Psychological ED: Link Between Mind and Erectile Dysfunction

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Written By Julie Ingram
psychological ed

Erectile Dysfunction (ED) is the inability to get or maintain a firm erection. 

This sexual disorder has affected 30 million males in the US alone.

The majority of cases of ED involve physical factors, but psychological factors can also contribute to the condition.

For some males, psychological concerns like anxiety are the root causes of ED.

Psychological ED can be just as distressing as physical ED.

This article will elaborate on the causes, symptoms, and treatment of psychological ED.

What is psychological ED

Psychological ED is an inability to get or maintain an erection due to psychological factors. 

It is also known as psychogenic Erectile Dysfunction. 

Erection is a complex process. It involves the interplay of the following: 

  • Blood vessels
  • Hormones
  • Nervous system
  • Muscles
  • Emotions

Any disruption in these factors can result in impotence or ED. 

Depression, anxiety, low self-esteem, etc., are the psychological reasons that can interfere. 

Thus, disrupting the signals the brain sends to the penis during sexual activity. 

This can inhibit the dilation of penile blood vessels. It results in less blood flow and a failed erection.

What are the causes of psychological ED

What are the causes of psychological EDSource: Getty-images
What are the causes of psychological ED

Psychological Erectile Dysfunction can have many underlying causes. 

This includes depression, anxiety, low-self esteem, and guilt . 

Relationship issues and consumption of excessive porn can also lead to ED.

Let’s delve deeper into each of the causes of Psychogenic ED.


As per research, the possibility of ED rises by 39% in people with Depression. 

Depression can result in Erectile Dysfunction in more than one way.

  1. Dopamine and Serotonin are the brain chemicals that help you get sexually aroused. When you’re depressed, these chemicals are out of function. Thus, it is difficult to become aroused, which is essential for an erection. 
  1. Depression may also lead to fatigue. As per Healthline, fatigue is a contributory factor to Erectile Dysfunction. 
  1. Many antidepressant medicines might exacerbate Erectile Dysfunction.  

Due to the above causes, depression leads to psychological ED.

But, it is crucial to remember that not all males with depression suffer from ED.

Consult a doctor to identify the underlying factor of your ED issues.


Anxiety is one of the most common psychological factors of ED.

Many people think anxiety is just in their heads. But, psychological issues can have physical effects on your body. 

Healthline says anxiousness results in rapid breathing, muscle tension, and a faster heartbeat.

This all interferes with the process of an erection. Thus, leading to Erectile Dysfunction. 

Also, when you experience anxiety, your body releases stress hormones such as cortisol. Adrenaline is also released. 

As per a study, higher levels of these hormones may lead to ED. 

Furthermore, anxiety can trigger ED by affecting your response to sexual stimulation.

Low self-esteem

A person with low self-esteem may perceive himself as not good enough for a relationship.

This makes it difficult for him to feel confident and relaxed during sexual activity.

Thus, leading to performance anxiety, which is a common cause of ED. 

Low self-esteem may also indulge you in unhealthy habits.

These habits include smoking, drinking alcohol, etc., which are significant causes of ED.


Past sexual experiences or trauma may be responsible for the feeling of guilt. 

You may experience the guilt of not being able to satisfy your partner. 

These feelings accumulate  and lead to problems like performance anxiety. As mentioned, performance anxiety is one of the biggest causes of ED. 

You may start avoiding sexual intimacy in such a situation. 
Also, guilt is a common symptom of depression, which leads to Erectile Dysfunction.

Relationship issues

Conflicts, poor communication, emotional disconnection, etc., are all signs of relationship problems. 

These can lead to stress and anxiety, which contribute to psychological ED. 

A lack of emotional intimacy in a relationship can also result in ED. When you are emotionally disconnected from your partner, it reduces your sexual desire.

Lack of sexual interest makes getting or maintaining an erection difficult.

Due to the communication gap in a relationship, you start assuming things differently. You may perceive a negative image of yourself. 

This leads to low self-esteem, which is a cause of psychological Erectile Dysfunction.

Excessive porn usage

Research says exposure to porn does not affect erectile function. It impacts your sexual desire for your partner. 

It can cause unrealistic expectations, leading to stress and guilt. 

