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True Canada Pharmacy

Erectile Dysfunction and the Mind

Friday 21 May 2021
Erectile Dysfunction
6 minute(s) read

Table of Contents

I. How common is ED?

II. Anxiety and Stress

a. Performance anxiety

III. Relationship problems

a. Guilt and self-esteem

IV. Depression

a. Sexual trauma

V. Is my ED psychological?

VI. Treatment

a. Sex therapy

b. Cognitive-behavioral therapy (CBT)

How common is ED?

Many men believe erectile dysfunction (ED) is an older man’s problem, but it can affect men at any age. Approximately 25% of new ED cases occur in men under 40 years old. In older men, underlying health problems often lead to performance problems during sex. Physical issues may occur in younger men too, but psychological causes are more common in the younger demographic. ED occurs because of a problem during sexual arousal, which is characterized when the muscles in the penis relax, allowing blood to fill the chambers within the penis.

There are three different types of erections men experience:

  • Physical stimulation causes a reflexive erection.
  • Visual or mental images trigger psychogenic erections.
  • Nocturnal erections occur during sleep.

These types of erections depend on a lot of physical as well as physiological systems. If any of these systems get thrown out of balance, then ED can occur. Psychological causes of ED can stem from many past experiences and stresses. To learn more about the various ways psychological factors impact your sex life, please read below. [1]

a man looking upset

Anxiety & stress

It sometimes may appear that stress is only in our head, but those stressors can manifest themselves into physical effects. This stress can lead to increased heart rate, blood, pressure, fatigue, and decreased sexual performance. If you are stressed at work or a particular worry is plaguing your brain, you may experience difficulty focusing on your sex life. ED can be an infrequent occurrence, but you may want to seek a doctor’s opinion if it continues to be a problem. [2]

If you are experiencing a lot of stress and anxiety, the brain’s ability to send the necessary physical signals during sex may be affected. A study of patient case files in Comprehensive Psychiatry found that 64 men with ED had a history of depression or anxiety. ED and anxiety can be an ongoing cycle. Sexual dissatisfaction may contribute to anxiety and vice versa.

a. Performance anxiety

If you do experience anxiety-based ED, then you may become worried that you’ll never regain normal sexual function. If a man thinks that their ED is now irreversible, that fear will continue to plague their sexual encounters. Performance anxiety can create self-esteem issues and lead to a fear of being unable to satisfy your partner. This cycle can be broken if you seek the treatment of a doctor or therapist.  

Relationship Problems

Maintaining a healthy relationship can be difficult at times with all the other responsibilities of everyday life. Some of your ED problems may be linked to underlying issues with your significant other. If you and your partner are experiencing problems, it can quickly bleed over into your intimate life. It is crucial to maintain excellent communication with your partner. If you are feeling unhappy or stressed about an aspect of your relationship, it is healthy to voice those concerns.

Those with ED can begin to feel embarrassed or ashamed of their condition. Working through issues that may cause your ED will likely improve the condition and can strengthen your relationship. It may be best to seek out the counseling of a professional to mediate these difficult conversations. [1]

a. Guilt and self-esteem

Men with ED may experience guilt and self-esteem issues concerning sex with their partners. If you or your partner is not pleased with your sex life, it can cause a lack of connection that is often essential to a healthy partnership. If a couple does not engage in physical touch because of ED, then guilt and self-esteem issues can occur for both people. If these behaviors continue, steps should be taken to remedy the ED and improve communication.


A chemical imbalance causes depression in the brain. There are 16.2 million adults in the United States who suffer from depression, and at least 6.7% of American adults have suffered from one major depressive episode in a given year. This chemical imbalance can affect both mental and sexual functions. Depression can be hard to diagnose. A person’s bad day might turn into a bad week, then a bad month, or even a bad year. Depression can feel like many things, but it is usually characterized by a lingering feeling of sadness or lethargy.

a man looking depressed

Depression can weigh on your body and mind, which can then affect your sexual performance. Depression often accompanies feelings of worthlessness and a loss of interest in normal activities. Medications like Zoloft and Lexapro are common medications used to treat some depressive disorders. If a man can improve his depressive symptoms, then his ED may improve as well. [3]

a. Sexual trauma

If a person experiences sexual trauma in their life, it can have long-lasting effects on their sexuality. Men who experience sexual abuse may have trouble having consensual sexual encounters and experience ED as a result. If you have experienced trauma of this sort and suffer from ED, then seeking some therapy may be beneficial to your sex life as well as your mental well being.[4]

Is my ED psychological?

There are many physiological reasons behind ED like high cholesterol, alcoholism, and metabolic syndromes, so a doctor may have to perform tests to rule these causes out. Complete blood count tests, fasting blood glucose tests, and urinalyses help doctors determine if your ED problems stem from physical abnormalities. Doctors usually ask you to complete self-reports to gauge the level of sexual function and satisfaction level with intercourse. These answers may lead your doctor to refer you to a psychologist. Some questions that help your doctor determine psychological ED can include:

  • Are you currently under a lot of stress or anxiety?
  • Do you get nervous about pleasing your partner?
  • Are you interested in sex and your partner but have trouble performing?

If you answer “yes” to any of these questions, then your erectile dysfunction may be linked to mental health issues like anxiety or depression. [1]


If it is found that you have psychological impotence, treatment can vary. When a man suffers from physical causes of ED, they can take medications like Viagra or Cialis to help with erections during sexual stimulation. These medications may not work for those with psychological ED because the symptoms stem from mental symptoms, not physical. Seeking professional therapeutic help is often the best route to normal functioning.

a man reading a book

a. Sex therapy

Sex therapy can be an asset to men with ED who are in good health. In this type of treatment, the counselor may assign books about sexuality as well as techniques to improve sexual communication skills with your partner. This type of therapy works best if the man’s partner is a willing participant in the counseling sessions. Studies show that if a man and his partner successfully participate in this therapy, ED is resolved in 50-70% of cases. [5]

b. Cognitive-behavioral therapy (CBT)

CBT can be a successful method in treating ED. This proactive therapy helps you change the way you think and behave concerning certain behaviors. A CBT therapist enables you to understand specific triggers and feelings surrounding your ED through in-depth discussion. Once you discover why your attitudes and behaviors inhibit your sex life, you can adopt more positive approaches to sex. Understanding your brain can be the first step to resolving erectile dysfunction. [6]

The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical condition, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis or treatment.