The Psychology Behind It All: A Guide to Erectile Dysfunction

Impotence, or the inability or struggle to achieve an erection, stems from a variety of physical and psychological causes. A large number of erectile dysfunction cases are caused by mental and emotional disturbances that inhibit the body’s ability to achieve or sustain an erection. Unlike cases with a physiological explanation, these must be remedied by treating the underlying psychological cause. 

Erectile dysfunction is an already distressing condition, and the more a psychological concern exacerbates, the worse the condition may become. Read on to discover some of the most common psychological conditions that can cause or worsen impotence. 

Man talking to doctor about erectile dysfunction


Worries that relate to matters of the bedroom can certainly impact your ability to achieve or maintain an erection, but stress that is experienced outside of your sex life can have a major impact on your sexual function as well. Chronic stress is often responsible for a weakened immune system, diminished energy, ongoing illness, and a reduced ability to perform mentally, physically, and sexually, which means stress can be one of the most prominent psychological effects of erectile dysfunction – both as a cause and as an outcome of the dysfunction. 

Financial concerns, conflicts in the home, or looming deadlines at work may not be present on your mind during a sexual encounter, but the effects of stress can linger and disrupt sexual function in times when your mind and body otherwise seem to feel ready.


Those who live with, or begin to notice, the symptoms of acute or chronic clinical depression often experience persistent feelings of sadness, hopelessness, fatigue, irritability, emptiness, or frustration. Depression is the result of several factors, including environmental inputs, chemical imbalances in the brain, unresolved trauma, family history, health issues, and medication or substance use. These factors, whether directly related to your sex life or not, can disrupt your sexual performance. 

Depression can also aggravate symptoms of erectile dysfunction– both psychological and physiological, as well as play a role in the cause of impotence, too. It can also inhibit the body’s ability to perform in sexual situations even when the person is otherwise completely relaxed and comfortable with themselves, the circumstances, and their partner. 


Many who experience erectile dysfunction also experience significant fears and worries about their ability to perform or satisfy their partner. Sexual performance anxiety is a common cofactor that accompanies impotence, but generalised anxiety also impacts your body’s baseline capacity for sexual efficiency and success as well. Chronic feelings of dread, uneasiness, fear, and unrest about any facet of your life cause your body to enter a fight or flight state that can make relaxation and the ability to loosen up in the bedroom difficult, and even nearly impossible. Ironically, anxiety about how to deal with psychological erectile dysfunction often worsens the issue. Sexual dysfunction is a common symptom in those diagnosed with an anxiety disorder, but even those who experience acute bouts of anxiety may suffer worrisome dysfunction, too. 


Erectile dysfunction can cause feelings of inadequacy, low self-esteem, and shame about the issue in those who experience the problem on a consistent basis, but even one instance can prompt anxiety over the embarrassment that persists into future sexual interactions. You may even experience a sense of guilt or loss due to your perceived lack of performance. Not only are these feelings a common side effect of impotence, but pre-existing feelings of shame surrounding sex, intimacy, body image, or a lack of confidence can affect your ability to sustain normal sexual function. 

Relationship Dysfunction

For many in romantic relationships, sex is a significant form of expression, connection, and togetherness. When problems in your relationship arise, whether due to frequent arguments, perceived emotional distance, communication struggles, or an overabundance of negative interactions, it can also negatively affect your sex life. In these cases, seeking psychological help for erectile dysfunction may come in the form of couples therapy or individual therapy to work out some of the issues that have driven the two of you apart or resulted in sexual dysfunction for one or both of you. 


Unlike physical causes of impotence, psychological causes do not always respond to standard medication or other treatments. Those who experience erectile dysfunction that is caused or worsened by psychological factors should see a doctor. Only with treatment of the underlying psychological causes can the condition improve, and the intense pressure to perform lifted. Dr Katelaris of Katelaris Urology is a specialist in this area and can help to diagnose and treat any and all causes of impotence. Call to get in touch today and schedule an appointment.