What Are the Psychological Factors Involved in E.D.?

As we have written before, nearly 12% of American men suffer from erectile dysfunction (E.D.) That is more than twice as many as suffer from cancer. Yet shame and stigma often stop men from seeking help.

In our blog post, What Causes Erectile Dysfunction, we discussed E.D. in general and some of its causes. Most physically-caused cases of erectile dysfunction stem from a handful of diagnoses including diabetes, high blood pressure, obesity, and heart disease – all of which affect blood flow. If you are suffering from any of these overarching causes, resolving these may eliminate the E.D. problem entirely.

RELATED: Performance Anxiety ED: How to Overcome Fear Of Sex


In this article, we look beyond the physical causes of E.D. and expand on the psychological factors that can cause it as well. For those men who are basically healthy and still suffering occasional E.D. and under circumstances that point to psychological factors, there are several ways in which our frame of mind can affect our sexual experience and performance.

It has been estimated that no less than 10% and as much as 20% of all erectile dysfunction cases are attributable to psychological factors rather than physical ones.

To illustrate psychological factors in erectile dysfunction, consider the example of a healthy 35-year-old man who is able to achieve and maintain an erection at home alone and can masturbate to completion. This man has no physical E.D. as proven by his ability to remain erect and masturbate to completion in privacy. But many men who are able to do this also experience E.D. issues when in sexual scenarios with a partner present. This E.D. that shows up only under pressure is a good example of psychological erectile dysfunction, and there are several underlying causes.


Beyond Physical Here Are The Psychological Factors That Can Cause E.D.

1. Childhood Trauma

Unpleasant memories stemming from traumatic childhood events can create mental blocks against sexual intimacy that manifest as psychological E.D. This cause is actually the least prevalent but can be challenging to move past. Speak with a doctor or therapist about troubling thoughts that enter your mind consistently when sexual encounters arise. They may be carrying baggage of early traumas.


2. Stress

Man-stressed-while-working-on-laptop- | What Are the Psychological Factors Involved in E.D.?

Stress at work. Stress at home. Stress about money, health, marriage – STRESS! When you experience stress, your body responds by secreting a hormone called cortisol. Cortisol can inhibit your body’s natural ability to produce testosterone, which can affect libido, erection, and stamina. Stress can also interfere with the neurotransmitters responsible for communicating desire, which may depress both interest and erection.

RELATED: How Common is ED in Young Men?


3. Performance Anxiety

Performance anxiety is the fear of inadequacy in action. When our minds harbor concerns about our ability to perform, it can become a self-fulfilling prophecy, reducing our ability to perform based solely on the fear of the same. This problem becomes cyclical: anxiety causes E.D. which causes anxiety. This loop can be difficult to depart but in reality, is purely psychological – not physical.


4. Depression

Depression can cause erectile dysfunction in otherwise sexually and physically healthy men. Because depression unsettles the psyche, many depressed people narrow their thinking to remove unnecessary stresses. Nonessential functions like intimacy and desire tend to be sidelined by the brain in those that suffer from depression. To make it worse, antidepressant drugs often cause E.D. To move past this, discuss your scenario with the doctor who prescribed the antidepressants to see if a better regimen is available.


5. Self Esteem Struggles

The act of seduction is one requiring enthusiasm, confidence, and a sense of well-being. Fear of rejection is most acute in those struggling with self-esteem, and this fear can lead to erectile dysfunction. Self esteem comes from performing esteemable acts, so recommit to the gym and to your grooming and dressing routines to heighten your confidence in this area.

Most of the physical causes of E.D. are absent in younger men. So psychological causes of erectile dysfunction are much of why young men experience E.D. at all. To determine if you are suffering from psychological causes of E.D., ask yourself these questions:

  • Do you have known psychological causes of E.D., like depression or childhood trauma?
  • Are you able to maintain an erection well enough to masturbate to completion, but experience erectile dysfunction when in a sexual scenario with a partner?
  • Are their lifestyle factors involved, like smoking, alcohol consumption, or recreational drugs?


Seek help if you answered yes to any of these questions or if ED is causing discord between you and your sexual partner. It is a lot to think about – we get it. If you have questions about psychological causes of erectile dysfunction or any of the conditions discussed here, connecting with a doctor in a discrete setting has never been easier.


Opt Health is a telehealth platform that reconnects men with wellness, fitness, strength, and sexual vitality through scientific preventive medicine. From your own home, you can schedule with a physician, meet one-on-one via video conference, receive test results, and have medications delivered to your door.

For questions, inquiries, or appointments, don’t hesitate to contact us. Get personalized support and insight from top-tier physicians available 24/7.

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