Psychological erectile dysfunction (ED) is a real thing, and it is much more common than you might think. The good news is that there are solutions that can help address the problem.
Psychological erectile dysfunction (also called psychological impotence) is a difficult problem to grapple with. Although it isn’t something people enjoy talking about openly, it is more common than you might imagine —and despite what you may think, it is a treatable condition.
What is psychological erectile dysfunction?
Psychological erectile dysfunction is a condition caused by psychological factors, in which a man struggles to get or maintain an erection. Stress, depression, guilt, low body image, relationship issues or anxiety—including performance anxiety, could all lead to ED.
Physical erectile dysfunction, on the other hand, may happen naturally due to ageing or medical conditions that affect genital blood flow. These include type 2 diabetes, cardiovascular issues or pulmonary problems, for example.
As such, psychological ED is not the sort of condition that should be treated by taking a pill — but it can be treated if you address the underlying cause right at the source.
How common is psychological erectile dysfunction?
Erectile difficulties shouldn’t come as a surprise, because they’re fairly common. How common, exactly? The Cambridge Well-Being Institute suggests that as many as 10% to 20% of us have experienced psychological erectile dysfunction at some point in our lives.
However, the true number may be even higher than 20%. People who are ashamed may neglect to tell researchers about their embarrassing experiences. This means that psychological erectile dysfunction is more common than most would think.
Men tend to take their erections for granted; and those who suddenly experience erectile dysfunction are often shocked when it happens to them for the first time.
You could be experiencing no problems in achieving or maintaining erections one day, and then suddenly have erectile problems with no obvious explanation the next.
Sex Therapist, Kamil Lewis (MA, LMFT), shares from her experience “Struggling to maintain or achieve erections is incredibly common.
There is often an association between masculinity and the quality of an erection, so if ever there comes a time when your body doesn’t experience an erection, it’s likely that you will immediately feel shame or disappointment.
These subsequent feelings tend to compound upon themselves. For instance, the fear or anticipation of not being able to achieve an erection may end up as a self-fulfilling prophecy.
Because our bodies don’t always behave exactly how we want them to, psychological ED happens much more often than we might assume!”
Is psychological ED more common in young men?
Not necessarily. This recent study for example, showed that a quarter of all men under the age of 40 experience erectile dysfunction of some kind!
And we already know that in young, healthy men, the main cause of ED is usually psychological.
Psychological erectile dysfunction is a problem that can happen to both younger and older men, regardless of their physical health or sexual experience.
Let’s look at some questions you can ask to work out whether your erectile dysfunction is psychological in nature.
How do I know if my ED is physical or psychological?
Behavioral neuroscience researcher and certified sex therapist Dr. Nan Wise explains, “If you rule out medical causes, you can probably attribute ED to psychological factors, especially if you have morning erections, can masturbate, or only experience the ED in certain circumstances.
It’s always a good idea to consult your family doctor to rule out potential medical causes of erectile dysfunction such as heart disease, hypertension, diabetes, or illnesses that impair nervous system functioning.
Typically, stress is the culprit. It hijacks the nervous system into flight or fight mode, which is physiologically not conducive to the state of relaxed arousal that is necessary for erection.
Men who get anxious about occasional erection issues can develop performance anxiety that creates a vicious cycle.”
But what else can make a man experience psychological erectile dysfunction? Let’s explore the most common underlying causes.
Psychological causes of erectile dysfunction
Although erectile dysfunction can be caused by physical reasons, for many men psychological factors can be the main cause of ED.
Even when the cause is physical, there are almost always psychological factors at play as well.
Mental health issues that reduce sexual arousal and excitement make it hard for men to get and maintain an erection.
These are some common causes of psychological erectile dysfunction that can affect erections by creating a “mental block” between your brain and penis:
Anxiety is one of the main psychological causes of erectile dysfunction. The more anxiety you have in your life the more likely you are to experience psychological ED.
When your mind is bogged down with concerns related to anxiety, it can have a serious impact on your sexual performance.
Ironically, anxiety about not being able to get or maintain your erection usually makes things worse. It’s common for a cycle that is driven by fear of failure to occur.
