The Psychological Causes of Erectile Dysfunction

Erectile dysfunction (ED) can have a multitude of causes, from hormonal imbalances to injury to the more esoteric. Today, we will go through some of the possible psychological causes of ED, and what can be done about them.

Erectile dysfunction is a common complaint among men – research suggests that around a third of older men (50+) have experienced erectile dysfunction. However, men of any age can experience it, particularly if the causes are psychological rather than physical.

Please note – reading a blog post is not a suitable substitute for therapy! If any of the issues raised here affect you and your sexual performance, please speak to a mental health professional, or arrange an appointment through the NHS.

Stress & Anxiety

Stress and anxiety are technically two separate issues, but are the two main erectile dysfunction causes, and operate in very similar ways.

Whether it’s stress about money, work, your personal life or any other issue, stress places an extra burden on your body and mind. When you are stressed out, your body is producing adrenocorticotropic hormone (ACTH). This hormone is used in the body to produce cortisol, which triggers changes in body chemistry including preventing inflammation, increased blood clotting and inducing the adrenal glands to produce adrenaline. This contributes to the tension and aggression you feel when stressed out.

When the stressor is removed, your body will slowly return to normal. If it doesn’t, that’s anxiety – a constant state of stress with no obvious cause. Both of these conditions can contribute to ED, by lowering your body’s tolerance to “non-essential” hormones, tiring you out, or causing imbalances in your muscular, nervous or autocrine systems.

Unfortunately, an inverse relationship can also be drawn – you are more likely to be stressed out if you are already suffering from ED. You may notice a recurring “chicken and egg” dichotomy as we progress; many of the conditions that can cause ED can also be made worse by ED, thus causing further ED. One of the key steps in most forms of therapy is to help you break these cycles of thought.

The first step in dealing with stress is figuring out exactly what is causing you stress. One way this can be achieved is through Cognitive Behavioural Therapy (CBT). CBT is a short-term form of therapy, which can help you problem-solve, reveal the patterns of thought that can lead to certain psychological issues, and the relationships between beliefs, thoughts and feelings, and how each of them can affect your behaviour.

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Depression & Low Self-Esteem

Similarly to stress & anxiety, depression and low self-esteem have similar effects on the body and cause ED in similar ways. Indeed, one of the main symptoms of depression can be low self-esteem.

Both of these conditions may leave you feeling guilty, which can remove or overwrite the idea of sex as a pleasurable activity. In turn, this creates a psychological feedback loop, where you start feeling guilty about being unable to enjoy sex, thus making you less likely to want sex going forward.

Antidepressants can help with feelings of depression, guilt and a lack of self-esteem. However, as a side effect, they can also cause anorgasmia (an inability to orgasm), which can replace one worry about sex with another. Speak to your doctor or mental health professional to find out which antidepressants might be right for you. Once you have established a prescription that works for you, we can arrange convenient delivery straight to your door with our NHS Prescriptions service.

Porn Addiction

While there is not currently a consensus on porn addiction as a psychological disorder in and of itself, it can have an effect on your sexual health. In many cases, excessive use of pornography can result in placing unrealistic standards on your partner, which can in turn lead to you feeling less attracted to them.

Speaking to an addiction counselling service can help you to control your relationship with any vice, and work out whether it will be possible to have a healthy relationship with it going forward.

Problems in your Relationships

Maintaining a healthy relationship can be a difficult task under the best of circumstances; when issues elsewhere in the relationship transfer into your sex life, it can become even more difficult to deal with. Even worse, in some relationships, the issue that is causing problems can be ED, forming a feedback loop of issues and stress which can prevent you from wanting to try again and cause more problems.

The first step in dealing with any relationship problem is communication; couple’s therapy and counselling may help you to learn how best to communicate with your partner, and ways in which both of you can discuss your sex life without fear of judgement or shame.


Here at Simple Online Pharmacy, we do provide treatments for ED. However, they are designed to treat erectile dysfunction’s physical causes – they help relax blood vessels around the penis, making it easier to achieve and maintain an erection. In some cases, this may help some men who are facing a psychologically-induced form of ED – just knowing that you can achieve an erection can make it easier to do so in the future.

While pills such as Viagra, Cialis and Sildenafil can treat ED, they may not be the best option for some people. Where possible, we recommend speaking to your doctor about your options. Going through your medical history, existing health conditions and possibly a physical examination can help you to establish the root cause of your ED issues.

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