Erectile Dysfunction Psychological Causes: Stress, Depression, and More

Pharmacology, Biochemistry and Behavior, 48(3), pp.

Saline is infused under pressure into the corpus cavernosum with a butterfly needle, and the flow rate needed to maintain an erection indicates the degree of venous leakage. Vasoactive gels can be produced in different dosage levels and with different mixtures of vasodilators, such as alprostadil, prostaglandin EL, phentolamine, and papavarine. EEG hemispheric asymmetry during sexual arousal: Journal of Abnormal Psychology, 94(4), pp. More recently, a new drug in this class, Levitra, was approved which functions using the same mechanism. These are some of the most common: What are your options if your inability to have or maintain an erection is due to a psychological problem? Arteriogenic (insufficient arterial blood supply) – Possible causes include atherosclerosis, HTN, hyperlipidemia, smoking, pelvic trauma and diabetes mellitus.

Paying attention to the signs of erectile dysfunction and finding the causes of ED will help you focus on the right approach for ED solutions. Need help or have questions?, this action can complicate medication management if veterans do not report use of these medications to VA providers. The sooner men seek help the easier it is to treat the problem. Ask yourself the following questions: Men may hold some imagined fantasy of good sex, which leads to pressure to perform.

Site of action in brain.

For example, a physical ailment could impede your body’s ability to get an erection. Physical examination. Sexual stimulation is required for sildenafil citrate to have the best efficacy.

  • ED is a frustrating condition that often causes problems in relationships and diminished self-esteem.
  • Voluntary control of penile tumescence among homosexual and heterosexual subjects.
  • Specific devices are mentioned for information only; mention should not be taken as endorsement.
  • Voluntary control of penile responses as a function of stimulus duration and instructions.

Erectile Dysfunction Treatment Options

For instance, a minor physical condition that slows your sexual response might cause anxiety about maintaining an erection. If communication is an issue, you and your partner may benefit from talking to a relationship counsellor. This can lead to a feeling of being not confident in that zone or area or not feeling confident enough to be a “penetrator” if penetration of the activity desired. Penile implants are generally considered a last resort treatment technique when tissue damage or deterioration is severe or when all other treatments have failed.

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. Prevalence of Erectile Dysfunction Among Young Adults: Inhibitory effect of GABAergic drugs in cocaine-induced genital reflexes in paradoxical sleep-deprived male rats. Working through these problems with your partner can help ease your symptoms of ED. Another facilitator of erectile dysfunction is stress, which can be related to their job money, marital problems, unresolved emotional issues occurring in the relationship, or even unresolved emotional issues from things not involved in the relationship. They also include steroid abuse by bodybuilders, too much or too little thyroid hormone, and hormones used to treat prostate cancer.

Neuropharmacology, 35(3), pp. Today more than ever, science is telling us that the body and mind are closely connected. The normal physiology of erection involves a complex series of events. Physical causes, testosterone supplementation is not recommended for men who have normal testosterone levels for their age group due to the risk of prostate enlargement and other side effects. Treatment of male erectile disorder: This may include concerns about getting someone pregnant, not wanting to appear inexperienced, or worrying about using a condom without embarrassment or losing your erection while putting a condom on. Some of these areas also affect your sex drive and ability to have an erection. Psychologically based treatment for male erectile disorder:

  • This is particularly common if you are dealing with a partner who is very critical or verbally abusive.
  • Implants can be hydraulic, semi-rigid or soft silicone and consist of two or three cylinders placed in the space normally occupied by the spongy tissue in the penis.
  • The first, primary erectile dysfunction, is when a man has never had an erection.

Reassuring The Patient

Men recovering from prostate surgery are prone to erection dysfunction as well. An analysis of the case for funding. Sleep investigations in erectile dysfunction. A case for early androgen use in postprostatectomy hypogonadal men.

Joshua Matacotta: Do Gay Men Fear Intimacy?

Research shows that most healthy men occasionally experience erectile dysfunction or failure. Effects of pelvic nerve and pudendal nerve transection on mating behavior in the male rat. While psychological issues may be at the root of your problem, they are just as valid as many physiological causes for ED. Impotence can be simply a result of anxiety in performance in bed, especially if there is no other condition that can be traced to it. Key facts of ed, your health care provider may also suggest treating emotional problems. When the brain is dealing with stress, it becomes much harder to remain focussed on intercourse.

