.

A lot of people who have tried guided meditation have also found that guided imagery therapy to be helpful. The patient is instructed to close his eyes, calm down, and go through a series of visualizations designed to assist his mind regain command 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.


Practice meditation just fifteen minutes a day will drastically reduce anxiety and stress. There are many options from meditation groups on mediation apps you can access.

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 exam or blood work to help identify any underlying physical causes of ED and may ask questions about the man’s mental health and stress levels. A physician from a Urology Clinic 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 on managing performance anxiety and Erectile dysfunction. 

In Summary

Psychological erectile dysfunction is a problem that can happen to both younger and older men, regardless of their physical health or sexual experience. In modern medicine, there are tons of sexual medicine 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.

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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