This may indirectly result in trouble getting or maintaining an erection. 

Also, consuming excessive porn content can desensitize the nerves in the penis.

This may decrease response to real-life sexual stimulation activities.

Thus, resulting in psychological Erectile Dysfunction. 

As per a study, if it reaches the level of addiction, the risk of impotence rises by 60%.

Psychological Erectile Dysfunction symptoms

Erectile Dysfunction symptomsSource: Anton-Estrada
Erectile Dysfunction symptoms

Erection issues may happen occasionally. 

It is neither uncommon nor a big cause for concern. 

Yet, if it becomes a regular scenario, you might suffer from ED.

There are some symptoms of ED. If you experience any of these on a regular basis, consult a doctor immediately. 

  • Difficulty getting an erection
  • Inability to maintain an erection throughout sexual activity
  • Reduced sexual interest or desire
  • Avoiding sexual intimacy
  • Performance anxiety or fear of sex
  • Depression related to sexual activity

The above-mentioned symptoms might differ from person to person.

If you know these signs of psychological ED, it can improve by discussing with a doctor.

Psychological Erectile Dysfunction treatments

Several psychological ED treatments are available. 

They emphasize addressing the underlying mental health issue.

Cognitive Behavioral Therapy, relaxation techniques, and psychosexual therapy are the three most common treatments.

Medications may also be used sometimes to treat this type of ED. 

Here, we cover each treatment option in detail. 

Cognitive Behavioral Therapy (CBT)  

Cognitive Behavioral Therapy is a type of talk therapy.

It focuses on changing negative patterns of thinking to improve mental health.

Thus, helps in treating anxiety and depression, which may contribute to ED issues. 

If you have ED due to either of these mental health problems, then CBT might help you.

A study states that combining Sildenafil and CBT is superior to Sildenafil alone in treating psychogenic ED.

Relaxation techniques

Relaxation techniques can also be helpful in treating psychological ED. 

Techniques like deep breathing, yoga, and meditation might reduce stress. 

Since stress is a cause of psychological ED, relaxation techniques might improve ED.

Psychosexual therapy

Another therapy that can help treat psychological ED is psychosexual therapy. 

Sex therapy focuses on overcoming sexual dysfunctions.

It helps improve the physical intimacy between you and your partner. 

A 1992 study surveyed 36 couples who took sex therapy to treat their male partner’s ED. 

As per the above study, 69.4% of couples reported a positive outcome.


Healthline says oral ED medicines may not be fully effective in treating psychogenic ED.

This is because their effects are purely physical rather than psychological. 

But in some cases, physical factors can trigger ED, leading to performance anxiety. 

In these scenarios, medications such as Sildenafil and Tadalafil may prove beneficial.

They treat the physical symptoms of ED. Thus, reducing performance anxiety as a result.

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  • Sildenafil
  • Vardenafil
  • Tadalafil
  • How to prevent psychological ED

    You can take various steps to  prevent psychological Erectile Dysfunction.

    By adopting little changes in your way of living, you can maintain a healthy sex life. 

    Here are some of the steps mentioned.

    • Improve communication
    • Adopt a healthy lifestyle
    • Address anxiety and depression
    • Manage stress
    • Go for regular checkups
    If you are experiencing ED, do not wait for it to become worse. Consult a doctor right away. They will run some tests to know the underlying cause of your ED issues. According to those test results, they will determine the appropriate treatment.

    Frequently Asked Questions

    Is ED psychological?

    Erectile Dysfunction can happen due to psychological as well as physiological factors. Depression, anxiety, low self-esteem, etc., are the psychological causes that can trigger ED. In contrast, Diabetes, Hypertension, etc., are all physical causes of ED.

    How common is psychological ED?

    Studies have shown that 10%-20% of all cases of ED are due to psychological factors. But this percentage can vary based on the research and population studied.

    How do you fix psychological ED?

    There are various ways to fix psychological Erectile Dysfunction (ED). These include:
    Cognitive Behavioral Therapy (CBT), Lifestyle changes, Sex therapy, Medications
    Consult your doctor before getting any treatment for psychogenic ED. They will diagnose the underlying cause of ED and suggest the appropriate treatment.

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