Psychological aspects of erectile dysfunction. The assessment of nocturnal REM erection in the differential diagnosis of sexual impotence. Testosterone replacement therapy is available as a cream or gel, topical solution, skin patch, injectable form and pellet form placed under the skin. Here’s how the cycle starts: Hormonal problems — Abnormal levels of certain hormones can interfere with erections and sex drive. Hormonal problems, kidney disease, liver disease, excessive alcohol ingestion, and infections can also cause ED. Because men are expecting the impossible from themselves, they often develop performance anxiety due to feelings of inadequacy and guilt.

Outcome results and a new direction. She was just so angry. The above policy is based on the following references:, moreover, they noted significant improvement in penile curvature and patient reported outcome symptom bother scores, suggesting that this may be a safe, non-surgical alternative for Peyronie disease. Penile erection is managed by two different mechanisms. Sexual responses to consenting and forced sex in a large sample of rapists and nonrapists.

Young Men

Some antidepressant medications cause erectile failure. What causes erectile dysfunction? What is erectile dysfunction? He may choose to take these routes on his own or with his partner. A pump and two cylinders are placed within the erection chambers of the penis, which causes an erection by releasing a saline solution; it can also remove the solution to deflate the penis.

Improved Procedure for Cancer-Related Erectile Dysfunction

Concordance between physiological and subjective measures of sexual arousal. A six to twelve week course of sex therapy has been useful in such cases as well. Journal of Research and Treatment, 7(1), pp. Persistent, unwanted erections in an 8-year-old boy. Please contact us to schedule an appointment at 1-866-844-2273. Viewing time as a measure of sexual interest. It is the most common cause of ED, especially in older men.

It is important to take note of the signs of your erectile dysfunction, find the causes specific to you and get prompt medical attention. Novel actions, deleterious effects, and clinical potential (pp. )However, if one is noticing that erection is not lasting, even though an occurrence of orgasm occurs, there is likely some medical or biological impact going on.

There are some ways to analyze erectile dysfunction. To find out more about the cause of your ED, and to find out the best treatment options for you, you can complete a free online consultation with one of our doctors at the link below. The best treatment for psychological ED will address the problem at its root. Guilt can also happen as a result of strict religious upbringing regarding sexuality which can also lead to ED. While psychological factors may play a role, there are often underlying physical or physiological causes that result in the inability to attain or maintain an erection. A meta-analysis. J Am Coll Cardiol. Smoking, excessive alcohol use, being overweight and not exercising can also lead to ED.

Journal of Neuroendocrinology, 14(5), pp.


For example, a history of sexual abuse or other traumatic sexual experience may be helped by treatment by a psychologist. ED is often strongly linked to performance anxiety. Furthermore, people with a low self-esteem are more vulnerable to experiencing guilt, depression, anxiety and fear of rejection. There are no formal tests to diagnose erectile dysfunction. Most men have heard of losing their erection during sex and are scared of it happening to them. Sleeping and waking-state measurement of erectile function in an aging male population.

These can also be very beneficial for patients with predominantly physical ED, when used in conjunction with erectile dysfunction medication.

Search For More Therapy Techniques:

Psychogenic erectile dysfunction on the other hand, is described by one study as that largely caused by psychological or interpersonal determinants. Archives of Sexual Behavior, 8(2), pp. Cavernosometry/cavernosography - invasive testing to determine the capacity of penile tissue to trap blood, by measuring its ability to trap infused saline under pharmacological stimulation. Pharmacology, Biochemistry and Behavior, 31(3), pp. These include type 2 diabetes, cardiovascular issues or pulmonary problems, for example.

How Sexual Health Clinics Can Help With Erection Problems

A physician measures the latency between squeeze and contraction by observing the anal sphincter or by feeling it with a gloved finger inserted past the anus. The effects of group desensitization on secondary erectile failure. Journal of Consulting and Clinical Psychology, 45(5), pp. The psychometric properties of the penile tumescence assessment of child molesters. Journal of Sleep Research & Sleep Medicine, 12(3), pp.