We all know what stress feels like – and some of us experience it more often than others. Maybe it’s your job or a difficult life event; maybe it’s conflict at home or financial concerns.
Whether you experience chronic stress, or just occasional worries, stress can mentally cause ED by interfering with sexual arousal. When that happens it is going to be difficult to get or keep your erection.
Depression is a psychological factor that can affect your ability to get or maintain an erection. In fact, research shows that depression and psychological ED are connected and can affect one another.
When you feel down and low on energy, it can be extremely difficult to experience sexual arousal. Furthermore, depression can also lead to reduced sexual desire (hyposexuality) due to the way that depression affects the brain.
Depression negatively affects your sexual performance and makes erectile dysfunction much more likely to happen.
Is your relationship experiencing troubled times? Well, this can “bleed over” into your sex life.
Dr. Laurie Betito, clinical psychologist with a specialty in sexual wellness explains, “When a couple is experiencing tension, frequent conflict, constant bickering, resentments, etc., the result is a feeling of disconnect.
When a couple feels disconnected, they tend to feel awkward around each other, they do not feel warmth and closeness, and thus they have difficulty being vulnerability with one another.
This directly affects desire for sex. When a person does not feel “safe”, when there is a lack of emotional intimacy, it is often difficult to engage in the intimate act of sex.
Without desire, it is difficult for both men and women to get aroused. For men, however, it is far more obvious as it results in difficulty with erections.
Men have added pressure to perform as they often ascribe to myths that “men should always want sex” and that they are “always willing and able”. These kinds of pressures reinforce the erectile dysfunction.
When there are lots of negative thoughts and feelings occupying the mind, there is little room for the experience of pleasure (and the easy blood flow to the penis).
For some men, a dependence on pornography can cause erectile dysfunction problems. Particularly when is it used as an aid to masturbation. You may find that you can only get an erection when you’re watching porn.
This is because on a neurochemical level the brain can become “trained” to expect and need pornography for sexual arousal to occur.
Aside from that, watching porn can lead you to develop unrealistic expectations about your body and sexual abilities.
This, in turn, can cause anxiety and low self-esteem, leading to psychological ED.
You can learn more about porn-induced erectile dysfunction here.
How to overcome psychological ED?
If you think you’re suffering from psychological erectile dysfunction, don’t lose heart. It’s a common issue that fortunately can be treated easily.
To overcome this issue, you need to address the erectile dysfunction mental block that is causing you to lose your erection.
Keep in mind that even if there is a physical reason for ED, in almost all cases there are psychological factors that worsen ED as well.
Let’s take a look at some psychological ED treatments for taking back control.
Practicing mindfulness meditation for about 15 minutes a day can drastically reduce daily stress and anxiety.
Not only that, research shown that a specific mindfulness meditation program for ED helped 9 out of 10 men overcome psychological erectile dysfunction.
What’s great about meditation is that other than helping with erectile dysfunction, it is also a fun and calming activity.
There are different ways of practicing guided mediation, from in-person groups to apps and online programs.
Certified sex therapist, Angela Skurtu, shares from her experience, “Mindfulness is the practice of being present and in the moment when you engage in various activities.
For men who struggle with erectile dysfunction, mindfulness can be a very helpful way to address the problem.
For some men, erectile dysfunction is the result of performance anxiety.
Essentially, a man is hyper focusing on his erection and as a result, he is putting a lot of pressure on the sexual situation which then makes it impossible to achieve his erection.
Using mindfulness, men can work on focusing their attention on sexual sensations. A man can use mindfulness to focus on any of his five senses – taste, touch, smell, sound, and sight.
As performance anxiety comes up, the male acknowledges he has anxiety and works to refocus his attention on the things that are sexy or relaxing.
For example, he can focus on the sensation of touching his partner’s breasts under his fingertips mindfully.
By refocusing his attention on the things that are sexy and sensations that feel pleasurable, his erection will come naturally as a by-product of engaging in relaxing, sensual activities.
