Our expert says:
In some cases, men who experience abuse
or sexual trauma in childhood may develop erectile issues later in life. If you
have had this kind of experience, the chances are good that erectile
dysfunction is not your only struggle and you should seriously consider seeking
professional help. Though childhood trauma is a completely valid reason for
developing ED, we’re going to focus on the psychological issues that develop
later in life.
When erectile dysfunction is caused by
psychological triggers, it is referred to as psychological impotence. Some of
the most common causes of this type of ED include the following:
Many of these triggers are correlated
and you may be affected by more than one. Let’s now take a closer look at each
of these causes for psychological ED.
Stress and Anxiety
Though stress and anxiety are two
different things, they are closely related when it comes to issues of erectile
dysfunction. In many cases, stress is the underlying factor, but it causes
anxiety which then triggers more stress – it is a vicious cycle. If you take a
look at the physical side of things, however, you’ll see that stress and
anxiety are even more closely related than you may realize.
Many men do not realize that there are
different types of erections – three, to be exact. A reflexive erection is due
to physical stimulation while a psychogenic erection is triggered by visual or
mental images. A nocturnal erection is one that occurs during sleep.
All three of these involve specific
bodily systems including the hormones, muscles, blood vessels, nervous system,
and emotions. If any of these systems become compromised, it can cause ED. In
the case of anxiety and stress, these things can affect the brain’s ability to
send the necessary signals to trigger the desired physical response – an
erection. Stress and anxiety can also contribute to an ongoing cycle of ED, as
To give you some evidence of the link
between anxiety, stress, and ED consider the results of a study published in a
2015 edition of Comprehensive Psychiatry. In a study of case
records for 64 men with erectile dysfunction or premature ejaculation, there
was a significant link between ED and anxiety disorders or depression. Of the
64 participants, 8 had comorbid depressive disorders and 15 had anxiety
disorders. In the majority of patients, these disorders predated the onset of
sexual dysfunction which suggests that the disorders may have been a contributing
Cultivating and maintaining a healthy
relationship is not easy. It takes time to truly get to know someone and to
trust them. If you and your partner are experiencing trouble with your
relationship, it could very well bleed over into your sex life. It could also
be the case that your erectile dysfunction is creating problems in the
relationship – it is another example of the cycle of ED that can affect many
different aspects of your life. Communication is the first step in resolving
this particular cause for psychological ED but it is also one of the most
difficult steps to take.
Unless you have experienced depression
for yourself, you may think of it as something akin to sadness. While
depression may cause feelings of sadness, it goes much deeper and it tends to
linger well beyond any specific cause or trigger.
Depression acts much like an anchor,
weighing you down in body and mind, affecting all aspects of your life –
physical and mental.
Some of the most common symptoms of
depression include the following:
of sadness, emptiness, or hopelessness
outbursts, irritability or frustration
of interest in most or all normal activities
or lack of energy
agitation, or restlessness
of worthlessness or guilt
thinking or concentrating
In many ways, performance anxiety
becomes a self-fulfilling prophecy wherein you become nervous about being able
to satisfy your partner and the nerves lead to sexual dysfunction. In many
cases, performance anxiety is triggered by negative self-talk –
worries about being able to achieve an erection, pleasing a partner, or
ejaculating too early. If you have had erectile issues in the past, those
experiences will add to the weight of performance anxiety.
Guilt and Low Self-Esteem
Many men who suffer from erectile
dysfunction feel guilty about being unable to please their partner. If the
problem persists, the guilt becomes more than just a side effect – it can
contribute to the ongoing cycle of ED as well. Guilt is often paired with low
self-esteem, and not just in men with erectile dysfunction. Guilt and shame are
feelings that are commonly linked to mental health issues such as depression.
In fact, feelings of worthlessness and inappropriate guilt is one of the
clinical criteria for major depressive disorder, according to the DSM-5.
Not only can guilt affect your ability
to perform sexually, but so can low self-esteem. The correlation between
erectile dysfunction and low self-esteem seems obvious from one direction – an
inability to perform in the bedroom can cause you to feel bad about yourself. But
how does low self-esteem cause ED? Self-esteem is defined as, “confidence in
one’s own worth or abilities.”
While self-esteem can be affected by
the perceptions of others, it is largely how you feel about yourself. If you
have a negative view of yourself and your abilities, it is going to color your
experience and actions on a daily basis. Many people with low self-esteem get
so caught up in their own perception of themselves, that they begin to project
it onto others. For example, a man with low self-esteem might believe that he
is not capable of satisfying a woman and, as a result, he becomes unable to
perform in the bedroom. Low self-esteem can also be a sign of other
psychological issues such as depression.
Pornography addiction or dependence is
a potential cause for ED that many men fail to consider. If you spend a great
deal of time watching and masturbating to pornography, it could cause you to
develop unrealistic expectations about sex or about your sexual partners. When
this happens, your brain becomes “trained” to not only expect but, in a way, to
need that kind of experience in order to achieve arousal and climax.
Researchers have actually studied this effect and have given the condition its
own name – pornography-induced erectile dysfunction (PIED).
The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal
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