ED is a symptom that is linked to many health problems such as: The media does a horrible job of teaching us how to be sexual. However, the combination of lifestyle modifications and PDE-5 inhibitors may more effectively improve erectile function than either method alone. When the problem is arterial, it is usually caused by arteriosclerosis, or hardening of the arteries, although trauma to the arteries may be the cause. Please help to improve this page yourself if you can. Psychological erectile dysfunction characteristics include the following: Taking nitrates with one of these medications can lower blood pressure too much. Bonierbale-Branchereau, M.

Countless men suffer from psychological erectile dysfunction (or ED) – an inability to get or maintain an erection. But, when your brain and body are focused on surviving a threat, getting an erection is simply not the sort of physical response that is prioritized! Sexuality and Disability, 22(2), pp.

Acute illness - See all treatments and conditions

Patient/partner satisfaction with penile implant surgery. Journal of Consultation Liaison Psychiatry, 23(4), pp. A review of the experimental and clinical literature. If you are a Health Provider looking to refer a patient, please visit the Health Provider informational site. It is not uncommon in new relationships, where a man might be nervous about a sexual encounter and eager to impress their partner. Differential erection response patterns of sexual child abusers to stimuli describing activities with children.

Another possible reason for impotence is confusion on one’s sexual preference. — Many medications cause problems with sexual function. Performance anxiety is a widespread psychological phenomenon that affects many aspects of life, not just sex. Depending on your answers, and the results of your laboratory tests, your doctor may recommend a psychological evaluation to further explore the potential cause for your ED. Most cases of ED have a physical cause, such as heart disease, diabetes, and obesity.

Again, dedication and investing time in the exercises outside of sessions are needed for maximum effectiveness.

To Sum Things Up

However, as stated before, they often coexist. Causes of ED can be medical or age-related – but there are also many men who suffer from psychological erectile dysfunction. In the past, erectile dysfunction was commonly believed to be caused by psychological problems. This may reveal conditions or diseases that lead to impotence and help distinguish among problems with erection, ejaculation, orgasm, or sexual desire. These are two probable medical conditions which are related to erectile dysfunction. I've been a psychotherapist trainer since 1998, specializing in brief, solution focused approaches.

, & Schwarz, E.
Doctors now know that physical factors cause impotence in most men with the problem.

Health Solutions From Our Sponsors

What’s the significance of a morning erection? Identifying specific erotic cues in sexual deviations by audiotaped descriptions. Journal of Men's Health & Gender, 3(1), pp. It also plays a crucial role in helping you to get an erection! The counselor can also provide you with activities and tips to improve trust and communication within your relationship. Central oxytocinergic and dopaminergic mechanisms regulating penile erection in conscious rats. That’s not to say that causes can’t be intertwined; they certainly can. Psychopharmacology, 105(2), pp.


However sex therapy is not widely available on the NHS, you can look for qualified registered therapists on the College of Sexual and Relationship Therapists (COSRT) or the Institute of Psychosexual Medicine. The good news is that there are solutions that can help address the problem. Results have been mixed and are not at all guaranteed, although progress is more likely to be achieved if both partners approach sessions with an open-mind and willingness to share. Brinkley began a fad for finding cures for male impotence during the 1930s. Guided imagery – This practice involves calming your mind and slowing your breathing while creating peaceful imagery in your head. Or, sex can be lovemaking. Central initiators of erection such as apo SL can help to break the failure cycle by removing the anxious inhibition related to anticipation of failure.

It's usually nothing to worry about, but you should see a GP if it keeps happening. To restore access and understand how to better interact with our site to avoid this in the future, please have your system administrator contact [email protected] Maybe it’s your job or a difficult life event; maybe it’s conflict at home or financial concerns. Sexual and Relationship Therapy, 15(4), pp. You may not know what turns you on the most. The tube (and penis) can then be made erect by the man manipulating a pump in the scrotum.