Mindfulness works best if practiced daily. This means practice daily refocusing your attention on the five senses through mindfulness. You acknowledge anxiety is present, but then refocus your attention on the cup of coffee you are drinking. Essentially, you are training yourself to feel your senses fully again.”
Talking to a therapist may help
Although erectile dysfunction is a sensitive subject and a private matter that most men don’t like discussing, speaking with a therapist can be helpful.
Also keep in mind that this is a safe space in which you’re protected by confidentiality.
Therapy is a powerful way of targeting any feelings of guilt, shame, anxiety or inadequacy that might underlie your erectile difficulties.
Working through your psychological issues or relationship problems with a mental health professional can help to eliminate the effects those issues have on your sexual performance.
Certified sex therapist, Dr. Carli Blau, elaborates, “Penile functioning is often associated with masculinity for many men.
When a man’s penis stops working in the way it used to, or in a way that is pleasurable to themselves or their partner, it can make men feel anxious, shame and guilt.
Sex therapy including cognitive behavioral therapy (CBT) and mindfulness can help change unhealthy thinking patterns around sex.
Sex therapy can also help validate a man’s experience with their erectile dysfunction and give them tools to regain functioning in a new way that is pleasurable to both themselves and their partners.
If ED is caused by anxiety or depression, or relationship issues, speaking to a sex therapist can help relieve the stress that is causing the sexual dysfunction to occur.”
Consider using guided imagery
Guided imagery therapy has proven very effective in treating psychological ED.
For example, research found that 70% of men treated with Guided Imagery and sexual re-education succeeded in overcoming their mental erectile dysfunction and were able to get erection whenever they wanted to.
Guided imagery therapy is similar to guided meditation. The client is asked to relax, close his eyes and undergo visualization exercises that allow the mind to reassert control over the body by simply letting go of any unhelpful thoughts or feelings.
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.
Talk it out with your partner
Communication is key: don’t try to hide your erectile dysfunction from your partner, or avoid discussing it out of embarrassment or shame.
Kate Moyle, Psychosexual Therapist and Host Of The Sexual Wellness Sessions Podcast, shares for her experience, “Struggling with psychological erectile dysfunction can be made worse by assumptions, and assumptions can be broken down by communication as it offers clarity.
This is why communication is key to managing any part of your sex life, but particularly if you are experiencing sexual challenges or difficulties.
Our assumptions about what our partner might be thinking often jump to the worst-case scenario, as where we have an information gap we fill it with our thoughts which often holds a negative and self-criticizing bias.
So talking to your partner about what you are going through can help you both to acknowledge, clarify and also help you to both tackle it as a shared problem rather than it being so personalized and focused on you.
This in itself can alleviate pressure which is one of the main causes of psychological erectile dysfunction, and with less pressure and performance anxiety you can get back to focusing on what feels good and pleasurable, which is key to you getting the most out of your physical experience of arousal and desire.“
Relaxation techniques that help reduce stress can help you get over psychological erectile dysfunction. These can include: rhythmic breathing techniques, yoga, exercising, or anything else you find relaxing.
Can Viagra help psychological erectile dysfunction?
ED medications such as Viagra are not the ideal treatment for men with psychological ED.
Karen Washington, certified sex therapist explains, “In my clinical observation, Viagra does not consistently solve psychologically induced erectile inconsistency.
The penis owner is not having an issue with blood flow. Until the penis owner can learn to manage the [often] anxiety-based responses they experience, they will continue to encounter uncertainty about sexual encounters.
Depending on how long the person has been dealing with the erectile inconsistency, they likely also perceive increased pressure to “perform” i.e. achieve/maintain erection throughout the sexual experience until climax.
That pressure also contraindicates a successful sexual experience by contributing to/exacerbating the anxiety they experience.”
To sum things up
Today more than ever, science is telling us that the body and mind are closely connected. There is no clearer demonstration of this than psychological erectile dysfunction. Psychological ED is an emotional barometer: it tells you that there are other areas of your life that need your attention.
Don’t ignore the signs that your body is sending – Take action and treat your psychological ED. Talking about it with your partner, seeing a sex therapist, re-educating yourself, and using mindfulness meditation will all help you take back control of your body, mind, and destiny.