Erectile dysfunction (ED) is the inability to get or keep an erection firm enough for sexual function. It’s a common sexual problem, affecting as many as 30 million men in the United States. Most cases of ED have a physical cause, such as heart disease, diabetes, and obesity. Lifestyle choices like smoking and drinking excessive amounts of alcohol can also lead to ED. But for some men, psychological issues are the root of the problem.

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

Psychological issues contributing to ED aren’t as easy to detect, diagnose, and treat. The most common psychological causes for ED include the following:


Psychological issues have real, physical effects. Anxiety, for example, is something that many people assume exists in your head. But 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.


Everyone experiences stress at some point in their life. Sometimes, stress can serve as a powerful motivator. But 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 is often caused by a chemical imbalance in the brain. It can affect both 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 proper 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 you have trouble resolving relationship issues on your own, seek out a counselor or therapist who can help.

Fear of sexual dysfunction

The first time you experience ED, you may become worried that you’ll never regain normal sexual function. This can lead to fear or low self-esteem. These feelings 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 found the right treatment, your fear of sexual dysfunction should subside.

Psychological causes of ED aren’t typically treated with medication. However, medications can help in cases where a chemical imbalance is causing an issue. For example, men who have depression may find relief for their symptoms, as well as ED, when they begin anti-depressant treatment.

Many of the psychological issues above require therapy, patience, and time. Your doctor can work with you to find the best course of treatment.

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. If you’re experiencing ED along with psychological issues, talk with your doctor. Together, you and your doctor can find a cause and a treatment to bring your sexual health back to normal.