The Psychology Behind It All: A Guide to Erectile Dysfunction

Erectile dysfunction (ED) – also known as impotence – refers to the struggle to achieve or sustaining an erection. The condition can stem from numerous physical causes, but it can also be down to psychological causes. 

Our latest article addresses the subject in detail and explores how to recognise and address ED resulting from emotional problems.   

Man talking to doctor about erectile dysfunction

What is Emotional Impotence? 

Impotence refers to difficulty with generating or sustaining an erection to perform sexual relations. It is a widespread issue in Australia and is said to affect as many as 1 in 5 men above the age of 40. 

For many older men, impotence derives from a physical condition such as abnormal arteries or veins preventing blood supply to the genitalia. Some, though, experience this common problem because of a psychological factor, such as stress, depression or anxiety. Younger men, in particular, fall prey to emotional impotence as opposed to physical impotence. 

It is important for men to equip themselves to manage any mental or emotional disturbances that can create or sustain this condition to enjoy a healthy sex life. 

Psychology of Impotent Man: The Key Causes


Stress can certainly make it difficult to achieve or maintain an erection and impact life in the bedroom, and sometimes, it’s due to what’s occurring outside of the bedroom.  

Chronic stress is often responsible for a weakened immune system, diminished energy, ongoing illness, and a reduced ability to perform mentally, physically, and sexually. This places stress as both a cause and an outcome of erectile dysfunction. 

You may not always be aware of the effects of external stress – financial concerns, conflicts in the home, or looming deadlines at work –  however, these worries often linger and disrupt your sexual function subconsciously.


Men living with the symptoms of acute or chronic clinical depression often experience persistent feelings of sadness, irritability, emptiness, and frustration. Depression can result from several factors, including environmental inputs, a chemical imbalance in the brain, unresolved trauma, family history, health issues, and medication or substance use. These factors can all help contribute towards your sexual performance. 

Depression can also aggravate symptoms of erectile dysfunction– both psychological and physiological –  and inhibit the body’s ability to perform in sexual situations even when an individual is otherwise relaxed and comfortable with themselves and their partner. 


Most of us will appreciate how the inability to perform sexually drives anxiety. But what happens when impotence is caused by general anxiety?  

Feelings of dread, fear or uneasiness about any aspect of life can cause the body to enter a state of ‘fight or flight’, making it difficult to relax – and it’s the same when it comes to performing in the bedroom. Even shame about our body image can cause anxiety, impacting sexual performance. 

Relationship issues 

For many couples, sex is a significant form of expression, connection, and togetherness in a romantic relationship. When problems in your relationship arise, whether it’s frequent arguing, perceived emotional distance, communication struggles, or an overabundance of negative interactions, it can interfere with your sex life.  

These psychological causes of emotional impotence can continue to aggravate the issue, becoming a self-perpetuating problem. That’s why seeking help to overcome the situation is critical, whatever the cause. 

How to Cure Psychological ED 

We have seen there are numerous causes behind emotional impotence. Once you have established a cause, finding a method to manage or cure the problem becomes much easier.  

Unlike physical causes of impotence, psychological causes do not always respond to standard medication or other physical treatments. This doesn’t mean you can’t treat ED; here are some of the primary ways to do so. 


Men are famed for not wanting to talk about their problems. Thankfully, it is becoming much more the norm nowadays to discuss issues with a therapist, and it is often the best remedy to overcome emotional ED. Whether it’s a solo visit to talk about anxiety or stress with a trusted professional therapist, or seeing a relationship therapist as a couple, talking about the problem helps to find a method to resolve it. 

Guided imagery 

This treatment method involves putting oneself into a calm state – relaxed, eyes closed, no noise or distractions – and working through a series of images designed to help regain command of the body. A therapist provides the guidance at a professional practice or you can listen to an audio recording any instructions. Lots of men using this type of therapy report it has helped their ED problem. 


The art of meditation has been practiced for centuries as a means of calming the mind. Many people who suffer from anxiety or stress find meditation useful, and if this is the root cause of your emotional impotence, then it may help to calm the anxiety and, in turn, resolve the ED. 

Click here to learn more about erectile dysfunction causes and treatments 

If you suffer from emotional impotence or ED, talk to a specialist.   

Men experiencing erectile dysfunction caused by psychological factors needn’t suffer in silence. A specialist can help establish the root cause of your condition and offer support to have it treated permanently, ensuring a more contented sex life.  

Dr Katelaris is a leading urologist based in Sydney, specialising in ED, and can help to diagnose and treat your condition with the utmost discretion and privacy. 

To discuss your options further, book an appointment at Katelaris Urology today. 

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