The assessment of sexual functions in women with male partners complaining of erectile dysfunction: It could be not knowing what the other person wants because the lack of communication or conversation regarding sexual behavior. Physiology & Behavior, 49(6), pp. Sex needs to be relaxed, spontaneous, and fun; a chance to deepen intimacy and be totally absorbed in the immediate. In general, exercise, particularly of the aerobic type, is effective for preventing ED during midlife. Sensate focus is considered to be the cornerstone of sex therapy. Let’s take a look at some effective options for taking back control. Neuropsychobiology, 47(2), pp.

Diagnosis of Male Pattern Baldness

They will be able to provide advice, or if appropriate, suggest a short-term treatment which can help to get you through a difficult period and restore confidence. Understanding PDE5 Inhibitor Treatment Seeking Patterns, among Men with Erectile Dysfunction. Group treatment of single males with erectile dysfunction. A pragmatic approach addressing organic and psychogenic components. How successful is this treatment? While we are not against drugs as one possible pathway to greater confidence, we believe starting with more natural, holistic solutions should be first. What’s the brain science behind this? Performance anxiety can be the original cause for ED, or it could be a result of a bad sexual experience.

One way to expunge erectile dysfunction is to take the pressure out of sex.

For men, however, depression isn’t always an easy diagnosis. Journal of Psychiatry & Neuroscience, 20(3), pp. The following are some of the different types and possible causes of erectile dysfunction: They will be able to assist you by pointing you in the direction of a therapist.


Let’s say that getting erect whilst masturbating is not a problem. One study has shown that prescription treatments like Viagra can improve cases of ED in depressed males and, to some extent, alleviate depressive symptoms. Once this happens once, the man’s self-esteem takes yet another blow. If you're concerned about erectile dysfunction, talk to your doctor — even if you're embarrassed. What explanation is there for a 30-year-old man in perfect health to experience erectile issues? These stress hormones prevent our bodies from achieving an erection. He used the medium of radio to achieve the same kind of advertising boom to treat the same kind of symptoms. Sensory requirements for noncontact penile erection in the rat.

A comparison of the value of nocturnal penile tumescence monitoring and visual sexual stimulation assessment in the diagnosis of erectile dysfunction. Sex therapy is particularly useful for addressing ED caused by stress and poor sexual communication, as opposed to deeper psychological or sexual issues. She was late again and again, but we soon learned that it didn’t mean anything. A very smart man, psychologist, and mentor of mine.

An intermittent problem with getting an erection may be considered a normal part of life.

Aside from being referred by your GP, there are a number of places that provide therapy. A 66-Year-Old Man With Sexual Dysfunction. If allowed, it can reinitiate a positive sexual experience for the couple, which, while very important, does not provide a complete solution to the problem. They’re far from uncommon, and can be caused by any number of factors. Place of behavior therapies. The first line of treatment is typically a form of PDE-5 inhibitor (Viagra, Levitra, Staxyn, Stendra, or Cialis). Apocodeine-induced stereotypies and penile erection in rats.

Progress in Neuro-Psychopharmacology & Biological Psychiatry, 21(6), pp.
  • A retrospective analysis.
  • Variability of stimulus effect in the course of phallometric testing.
  • It may just make the situation worse.

External Links

The need to break out of the vicious cycle created within a relationship by ED ensures that any effective long-term therapy will need to provide a global approach that treats anxiety and relationship issues in addition to the ED. In such cases, it is important to talk about the problem sooner rather than later. Hypertension, diabetes, exhaustion, too much alcohol, and poor diet can all interfere with our sex lives. In order to meet the diagnostic criteria, these symptoms must have persisted for at least six months and must have occurred on at least 75% of occasions. Guilt can facilitate erectile dysfunction. This sudden influx of blood causes an erection by expanding, straightening and stiffening the penis. Sometimes issues at work, periods of financial strain, or stress related to just about any area of your life can have a significant effect on sexual performance too.

Causes Of Performance Anxiety

Chlordiazepoxide facilitates erections and inhibits seminal emission in rats. Speaking openly with your partner can help you to realize whether some of the expectations that you have for yourself are unrealistic. “This time she sort of went crazy. Erections not rigid or full, or are not maintained after a time, is a sign that there is a problem in the person. Since the response to the pills is not immediate, medication forces you to plan sex in advance and can destroy the magic of spontaneity. Sometimes, treating an underlying condition is enough to reverse erectile dysfunction. Organic ED involves abnormalities the penile arteries, veins, or both and is the most common cause of ED, especially in older men.

