Is Erectile Dysfunction Psychological?

Written by Kimberly Holland | Published on March 14, 2014
Medically Reviewed by George T. Krucik, MD, MBA on March 14, 2014

Your mind has more to say in the matter than you might think.

What Is Erectile Dysfunction?

Erectile dysfunction (ED) is a common sexual problem in which men experience difficulty achieving and maintaining an erection long enough for sexual function. At some point in their lives, almost all men will experience ED, according to the University of Maryland Medical Center (UMMC). This often corrects itself with time. However, chronic ED requires treatment.

Read on to learn about the physical and psychological causes of ED, and how they can be addressed.

Physical Causes for ED

A physical cause can be determined for most cases of ED. According to the Mayo Clinic, the following physical causes can contribute to ED:

  • heart disease
  • diabetes
  • obesity
  • high blood pressure
  • atherosclerosis
  • high cholesterol
  • neurological disease
  • blood vessel problems

Medication side effects also can cause ED. You may first notice ED after beginning a new medicine or changing doses. Use and abuse of substances such as tobacco, alcohol, and illicit drugs also can cause ED.

Psychological Causes

Most physical diseases or conditions contributing to ED can be addressed with lifestyle changes or medication. For some men, however, the cause isn’t so easy to pinpoint.

Psychological issues contributing to ED aren’t as easy to detect, diagnose, and treat. According to UMMC, psychological issues cause 15 percent of ED cases. The most common psychological causes for ED include stress, depression, relationship problems, and anxiety.

Anxiety Is Real

Here’s the thing about psychological issues: they have very real, physical effects. Anxiety, for example, is something that many people assume exists in your head. However, anxiety can cause increased heart rate, blood pressure issues, and fatigue. This, in turn, can affect your sexual performance. In fact, anxiety is one of the most common psychological causes of ED.


Almost every person experiences stress on a daily basis to some degree. Some stress may seem benign, or it can serve as a powerful motivator. However, even simple stress—a presentation at work tomorrow, for example—can affect your ability to achieve and maintain sexual performance. You don’t have to be carrying a large load of stress for it to affect your sexual health.

Depression and Sexual Function

Depression, often caused by a chemical imbalance in the brain, can affect sexual desire and sexual function. For men, however, depression isn’t always an easy diagnosis. Many men don’t recognize the symptoms of depression, and some are reluctant to seek help, according to the National Institute of Mental Health.

The good news is that most men will return to feeling normal, regain healthy sexual interest, and resolve their ED problem with treatment for depression.

Relationship Problems

The silent treatment isn’t the only thing you’ll experience if you and your partner have been arguing. Troubles in your emotional relationship can affect your sexual relationship.

Arguments, poor communication, and anger can affect your sexual desire and sexual function. Working through these problems with your partner can help ease your symptoms of ED.

If conquering your relationship issues on your own isn’t successful, seek out a counselor or therapist who can help.

Fear of Sexual Dysfunction

Failure and sexual health do not mix well. The first time you experience ED, you may become alarmed and worried that you’ll never regain normal sexual function. The fear and low self-esteem you suffered as a result of your past problem may affect your ability to achieve or maintain an erection in your next sexual encounter.

This cycle can continue until you see your doctor to find a treatment. Once you’ve fixed the problem, your fear of sexual dysfunction should subside.

Treatments for Psychological Causes of ED

Unlike physical causes of ED, psychological causes aren’t typically treated with medication. Medications can certainly help in the cases where a chemical imbalance is causing an issue. For example, men who are suffering from depression may find relief for their depression symptoms as well as ED when they begin anti-depressant treatment. However, many of these psychological issues require therapy, patience, and time. Your doctor can work with you to find the best course of treatment.

Your Mind Matters

The saying “It’s all in your mind” might be entirely accurate for some men dealing with ED. Psychological issues can affect more than just your mental health. Depression, anxiety, stress, and relationship problems can have a tremendous effect on your sexual function.

Talk with your doctor about how you’re feeling and any other symptoms you’re experiencing. Together, you and your doctor can find a cause and a treatment to bring your sexual health back to normal.

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