Erectile dysfunction (ED) can be one of the most discouraging physical problems a man can have. Not being able to achieve (or maintain) an erection while still feeling sexual desire is psychologically frustrating and can strain a relationship with even the most understanding partner. ED has both medical and psychological causes, and is often a mix of both.

“If a man is able to obtain and sustain an erection in certain circumstances, like self-stimulation, but not others, such as with a partner, those situations are often psychological in origin,” says S. Adam Ramin, MD, urologic surgeon and medical director of Urology Cancer Specialists in Los Angeles.

“And even in cases where the cause is purely physiological, such as a vascular problem affecting blood flow, there is also a psychological element,” he says.

This suggests your mind could play an important role in overcoming ED, regardless of its source. In fact, many people with ED report positive results using hypnosis to help get and maintain an erection.

An erection is achieved when the arteries that bring blood to the penis swell with blood and press closed the veins that allow blood to circulate back into the body. The contained blood and erectile tissue form and maintain the erection.

ED occurs when not enough blood flows to the penis to be erect long enough for sustained penetration. Medical causes include cardiovascular conditions such as hardening of the arteries, high blood pressure, and high cholesterol, since all of these conditions negatively affect blood flow.

Neurological and nerve disorders can also interrupt nerve signals and prevent an erection. Diabetes may also play a role in ED, because one of the long-term effects of that condition is nerve damage. Certain medications contribute to ED, including antidepressants and treatments for high blood pressure.

Men who smoke, habitually drink more than two alcoholic drinks a day, and are overweight have a greater risk of experiencing ED. The likelihood of ED also increases with age.

While only about 4 percent of men experience it at 50, that number rises to nearly 20 percent of men in their 60s. About half of men over 75 have ED.

In a sense, erections begin in the brain. ED can also be caused by:

  • a past negative sexual experience
  • feelings of shame about sex
  • the circumstances of a particular encounter
  • a lack of intimacy with a partner
  • stressors that have nothing to do with sex at all

Recalling one episode of ED can contribute to future episodes.

“An erection begins when a touch or thought nudges the brain to send signals of arousal into the nerves of the penis,” explains Dr. Kenneth Roth, MD, a urologist at Northern California Urology in Castro Valley, California. “Hypnotherapy can address the purely psychological, and can contribute significantly to the treatment of the mixed origins,” he says.

Dr. Ramin concurs. “Whether the problem is physiological or psychological in origin, the psychological aspect is amenable to hypnosis and relaxation techniques.”

Jerry Storey is a certified hypnotherapist who also suffers from ED. “I’m 50 now, and I had my first heart attack at 30,” he says.

“I know how ED can be a combination of physiological, neurological, and psychological factors. In many cases, the medical impairment will lead to a psychological increase in the physiological problems. You think you won’t ‘get it up,’ so you don’t.” Storey produces videos to help men overcome ED.

Licensed hypnotherapist Seth-Deborah Roth, CRNA, CCHr, CI recommends first working directly with a hypnotherapist in person or via video conferencing to learn self-hypnosis exercises you can practice on your own.

Roth’s simple self-hypnosis exercise begins with relaxation, then refining a focus on creating and maintaining an erection. Since anxiety is such a critical component of ED, the technique starts with about five minutes of closed-eyes relaxation.

“Close the eyes and relax them so much that you allow yourself to imagine they are so heavy and relaxed that they won’t open. Go ahead and give in to that feeling that they just won’t open, and tell yourself mentally how heavy they are. Then try to open them and notice you cannot,” she instructs.

Next, Roth advises several minutes of focused awareness on deepening relaxation with every breath.

Once you’re thoroughly relaxed and breathing easily, turn your focus to imagining your partner in sensual detail. “Imagine you have a dial and you can increase the blood flow to your penis. Just keep turning up the dial and increasing the flow,” Roth advises.

Visualization helps maintain the erection. Roth suggests closing your fists and imagining the power of your erection. “As long as your fists are closed, your erection is ‘closed,’” she says. Those closed fists can also create connection with your partner as you hold hands.

Roth also adds that hypnotherapy might not focus on getting the erection, but instead on the psychological issues that are preventing it. For example, she says: “Sometimes, emotionally damaging past experience can be released with hypnotherapy. Regressing to the experience and releasing it is a benefit of the session. The brain does not know the difference between reality and imagination, so in hypnosis we are able to imagine things differently.”

Erectile dysfunction may be the first sign of a serious problem like cardiovascular disease or diabetes. Regardless of the source, Dr. Ramin urges anyone experiencing it to see a medical doctor.