Neither drug should be taken more than once every 24 hours. They may also ask you to practice sexual yoga and mindful masturbation to get you more connected to your body, your arousal, and your pleasure. They help you sort out who you actually want to have sex with, and what kind of sex will be most arousing for you.

How Can You Tell If Your Erectile Dysfunction Is Psychological?

Measurement of testosterone in the blood is often done in men with ED, especially with a history of decreased libido or diabetes. Erectile dysfunctions: Safety and efficacy of sildenafil citrate in the treatment of male erectile dysfunction. Furthermore, depression is linked to changes in your brain chemistry and nervous system. Find your zen., numerous self-help techniques can contribute towards the alleviation of symptoms, such as limiting alcohol intake, quitting smoking, cutting down on fatty foods, and reducing stress. She even felt pregnant. Blood outflow can be measured by injecting agents such as papaverine into the penile corpora cavernosa. As you can imagine, these symptoms can make it difficult to take pleasure in much of anything, let alone sex.

, & Wolfinsohn, L.

Management of erectile dysfunction by the geriatrician. Research notes that there is a clear link between a man’s state of mind and his ability to perform sexually. Semi-rigid Penile Prosthesis. GABAergic regulation of penile reflexes and copulation in rats.

  • An integrative treatment protocol (ITP).
  • Laumann, Paik, and Rosen (1999) reported approximately 7% of men ages 18 to 29 years have erectile problems compared to 18% of men ages 50 to 59 years.
  • Depression and anxiety are more common in men with ED.

Effective Medications and Procedures

A model for men's health. Penile tumescence monitoring during morning naps to assess male erectile functioning: The first drug of this new class, Viagra, has received widespread attention and use. The causes of ED may include: Autonomic responses of transsexual and homosexual males to erotic film sequences.

What Type Of Erectile Dysfunction Solutions Are Available?

Response magnitude and method agreement. Postmodern sex therapy for erectile failure. Journal of Sex Education & Therapy, 16(1), pp. Harris, Carol A : This primes us, physically and mentally, to evade danger. Pharmacology, Biochemistry and Behavior, 53(3), pp. This is the number one way to combat ED! Archives of Sexual Behavior, 13(1), pp.

Normal erections during sleep and in the early morning suggest a psychogenic cause, while loss of these erections may signify underlying disease, often cardiovascular in origin. Journal of Sexual Medicine, 6(10), pp. Biomedical treatments for ED include vacuum devices and constriction rings, intracavernosal injections, intraurethral pharmacotherapy, topical pharmacotherapy, oral pharmacotherapy, and penile implants. This may come as a result of age and a subsequent loss of interest in sex, be the result of medications or stemming from problems in a couple's relationship.

Medical ED can be the result of diabetes or prostate surgery.

All forms of psychological illness still carry with them a degree of stigma and a reluctance to admit that they exist. Other men came to me because they had been sexually abused in the past and now associated sex with threat and shame. From herbal remedies to designer drugs. Many men might also prefer a non-invasive means of approaching their ED, as an alternative to penile injections.

Federated Search Page Form block

Sexuality and Disability, 22(3), pp. They were to do it outside of his wife’s most fertile time, just to “instigate intimacy” but not to “get an erection”, or at least “not for now”. If you find yourself in this situation, you may also feel like your inability to have sex profoundly impacts your relationships with your partner, affects your self-esteem, and reduces your overall sense of health and well-being. Acupuncture, in conclusion, increasing comorbidities and pathological changes in the erectile tissue and the supplying vessels result in a high prevalence of ED in the geriatric population. This can be particularly helpful at the beginning of a relationship – taking pressure off can sometimes help you function better. Keep reading to learn more about the psychological causes of ED and what you can do to resolve them. It’s natural for men to ‘rise and shine’ with an erection after a good night’s rest.

Evidence for naltrexone stimulation of erectile activity in patient therapy.