ED Pills for Performance Anxiety – Do They Work?

erectile dysfunction pills for performance anxiety

For the nearly 25% of men with sexual performance anxiety, trying an erectile dysfunction (ED) pill might seem like the best solution. After all, it’s an easy-to-swallow pill you take on demand to get a reliable erection. But, not so fast.

While they may help, ED pills do not get to the root of the anxious and distracting thoughts that men may face during sex.

This leaves men dependent on a pill rather than freeing them to have spontaneous and pleasurable sex. Not only that, in some cases which will explain later, they may not even work.

In this article, we will discuss if ED pills really work for performance anxiety and what men can do to take back control between the sheets. 

Do ED pills work for performance anxiety ED?

ED pills can work for performance anxiety, but not in all cases.

ED pills – called phosphodiesterase 5 (PDE5) inhibitors- like Cialis and Levitra work by increasing blood flow to the man’s penis, which is how the penis gets “hard.”

Without good blood flow, men can’t get erections at all, even when they are ready for sex, the mood is right, and they don’t have any anxiety. For men who have poor blood flow caused by medical illnesses, ED medications are an excellent option.

For men with performance anxiety (and normal blood flow) the medicines work in a more roundabout way. By increasing blood flow and making erections more likely, ED pills can break the cycle of negative thoughts so men are more confident they can perform.

But, if performance anxiety is severe, it may block arousal, which means the ED medicine will not work. Even on ED pills, you must be sexually aroused for an erection to happen. If you are too distracted by anxiety, an erection will not happen,

Unfortunately, these benefits come with a catch- ED medications have side effects such as headaches, nasal symptoms, stomach complaints and can affect the heart.

Also, men may replace anxiety with dependence, as they may feel they can only perform with the pills. Luckily for men with sexual performance anxiety, they can get to the root of the problem, rather than masking them with ED pills.

How can I manage performance anxiety ED?

Performance anxiety is caused by distracting thoughts or anticipating poor sexual outcomes such as being unable to have an erection or not pleasuring your partner. These thoughts crowd out the feelings of pleasure and connection, making performance anxiety a vicious cycle of negative thoughts leading to negative outcomes.

To break the cycle, men can use relaxation and mindfulness. Options include cognitive behavioural therapy (such as talk therapy with a sexual therapist) and mindfulness-based therapies.

Mindfulness practices focus on non-judgment and present moment awareness, the opposite of the causes of performance anxiety.

A recent small study of men who completed a month long mindfulness treatment for psychogenic ED showed that the training positively impacted erectile function, overall sexual satisfaction and men’s ability to remain non-judgemental about sex.

The results lasted up to 6 months after completing the training, suggesting that this tactic- unlike ED pills- can be long lasting and effective without side effects.

What is the best medication for performance anxiety ED?

The best medication for performance anxiety and ED is dependent on the root cause of ED. While some men may have psychogenic ED, others may have medical illnesses blocking blood flow to the penis. Commonly, men have both issues.

For example, a man with occasional ED from a medical problem may get preoccupied about his difficulty getting erections and develop performance anxiety ED, making it even less likely that he will get erections. In these cases, men should treat both issues to truly manage the ED.

Men with blood flow problems benefit from PDE5 inhibitors since they treat the root cause of poor blood flow to the penis. It’s also a good idea to deal with any underlying medical issues like diabetes or heart disease to improve blood flow throughout the body.

Some men may have low testosterone levels causing fatigue, low sexual desire and ED and may benefit from testosterone replacement.

Although the studies are mixed, there is some evidence that Trazadone, a medicine used for depression, also helps men with psychogenic ED. Trazadone can have serious side effects, so it should be used only when given by a medical professional. Another antidepressant medicine- Gepirone ER– improves sexual function in men with depression, an important issue since many antidepressants worsen sexual function.


Sexual performance anxiety has its roots in distracting thoughts and anticipating unsatisfactory sex. While there are some medicines that can help bypass this sabotaging thoughts, getting to the root of the problem may be the best solution to a long and exceptional sexual life.

About Oreoluwa Ogunyemi, MD

Urologist and Health and Wellness Coach

Dr. Ogunyemi is a medical doctor, trained urologist and a health and wellness coach. She received her medical degree from the David Geffen School of Medicine at UCLA. Her professional background and love of writing, allow her to efficiently synthesize complex and detailed research, making it accessible to a broader audience.

She serves as a medical writer for the Between Us Clinic.