Psychological Erectile Dysfunction

Psychological factors are responsible, in whole or in part, for about 20%-30% of all cases of ED.

Psychological or psychogenic ED can also sometimes be described as sexual performance anxiety.

Psychological factors, like anxiety, can be the cause of erectile dysfunction, as in the case of a man having erection trouble with a new girlfriend due to performance anxiety.

Psychogenic ED can also be secondary to a primary cause of ED, as in the case of a man with ED due to high cholesterol developing a related anxiety that he may not be able to perform sexually.

While most cases of ED stem from lifestyle choices (poor diet, lack of exercise, smoking, excessive drinking) or have a physical cause (heart disease, diabetes, sleep apnea, obesity, Peyronie’s disease), certain psychological factors (stress, depression, anxiety) can all contribute to erectile dysfunction.

What is Psychological ED?

Psychological ED is a condition where a man is unable to achieve and maintain an erection that allows for satisfactory sexual function – due to psychological factors like anxiety or depression.

Psychogenic ED could be diagnosed when a man’s physiology supports normal sexual function but anxiety prevents sufficient erectile function.

If a man regularly gets long-lasting erections upon waking but can’t get an erection during sexual activity that is evidence of psychological ED.

Male sexual arousal is a complex process that involves healthy bodily functions of the brain, hormones, muscles, blood vessels, nervous system and emotion regulation. ED can result from a problem with any of these. Stress and mental health concerns can cause or worsen erectile dysfunction.

Request Information

Psychological ED has No Age Limit

Epidemiological studies consistently show that the prevalence of erectile dysfunction (ED) increases with aging. But just because you’re below a certain age doesn’t mean you’re safe.

A recent study published in The Journal of Sexual Medicine shows that one out of every four erectile dysfunction patients is under 40 years old.

Evidence shows that, in younger subjects, organic, psychological, and relational conditions can contribute to the causes of ED.

No matter your age, you’re certainly not alone in experiencing ED symptoms.

ED is a treatable medical condition that is not related to masculinity or sexual prowess and can be caused by both physiological and psychological factors.

What Are the Most Common Psychological Causes of Erectile Dysfunction?

Psychological issues contributing to ED aren’t as easy to detect, diagnose, and treat. If everything checks out physically, often the case with younger men, psychological triggers are usually the cause. The most common psychological causes for ED include the following:
Life stressors are abundant. From work obligations, busy schedules, financial concerns to relationship issues. Stress can affect how your brain signals your body’s physical response, such as blood flowing into the penis.You might be psychologically aroused, but for one reason or another, your brain isn’t getting the message to produce an erection. It is one of the leading causes of ED when it comes to psychosocial impotence. Having ED can also lead to stress and anxiety thus creating a vicious cycle.
Communication problems with a partner or spouse can be one of the quickest ways to cause stress and tension that can easily result in erectile dysfunction. Relationship problems tend to house most of the causes of ED, and are usually at the root of the problem. Many times, men will avoid sexual situations due to the emotional pain associated with ED, causing their partner to feel rejected or inadequate. Working through these problems with your partner can help ease your symptoms of ED.
A common cause of ED, depression affects a person physically and psychologically. Depression is linked to a chemical imbalance in your brain and nervous system. Experiencing depression can affect your sex drive or sexual desire and ability or inability to reach full sexual arousal. Many men don’t recognize the symptoms of depression, and some are reluctant to seek help. Some antidepressant medications can also cause erectile failure and low libido.

Performance anxiety typically results from a person’s negative thoughts about their ability to perform well during sexual activity. Worries about being able to achieve an erection, pleasing a partner or ejaculating too early are all factors that can influence the ability to have and keep an erection. Having previous physiological erectile issues can also add to the severity of performance anxiety.

The complexity of guilt can be strong enough to interrupt the signals between your brain and body, stopping you from getting an erection. Sometimes a single episode of ED can make a man feel guilty that they are not satisfying their partner. This sense of guilt then builds, leading to further ED, and the cycle continues, much like performance anxiety.
Low self-esteem and erectile dysfunction feed off one another. This can be due to prior episodes of ED (thus a feeling of inadequacy) or can be the result of other issues unrelated to sexual performance. If there is a negative view of yourself and your abilities, it will display itself in many different ways in your life, including your sex life.
Pornography addiction or dependence is a potential cause for ED that many men fail to consider. This is because on a neurochemical level the brain can become “trained” to expect and need pornography for sexual arousal to occur. On a physiological level, the act of frequent masturbation to porn can also cause hyperstimulation. The stimulation felt by the physical act can make it difficult to gain the same level of arousal through sexual intercourse.


For years, men believed that sexual problems were a normal part of growing older.

ED isn’t just as simple as not being able to get an erection. It doesn’t manifest the same for everyone.

Psychological erectile dysfunction is a common problem that can happen to both younger and older men, regardless of their physical health or sexual experience.

Symptoms might include:

  • Trouble getting an erection
  • Trouble keeping an erection
  • Reduced sexual desire
  • Premature ejaculation
  • Inability to orgasm
  • Feeling worried or anxious during intimacy

Is Your Erectile Dysfunction Psychological or Physiological?

The key to treating any sexual dysfunction is to identify the underlying causes.

ED can be caused by an emotional or physical issue or a combination of the two.

A sign that may suggest your erectile dysfunction is psychological in nature is having regular difficulties getting an erection with a partner, but easily achieving an erection while masturbating, or experiencing regular and frequent morning erections.

Health conditions or lifestyle choices that affect blood circulation, structural anomalies in the penis or hormonal deficiencies can all contribute to erectile dysfunction.

While both psychological and biological factors can cause erectile dysfunction, in reality the mind and body work together in sexual arousal, so most men have both factors in varying proportions.

The sooner you start your treatment, the more options you have and the better results you are likely to get.

Call Us to Book
Or For Any Questions

Vancouver Treatment Options for Psychological ED at Pollock Clinics

Though psychological causes of erectile dysfunction may be more complex than medical causes, they are still treatable and most men are able to return to healthy sexual function. Our treatment options include:

Trimix Penile Injections

Trimix is an injectable prescription medication used to treat erectile dysfunction. It does not directly treat the cause of psychological ED, but can be a way back to normal sexual activity while pursuing treatment of the root causes.

Trimix is injected directly into the penis to cause an erection, circumventing any psychological factors that might impede strong sexual function.

The benefits include minimal systemic side-effects and the ability to get reliable one-hour erections within minutes once the correct dosage is calibrated. Unlike pills, Trimix acts locally directly on the penis to increase blood flow and create an erection. The active ingredients in the three-drug mixture are alprostadil, papaverine, and phentolamine.

The Pollock Clinics Trimix program includes self-injection training and support.

Sex Therapy

Sex therapy can help a man or couple overcome a variety of sexual difficulties and challenges.

Sex therapy is often helpful in the treatment of erectile dysfunction, even when physical factors are the principal cause.

Sexual difficulties, no matter what the cause, can strain your relationship. Frequently, a man with erectile problems experiences performance anxiety, which makes him reluctant to initiate sexual contact. His partner may perceive this as rejection, which could trigger feelings of frustration and resentment.

Sex therapy, with our experienced, certified sex therapist, can help a couple overcome these feelings and re-establish intimacy.

Rapid Access
Private Care
No Referral Needed

Call Us

Book Online

Quick Contact