Published Sep 19, 2023

Erectile dysfunction and mental health

Jake Bissaro
Written by
Jake Bissaro
Dr. Sudip Bose
Medically reviewed by
Dr. Sudip Bose
A handsome senior Black couple wearing long shirts sit looking at each other on a couch in a pretty living room.
Published Sep 19, 2023

Key Points:

  1. Mental health issues like depression, anxiety, stress and low self-esteem can contribute to erectile dysfunction (ED). When that happens, it’s referred to as psychogenic erectile dysfunction.
  2. Young people (especially) experience this type of erectile dysfunction. Counseling or therapy can help.
  3. If counseling or therapy doesn’t reverse ED, an online ED doctor can help you find a safe, effective prescription treatment.

Erectile dysfunction (ED) happens when you can’t consistently maintain or achieve an erection firm enough for sex. Sometimes called impotence, the condition is more common with advanced age. But it affects younger people, too. One study concluded that 25% of new ED cases happen in those under 40.

ED can be caused by a host of factors, including health issues, taking certain medications or alcohol use. Psychological or mental health issues can trigger ED, too. When that happens, it’s called ​​psychogenic erectile dysfunction.

Here, we explore how mental health affects ED. Plus, how you (or your partner!) can get safe, effective erectile dysfunction pills online with help from Dr. B.

How do the brain and body make an erection?

Erections require a complex series of actions. To make a penis erect, emotions, muscles and hormones must work together.

Here’s a summary of that process.

  • First, the brain is stimulated by a sexual or emotional trigger. It then triggers nerves in the penis, telling them to relax.
  • Next, blood flows into the penis, filling in spongy tissue.
  • Blood pressure then increases in the corpora cavernosa chambers. This expands the penis and creates an erection.
  • The tunica albuginea membrane traps the blood in the corpora cavernosa to sustain the erection.

Some long-term health conditions like diabetes, heart disease and high cholesterol can trigger ED as a side effect. Regularly drinking alcohol in large quantities can increase ED risk, too. So you may wonder, “If I stop drinking, will my ED go away?” No matter your health problems, you should always seek guidance from a licensed health provider before trying a treatment for erectile dysfunction.

What psychological causes impact erections?

Sexual arousal is a complex process that’s as mental as it is physical. So erectile dysfunction often stems from psychological issues. In fact, causes of erectile dysfunction in your 20s and 30s are more likely to stem from psychological—rather than physiological—problems.

Such psychological issues include:

  • Depression. One study identified a clear link between depression and ED. Men are often reluctant to seek help for depression (like cognitive therapy). But therapy for other issues often improves ED, too.
  • Anxiety. Common anxiety symptoms include tiredness, blood pressure issues and increased heart rate. These can trigger or worsen ED.
  • Relationship issues. Emotional issues in a relationship can affect what happens in the bedroom. Poor communication or anger at one’s partner can negatively impact sexual function. Working out these issues with the help of a couple’s counselor can help address relationship triggers.
  • Low self-esteem. Negative, self-directed thoughts can make it difficult to relax and lead to ED. These include concerns around the ability to please your partner, early ejaculation or other issues.

How erectile dysfunction causes stress and anxiety

After someone experiences ED, they may doubt their future ability to achieve an erection. Also called performance anxiety, this can exacerbate ED and lead to a worsening cycle.

How long does temporary erectile dysfunction last?

If the source of ED is psychological, symptoms may come and go.

  • You may get regular, incidental nocturnal erections—but struggle to get hard otherwise.
  • ED may come on suddenly in one circumstance—but not happen in another.
  • You may be able to get hard—but not sustain the erection.

Fortunately, most people with psychogenic erectile dysfunction respond very well to ED medications. The phosphodiesterase type 5 (PDE-5) inhibitors include Cialis and Viagra. So if you’ve already started to address the underlying causes of ED, you may be ready to get such ED meds online.

How do you treat psychological erectile dysfunction?

Taking active steps to improve your mental health can boost your sex life. So if you’re ready to treat erectile dysfunction at its source, talk to a medical provider. They may have you consider therapy, medication or couples counseling.

Before your consultation, consider the following:

  • Are you experiencing higher-than-normal stress levels?
  • Do you experience sexual attraction to your partner?
  • Do you feel stressed about pleasing your partner sexually?
  • Do you get morning erections (morning wood)?

Erectile dysfunction prescription medications like Tadalafil (Cialis), Avanafil (Stendra) and Vardenafil address the physiological causes of ED by improving blood flow. But they won’t address psychological factors like mood, feelings or sexual desire.

So while these medications may bolster a more significant treatment strategy, the best way to treat ED is to treat the root cause. Addressing psychological factors often requires patience and effort—plus help from a psychologist or counselor.

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Sources:

Capogrosso, P., et al. (2013). One patient out of four with newly diagnosed erectile dysfunction is a young man--worrisome picture from the everyday clinical practice. The Journal of Sexual Medicine.

Liu, Q., et al,(2018). Erectile dysfunction and depression: A systematic review and meta-analysis. The Journal of Sexual Medicine.

Rosen, R.C. (2001). Psychogenic erectile dysfunction: classification and management. Urologic Clinics of North America.

Yafi, F.A., et al. (2016). Erectile dysfunction. Nature Review Disease Primers.

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