Psychological Erectile Dysfunction

Causes of Erectile Dysfunction

Erectile dysfunction (ED) is a medical term that describes the inability to achieve and/or maintain an erection adequate for sexual function. ED has many causes, but one of the more common is psychological erectile dysfunction. This condition, sometimes called mental impotence, is one of the most common sexual issues for men and it increases with age. It is estimated between 15 to 30 million American men suffer from ED.

But just because you’re below a certain age doesn’t mean you’re safe. According to a study from the Journal of Sexual Medicine, one out of every four erectile dysfunction patients is under 40 years old. With increasing ED rates have during the last twenty to thirty years, especially among younger men, erectile dysfunction treatment has become a hot subject.

Before we delve into the relationship between the mind and the penis, these videos can catch you up on how the most popular and cutting edge treatments work on a physiological level:

There Are Different Kinds of Erections?

Achieving an erection is a complex process involving psychological impulses from the brain (psychosocial prompts), adequate levels of testosterone, a functioning nervous system, and an adequate and healthy vascular system. A simple history check, exam and lab work can rule out physiological causes, but what about the psychosocial causes that play a large role in achieving and maintaining erections?

There are three different types of erections. The first one is a nocturnal erection that occurs during sleep. Another is a reflexive erection due to physical stimulation. And the third one is a psychogenic erection, caused by visual or mental images. All three involve healthy bodily functions including hormones, muscles, blood vessels, nervous system and emotion regulation.

So What Causes Psychological Erectile Dysfunction?

If everything checks out physically, often the case with younger men, it is found that the psychosocial or psychological components are the cause of ED. So what are the most common triggers for psychological ED?

1. Stress

Life stressors are abundant. From work obligations, busy schedules, financial concerns or relationship issues, stress can take your head out of the game quickly. Since stress is so abundant, it’s one of the leading causes of ED when it comes to psychosocial impotence.

2. Performance Anxiety

One or two poor experiences can cause a self-fulfilling prophecy. Once nervous about being able to perform sexually, it can lead to further poor performance. Worry about achieving or maintaining an erection, negative self-talk, concern about pleasing a partner or thoughts about ejaculating too quickly adds to the anxiety.
Also, if there have been erectile issues in the past, those experiences will add to the weight of performance anxiety. If you believe this might be the cause of your ED, talking to your partner can help. And as always, AUI has plenty of resources in our arsenal.

3. Substance Use/Abuse

Alcohol, narcotics, marijuana, cocaine and most illegal drugs not only cause a decrease in the ability to perform due to difficulty with focus and thought, but will also interfere with the body’s natural process to achieve and sustain an erection. Not only may it temporarily cause difficulty with erections, but studies have noted a link between low testosterone and substance abuse/use. Testosterone plays a crucial role in erections. If you believe substance abuse might be causing your erectile dysfunction, a good place to start might be your local clinic or AA. We’ll be waiting to welcome you with open arms.

4. Depression/Anxiety

Depression and anxiety can also be potent causes of ED as it affects a person both physically and psychologically. Typical signs of depression and anxiety are:
– Feelings of sadness, emptiness, or hopelessness
– Angry outbursts, irritability or frustration
– Loss of interest in most or all normal activities
– Tiredness or lack of energy
– Anxiety, agitation, or restlessness
– Feelings of worthlessness or guilt
– Difficulty thinking or concentrating
– Feeling nervous, restless or tense
– Having a sense of impending danger, panic or doom
– Constant worry thoughts
Any of these symptoms can cause a loss in sexual desire and affect the body’s ability to perform normally– which includes ED. Additionally, many prescription medications often prescribed to treat depression and anxiety can also contribute to ED and low libido. When considering erectile dysfunction treatment, be sure to tell your provider all of the medications your taking.

5. Guilt

If unable to please a partner, if prior issues of infidelity, or other relationship issues are on the mind, than it’s common for it to inhibit erections. This can contribute to an ongoing cycle of ED, much like performance anxiety. Guilt can weigh heavy, so when it’s causing ED people can fall into a hole. The key here is to keep your head, and try to stay as confident as possible. But when you have us as a more than available resource, confidence comes second hand.

6. Low Self Esteem

The correlation between erectile dysfunction and low self-esteem seems obvious– an inability to perform can cause poor perception of oneself. Confidence in one’s abilities can be affected by the perceptions of others, as well, but largely by how one views oneself. If there is a negative view of yourself and your abilities, it will display itself in many different ways in your life, including your sex life. It can also be a sign of depression or be brought on by guilt or performance anxiety.

7. Indifference

When indifference causes ED, it usually has to do with your partner, low testosterone, depression, trust issues with the partner or disinterest/lack of connection with the sexual partner.

8. Relationship Problems

Fighting, lack of interest of sexual desire, performance anxiety, stress or pressure by your partner, abusive relationships, stressful family life, lack of time, poor scheduling and life stressors that can interfere with you and your partner’s ability to connect, poor communication, and discomfort during sex can create a perfect storm for ED. Relationship problems tend to house most of the causes of ED, and are usually at the root of the problem.

9. Pornography Addiction

A lot of time spent watching and masturbating to pornography can cause unrealistic expectations about sex or sexual partners. The brain can become “trained” to expect and need that kind of experience in order to achieve arousal for ED. This effect is so common it has its own diagnosis – pornography induced erectile dysfunction or (PIED).

All men, at some point, will experience ED. If the problem becomes persistent or becomes stressful, then it’s appropriate to seek out medical care to discuss possible ED treatment options to uncover, address and decrease the psychosocial and psychological barriers causing ED. Recommended treatment options may include medications, breathing techniques, meditation, guided imagery, exercise, discussion with your partner or therapy.

Facing Psychological Erectile Dysfunction

Above all else, we remind our patients and everyone in our community to keep their head. Beating yourself up about your condition won’t make things any better. The best place to start is with a consultation with one of Austin’s best urologists, where we can diagnosis what’s causing your ED and how we can treat it.