Stress and Erectile Dysfunction

Can stress cause erectile dysfunction? Discover everything you need to know in this comprehensive article.

Illustration that depicts a man who suffers from erectile dysfunction due to stress

Muscle tension. Racing thoughts. Excessive worry. Fear. Nausea. Headaches. Most of us feel some level of stress daily. But, did you know that stress can lead to psychological erectile dysfunction (ED)?

Erectile dysfunction is incredibly common. How common is ED? One study estimated that about 18 million men suffer from ED in America alone! In reality, however, the true number is likely far higher, given that us men tend to under-report sexual issues!

The risk for erectile dysfunction increases with age but, younger men are also at risk. According to the Massachusetts Male Aging Study at the age of 40, just under half of all men had ED! So, younger guys certainly aren’t immune – even in people who are fit and healthy.

Erectile dysfunction can be caused by a variety of factors. For some, the cause of erectile dysfunction is physical. At times, however, ED can be caused by psychological factors, which we review in a little more detail down below.

Experts suggest that 10% to 20% of all erectile dysfunction cases are caused by psychological factors, which we call ‘psychological erectile dysfunction’. 

Can stress cause erectile dysfunction?

The answer is yes – stress most certainly can cause ED. But, how can stress cause erectile dysfunction?

Erections require the body to synchronize a variety of systems: muscular, hormonal, vascular, nerve-based, emotional and psychological. If there’s a problem in any of these systems, it can result in erectile dysfunction.

Before getting an erection, psychological stimulation happens, which leads to excitement that triggers blood flow to the penis.

So, if you’re distracted by a looming deadline or a recent conflict, you’re not likely to get or maintain an erection. If you’re having sex mindlessly, without actually paying attention to the senses and experiences that arise, your chances of experiencing ED are high.

Stress have a direct physiological effect on the brain and body. Specifically, stress interrupts and hijacks the brain, stopping it from sending the signals that are needed to trigger an erection.

Chronic stress can also lead to a decrease in male sex hormones, which in turn is associated with erectile dysfunction.

What are some common sources of stress that can lead to ED?

Here is a list of common stressors that may lead to erectile dysfunction:

  • Work stress
  • Financial stress
  • Performance anxiety
  • Depression
  • General anxiety
  • Relationship issues and conflicts
  • Losing a loved one
  • Confrontations
  • Deadlines
  • Parenting
  • Retirement and other significant lifestyle changes

Stress, the performance anxiety cycle and ED

People with sexual performance anxiety have excessive worries about their ability to perform sexually. At times, a single occurrence of erectile dysfunction – which may be triggered by stress – is enough to set in motion a vicious cycle.

When this happens, you become increasingly anxious about your ability to perform. This, in turn, creates a self-fulfilling prophecy in which your anxiety makes it harder to achieve an erection, which then makes you more anxious!

Picture this: you’ve had a long and tiring day at work. Your boss is giving you slack; and you’re not meeting your quotas. That night, your partner wants to have sex. But you’re lost in your thoughts and find that you lose your erection quickly. As soon as you realize what’s happened, you’re humiliated. Try as you might, you can’t get your erection back. You worry that there’s something seriously wrong with you. The following night, you’re nervous that the same thing will happen again. Lo and behold – it does. What’s going on!?

an illustration of the sexual performance anxiety cycle

Sexual performance anxiety is different from everyday stress and it has the power to lead to psychological erectile dysfunction or other sexual issues, such as premature ejaculation.

If you would like to learn more about how to overcome sexual performance anxiety and erectile dysfunction, you can follow this link to a more comprehensive article that we wrote on the topic.

How do you overcome stress-induced erectile dysfunction?

Fortunately, psychological erectile dysfunction can be treated with good results. Let’s take a look at some methods for treating stress-induced erectile dysfunction:

  1. Lower your overall stress levels

    As you may have guessed, one of the best ways to treat stress-induced ED is to de-stress.

    Different people respond differently to different approaches. But if you’re able to reduce your overall stress levels, you’re likely to experience less ED and more sexual satisfaction all round. Here are some suggestions for activities that can help you to reduce stress:

    • Meditation
    • Yoga
    • Physical exercise (experts recommend at least 150 minutes of moderate intensity exercise per week)
    • Counselling and/or therapy
    • Reduce your caffeine, nicotine and alcohol intake
    • Find a hobby that you enjoy
    • Dance
    • Laugh
    • Write a journal
    • Socialize
  2. Guided imagery

    Guided imagery is a technique in which you listen to instructions and imagine a successful and positive scenario – in this case sex. The mind treats these imagined practice sessions as real, which makes you feel more confident the next time you try to have real sex.

    Research suggests that guided imagery is a powerful technique for treating psychological ED, depression, stress and anxiety.

    Guided imagery can be done with a therapist, or simply by listening to recordings that guide you through the process in the comfort of your own home.

  3. Sensate focus

    Another effective technique for treating psychological ED is called sensate focus. Sensate focus is all about using the senses – namely, touch – to enjoy and rediscover the power of physical intimacy. It involves using touch to reduce stress and gradually increase the level of sexual intimacy experienced between you and your couple over time.

    While you can perform techniques such as guided imagery and sensate focus on your own, these often form a part of sex therapy. Sex therapy is a form of psychotherapy in which a licensed sex therapist helps couples to address their sexual difficulties.

    It is widely known that many people with sexual issues are reluctant to speak to a therapist. Luckily, nowadays it possible to discreetly consult with a sex therapist online.

Erectile dysfunction stress test

If you’re young and physically healthy, it’s more likely that your ED is caused by psychological factors. Nonetheless, young men can also be affected by physical erectile dysfunction.

Older men can also experience stress-induced ED, so it’s worth getting a doctor’s opinion.

The following are some signs that your ED might be caused by stress:

  • You’re able to experience an erection while masturbating, but not with a partner
  • You’re worried about being able to please your partner
  • You experience nocturnal and/or morning erections
  • You experience high levels of stress and/or anxiety

What are some other possible psychological causes of ED?

Apart from everyday stress, there are a variety of other psychological factors that can cause ED. For example:

A chart that shows the psychological causes of erectile dysfunction

All of these factors can potentially lead to psychological erectile dysfunction.

If you want to learn more about common psychological causes of ED and how to treat them, take a look at this article on psychological erectile dysfunction.

De-stress for a better sex life

Stress: we’ve all experienced it and we’ve all heard about the possible negative consequences of a high-stress lifestyle for our physical health. What many people underestimate, however, is the extent to which stress can negatively affect our relationships, sex lives and overall wellbeing!

Stress is a common cause of erectile dysfunction and a host of other physical, emotional and sexual issues. Fortunately, stress can be managed. So, don’t forget to take a deep breath, keep calm and allow yourself to experience your full sexual potential!

About Daniel Sher, MA

Clinical Psychologist and Sex Therapy Expert

Daniel Sher is a registered clinical psychologist and a sex therapy expert practicing in Cape Town, South Africa. Daniel gained his master’s degree in clinical psychology from the University of Cape Town (UCT) in 2014. A component of his training and practice involves working in the context of sexual and sex-related issues.

Daniel is a professional consultant for the Between Us Clinic, where he writes, edits, and reviews, professional materials and articles. He also treats patients at his clinic for male sexual dysfunctions including, premature ejaculation, erectile dysfunction and sexual performance anxiety.