Erectile Dysfunction and Your Emotional Health

Think your sex life is all physical? Not true. What's going on in your head or between you and your partner can play a big part in what happens — or doesn't happen — during intimate moments.

By Diana Rodriguez

Medically reviewed by Pat F. Bass III, MD, MPH

Erectile dysfunction is linked to a number of physical causes — high blood pressure, diabetes, injury, and alcohol abuse to name a few. But what's going on in your head can lead to erectile dysfunction, too.
And while your doctor will run a number of tests to see if your impotence has a physical cause, he will also ask questions about your thoughts, feelings, and history of erectile dysfunction.

Psychological Factors and Erectile Dysfunction

Ten to 20 percent of all cases of erectile dysfunction may be attributed to psychological and emotional factors or problems with a sex partner. What could be going on in your head that's affecting your erections?

Thoughts, feelings, and fears. Think about how much your thoughts and fears can interrupt your daily life; they can affect your performance at work, interest in hobbies, and your ability to be a good friend and partner. It's no wonder these thought processes can have an impact on your sexual health too, because the mind and body work together to achieve erections and have satisfactory sexual experiences.
Psychological factors that can influence your ability to get and maintain an erection include:

• Feelings of guilt
• Low self-esteem
• Anxiety or fears about your sexual performance
• Feeling inadequate about your sexual partner's expectations
• Setting high expectations for yourself
• Anxiety about an issue outside the bedroom, such as money
• Stress about your relationship, sexual performance, or issues unrelated to sex
• Your comfort level with your sex partner
• Your ability to communicate with your sex partner.

Emotional health. Your emotional health also plays a big role in your ability to get and maintain erections. People who are depressed or under a great deal of stress may not be able to perform sexually and may experience erectile dysfunction. They may also turn to alcohol, tobacco use, and drugs to help them cope, and those factors can also contribute to erectile dysfunction.
Getting Help for Erectile Dysfunction
If you think your erectile dysfunction could be caused by a psychological problem, see your doctor. Psychological factors don't mean that you're not interested in sex or don't want sex, but that your mind and your emotional health are getting in the way of what your body wants to do. What may help:

• Having a candid dialogue with your doctor. Talk about what's going on in your life and what you think might be the cause of your erectile dysfunction. The visit may be even more helpful if your partner attends the appointment with you so that your doctor can get a better understanding of any relationship or psychological factors that may be contributing to your erectile dysfunction.
• Therapy. If psychological factors are the problem, your doctor can recommend therapy options; choices include psychotherapy, sex therapy, or other therapy for you; couples counseling for you and your partner; or medication and therapy to manage symptoms of depression. Attending couples counseling can improve the emotional and physical aspects of your relationship.
• Stress management. You can learn to manage stress, anxiety, and depression through methods like meditation, relaxation techniques, and regular exercise.

Try not to put pressure on yourself about your sexual performance, and talk to your partner if you feel like you're under pressure in the relationship. Start a discussion about what's on your mind, what you both what from your sex life, and how you can help to meet each other's needs and expectations. Working together and with the right outside help when needed, you can begin to enjoy sex again.

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