Ideas about what causes erectile dysfunction change throughout history along with popular beliefs of the time. In medieval Europe, it was a fairly common idea that magic was to blame for erectile dysfunction. Later, psychoanalysis brought the theory that psychological trauma was the cause of most erectile issues.
Today, doctors believe most cases of ED are caused by injury and illness like heart disease, diabetes, or nerve damage. Only 10–20% of cases are thought to be from psychogenic causes. But with many men having mixed sources of ED, it’s difficult to be exact.
The first step to treating psychogenic erectile dysfunction is identifying the underlying cause, which usually falls under 4 main categories:
Stress from various areas of life – problems at work, grief, financial insecurity – can manifest itself in the form of erectile dysfunction.
How does stress cause ED?
- Higher levels of cortisol (the “stress” hormone) are linked to problems with sexual function in men.
- Chronic stress can affect testosterone and sperm production, impacting both erectile function and fertility.
- Stress often leads to an increase in habits like smoking and drinking that contribute to erectile dysfunction.
How can stress-induced ED be resolved?
- Talk to someone. Stress can snowball when you feel like you’re facing it alone. Discussing stress with your partner or a counsellor can reduce the perceived pressure behind sexual performance.
- Make time for stress-reducing activities. Mindfulness meditation, exercise, reading, and art therapy are some of the most popular, but there are endless possibilities depending on your personal interests.
- Insomnia and stress feed into each other and create a cycle that’s difficult to break. If you’re stressed and fatigued, make sleep quality a top priority. This includes practicing a relaxing pre-sleep ritual, going to bed at a dedicated time, and removing distracting devices from your bedroom.
- Men who suffer from chronic stress may benefit from professional intervention where they can learn better coping strategies.
Approximately 40 million adults in the US have an anxiety disorder, and everyone else will experience anxiety at some point in life. For men who are worried about sexual performance or activity, this anxiety can lead to erectile dysfunction.
How does anxiety cause ED?
- Like stress, anxiety is usually accompanied by an increase in cortisol, which might interfere with sexual function.
- Many men experience some level of anxiety with a new partner or relationship, causing situational ED that usually resolves itself.
- Anxiety can cause a cycle where erectile difficulty causes more anxiety, which in turn worsens erectile dysfunction.
How can anxiety related ED be resolved?
- Cognitive behavior therapy can help provide you with practical ways to reduce anxiety by identifying problematic thinking patterns.
- Your doctor may choose to prescribe a drug like Viagra or Cialis to help overcome anxiety-related ED, but this will not treat any underlying anxiety disorders.
There’s a strong link between depression and erectile dysfunction, and men with either condition are likelier to develop the other.
How does depression cause ED?
- Depression is caused by an imbalance of neurotransmitters in the brain. These imbalances can lower libido or interfere with the nerve signals required for erection.
Making things more complicated, decreased libido and sexual dysfunction are side effects of some antidepressant medications:
- A commonly prescribed class of antidepressants, SSRIs work by increasing the amount of serotonin in the brain. Loss of desire and erectile dysfunction are among the most frequently reported side effects of this class of drugs.
How might ED due to depression be resolved?
- For men with untreated depression, working with doctors to manage your symptoms may alleviate ED.
- If SSRIs or other antidepressant medication is causing ED, talk to your doctor about changing your medication or dose. Never discontinue antidepressant use on your own, as this can lead to withdrawals or worse symptoms.
Feelings of anger, resentment, and betrayal can impact sexual function in both men and women. Relationship difficulties might manifest themselves as erectile dysfunction, even if a couple’s problem isn’t sexual in nature.
How can it be resolved?
- Open and honest conversation both about erectile dysfunction and the underlying relationship issues are an important step in overcoming this type of ED.
- Couples counselling or sex therapy can provide a safe space to address relationship issues with the guidance of a neutral third party.
A combination of medication, therapy, and changing behaviors can address most psychogenic causes of erectile dysfunction. While stress reduction techniques like exercise and meditation are low-cost options to help treat ED, other solutions can be costly.
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