Erectile dysfunction (ED) is a common condition that affects about 18 million American men over the age of 20. Some suggest the actual number is closer to 30 million, which may be due to low reporting.
As you age, your risk for ED increases. But having trouble maintaining an erection isn’t always related to age. Many men will experience ED at some point. The good news is that the cause of your ED can usually be identified, and ED will often go away with treatment.
The causes of ED can be both psychological and physical. The success of treatment for physical causes depends on your condition. Studies show that psychological factors are the most common cause of ED. Psychological causes, like emotional and environmental factors, are usually curable. This includes stress and anxiety.
Increased stress and anxiety can also increase your risk for other conditions that may cause ED, such as:
- heart disease
- high blood pressure
- high cholesterol levels
- excessive alcohol consumption
Read on to learn how stress and anxiety cause ED, how to manage your stress and anxiety levels, and how to prevent ED.
You can experience three types of erections: reflexive (due to physical stimulation), psychogenic (due to visual or mental associations), and nocturnal (during sleep). These types of erections involve important bodily systems and processes. A disruption in any of these processes can cause ED.
- nervous system
- blood vessels
Mental health conditions like stress and anxiety can also affect how your brain signals your body’s physical response. In the case of an erection, stress and anxiety can interrupt how your brain sends messages to the penis to allow extra blood flow.
Stress and anxiety about ED can also contribute to a cycle of ongoing ED. Experiencing ED can lead to behavioral changes that contribute to anxiety and incidences of ED. The reasons for ED vary per age group, but generally follow:
- Psychological ED (mainly nervousness and anxiety) affects about 90 percent of teenagers and young men. These events are fairly short-lived.
- Personal and professional stress, such as relationship trouble, is the main reason for ED in middle-aged men.
- Physical impotence is the most common cause for older men, but the loss of a partner and loneliness can also cause psychological stress.
The following life events can also cause enough stress and anxiety to lead to ED:
- job problems, loss, or stress
- relationship problems and conflicts
- illness or loss of a loved one
- fear of aging
- changes in health
- financial burdens
One study of veterans with posttraumatic stress disorder (PTSD) found that PTSD increased the risk for sexual dysfunction by more than three times. Long-term stress and anxiety can increase certain hormone levels in your body and interfere with your body’s processes. This can also lead to other health conditions that may cause ED.
Stress and anxiety can also worsen or develop into several health conditions. A 2013 study suggests that ED may also be a risk marker for future cardiovascular diseases.
Other health conditions associated with ED include:
- vascular disease
- nerve damage
- high cholesterol
- high blood pressure
- heart disease
- low testosterone
- metabolic syndrome
- prostate cancer or enlarged prostate
- certain prescription medications
Stress and anxiety may lead to certain lifestyle factors that contribute to ED, including:
- illicit drugs use
- tobacco use
- excessive alcohol consumption
- a sedentary lifestyle
Psychological ED tends to go away with time. For ED that doesn’t go away, talk to your doctor to see what treatment options are available for you. Treatment depends on what’s causing your stress and anxiety.
Treatment for psychological causes of ED typically involve therapy. Therapy can help you break out of the stress or anxiety and ED cycle. There is:
Counseling: You’ll work with a therapist to identify and address major stress or anxiety factors so you can manage them.
Psychodynamic therapy: This usually involves addressing a subconscious conflict to help find the root cause of your ED.
Sex therapy: This therapy focuses on sensational pleasure rather than arousal and sexual activity. It aims to reduce the stress factor by building more a secure and reliable sex life.
Sexual anxiety therapy: Your doctor will explain ED to you in full detail. This can help reduce problems and worries caused by a lack of knowledge. Then your doctor will address the emotional issues and help you find a solution. Solutions may vary from trying to achieve relaxation to reactivating imagination.
Alternative therapies may also help with stress and anxiety. Modern treatments include:
- relaxation techniques
These treatments may help you manage your stress and anxiety levels. Research shows that meditation can change brain chemistry and reduce stress.
But there is less evidence supporting the effectiveness of these alternative treatments compared to traditional therapies and medications for stress and anxiety. However, they may provide additional benefits alongside the treatments your doctor prescribes.
Herbs and supplements for stress, anxiety, and ED
Some herbs and supplements are marketed for ED as well as stress and anxiety. These supplements include:
- Panax ginseng, a Chinese and Korean herb that comes in the form of tablets or a cream
- black maca, a root vegetable helps alleviate stress and improve sexual performance
- kava, a plant that can help treat anxiety and improve mood
- chamomile, a plant that helps reduce symptoms of anxiety
Always talk to your doctor before trying herbs and supplements for any health concern. Some can cause serious side effects. For example, kava is known to cause serious liver damage and is banned in several European countries. Other possible side effects of these herbs and supplements include allergic reactions, nausea, and more. It’s important to understand that herbal medication is not controlled by the U.S. Food and Drug Administration (FDA) and not subject to the rigorous trials and safety reviews that are required before the approval of a prescription medication.
ED is often a symptom of an underlying condition. In some cases, stress and anxiety may increase your risk for ED but not cause it. Talk to your doctor if you have any other symptoms accompanying ED. They’ll be able to help diagnose the cause and potentially treat it.
The most common treatments for ED include:
- prescription medicine
- penis suppository
- testosterone replacement
- penis pump (vacuum erection device)
- penile implant
- blood vessel surgery
Lifestyle treatments include:
- sexual anxiety counseling
- psychological counseling
- reaching and maintaining a healthy weight
- stopping tobacco use
- reducing alcohol use
Talk to a doctor
Treatments for ED are often very successful. The sooner you talk to your doctor about your symptoms, the sooner they’ll be able to help you find a treatment. Erectile dysfunction can be an early sign of certain chronic diseases, including heart disease. This is one major reason why it’s important to discuss ED symptoms with your doctor.
Finding a cause for your ED can help your doctor identify and manage other health problems that you may be experiencing. The discussion about your ED problems can be an opportunity to talk about your overall health.