Understanding Psychogenic Causes of Erectile Dysfunction 

Understanding Psychogenic Causes of Erectile Dysfunction 


by Men's Health Clinic

Although erectile dysfunction can be a result of physical issues like high blood pressure, heart disease, diabetes, or obesity, it could also be a psychogenic issue, which means that erectile dysfunction is a result of a psychological problem. It can be caused by depression, stress, or even as simple as performance anxiety. In this article, we will dig deeper into the possible psychogenic causes of erectile dysfunction (ED). You will also learn about the various symptoms of psychogenic erectile dysfunction and how to overcome psychogenic erectile dysfunction. 

Psychogenic causes of erectile dysfunction 

Emotional or mental issues can prevent a man from achieving or maintaining an erection. While the failure to have erection can happen occasionally, it can be a sign of erectile dysfunction if it occurs regularly.  

Here are some of the most common psychogenic causes of erectile dysfunction or ED: 

Stress and Anxiety 

Stress and anxiety can disrupt the way your brain sends signals to the penis to increase blood flow. When this happens, you cannot achieve or maintain erection. According to a paper published by the National Library of Medicine, up to 37% of men with erectile dysfunction reported having anxiety disorders. 

Work-related stress can also cause erectile dysfunction. According to The American Institute of Stress, 80% of workers feel stress on the job. Men who work in a stressful environment can bring home that stress, which then affects their performance in the bedroom. 


Depression is another leading psychogenic cause of erectile dysfunction. According to a study published by the National Library of Medicine, 64.97% of ED patients suffer from depression. This is from data collected from 511 ED patients aged 18-60 years. Although the connection between depression and erectile dysfunction is not yet fully understood, some theories suggest that erectile dysfunction might be a side effect of the antidepressants that patients are taking. When this happens, a doctor might recommend a different antidepressant or prescribe a medication like sildenafil, commonly known as Viagra. 

Relationship problems 

Erectile dysfunction is common among men experiencing relationship problems. Issues such as lack of compatibility, conflicts, emotional distance, and communication issues may result in intimacy issues, including erectile dysfunction. When relationships are on the rocks, men might put up psychological barriers that could prevent them from achieving erection. Inversely, erectile dysfunction might cause relationship issues because the partner might take ED as a sign that their partner is no longer sexually attracted to them. 

Low self-esteem 

Low self-esteem as a cause of erectile dysfunction may be due to prior erectile dysfunction episodes or because of other issues unrelated to sex. For example, men with poor body image may experience erectile dysfunction because they might look at themselves as unattractive or unappealing for their partners. Low self-esteem can also be a result of other issues, such as the discrepancy between economic or professional standings between partners. 

Performance anxiety 

Erectile dysfunction may stem from fears of poor sexual performance. Men who are afraid that they won’t meet their partner’s expectations might encounter psychological issues, leading to erectile dysfunction. Contrary to popular belief, performance anxiety is not limited to those with limited sexual experience; it can also affect those who have been out of the action for a period of time. Performance anxiety may also affect men who feel that their partners are expecting too much in the bedroom. 

When you are too concerned about how well you perform in bed or if you can satisfy your partner, you might not be able to concentrate on the deed. It is easy to know if you are experiencing performance anxiety because there are warning signs. You might feel light-headed, or sweaty. Hyperventilating, shallow breathing, and rapid heartbeat may also signal an impending episode of performance anxiety. There is no need to feel shame when experiencing performance anxiety. According to the National Institutes of Health, sexual performance anxiety affects 9 to 25% of men and contributes to psychogenic erectile dysfunction and premature ejaculation. 


Guilt can cause erectile dysfunction, and it might stem from a variety of sources. It can be the guilt of an unfaithful partner or someone who is not emotionally attached to their sexual partner. Internalised beliefs about sex, religion, and morality can create psychological barriers that might prevent a man from achieving erection. Examples are those who feel guilty about premarital sex because of their religious beliefs. Guilt may also root from a past sexual encounter wherein the man failed to completely satisfy his partner. 

Mental health disorders 

Erectile dysfunction is prevalent among men suffering from mental health disorders such as schizophrenia and other psychotic disorders. According to an article by the National Library of Medicine, cases of erectile dysfunction can be as high as 80% among patients suffering from schizophrenia and other psychotic disorders. 


Men who experienced traumatic events, including sexual and physical abuse, might develop erectile dysfunction. The long-term psychological effects of these experiences can negatively impact an individual’s sexual functions. Those with Post-Traumatic Stress Disorder or PTSD can also develop erectile dysfunction. 

What are the symptoms of psychogenic erectile dysfunction? 

Here are some of the symptoms of psychogenic erectile dysfunction. 

  • Inability to have an erection – The most tell-tale sign of psychogenic erectile dysfunction is the inability to have an erection during sexual intercourse. While some men have issues achieving an erection occasionally, some men cannot achieve erection every time they try to. 
  • Difficulty achieving erection – Erectile dysfunction is not just about not being able to get an erection. If you take a long time to get an erection, it can be a sign of psychogenic erectile dysfunction. 
  • Inability to maintain erection – Men with psychogenic erectile dysfunction might have difficulty maintaining their erection throughout a sexual encounter. 
  • Inability to perform sexual function – Men who have psychogenic erectile dysfunction might have difficulties performing sexual functions no matter how interested they are in sex or their sexual partners. 

How do you treat psychogenic erectile dysfunction? 

Psychogenic erectile dysfunction treatment often involves treating the underlying psychological factor causing ED. Below are some of the approaches when treating psychogenic erectile dysfunction: 

  • Therapy – Therapies are excellent ways of uncovering the psychological issues causing erectile dysfunction. During therapy, a man with ED will learn about the various coping strategies and relaxation techniques he can employ to manage anxiety and arrest psychogenic erectile dysfunction. Therapies include Cognitive Behavioural Therapy (CBT), couples therapy, or sex therapy. 
  • Psychiatric Medication – A doctor may prescribe medication to alleviate symptoms of depression, stress, or anxiety that contribute to psychogenic erectile dysfunction. However, some medications may have side effects that might aggravate ED so be sure to inform your doctor immediately so your doctor can prescribe a different medication.
  • Custom ED treatments – Customised treatments like those offered at the Men's Health Clinic (MHC) are advantageous because they are tailored to an individual's health profile, reducing the likelihood of side effects. This personalised approach ensures that medications are aligned with the specific needs of one's body, minimising the risk of adverse reactions commonly associated with over-the-counter medications, which may contain higher dosages of certain components. By focusing on personalised treatments, such as those provided at MHC, men can receive more targeted and effective care for conditions like erectile dysfunction. 
  • Lifestyle changes – Positive lifestyle changes, such as exercising regularly, eating healthier, or avoiding cigarettes and alcohol can improve your physical and mental well-being. These changes can reduce stress and improve your sexual functions. 
  • Stress management – If stress is the primary contributor to your psychogenic erectile dysfunction, stress reduction techniques might do you wonders. These include breathing exercises, yoga, Pilates, and muscle relaxation techniques. Having a positive work-life balance can also help reduce stress, so make sure that you leave work-related stress to your office and not bring it home with you.


Whether it is because of physical or psychological causes, erectile dysfunction is a disorder that you need to address immediately. If you have psychogenic erectile dysfunction, be sure to tell your partner and consult a doctor immediately. Don’t hesitate to book an appointment at the Men’s Health Clinic (MHC). MHC’s licensed doctors can help identify the underlying cause of your psychogenic erectile dysfunction and devise a treatment plan that will best suit your needs so you can restore and improve the intimacy in your relationship. 


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