One of the most commonly known sexual problems is erectile dysfunction and sexual performance anxiety.
Research has shown that although ED is due to physiological issues in 80% of the cases, 20% of the problems are due to psychological problems.
There are multiple reasons for the psychological origin of erectile dysfunction. However, some of the most common causes include relationship issues, depression, stressful environment, or any history of negative sexual experience.
The article is a part of our series on “What is Erectile Dysfunction: A Complete Guide”
How to know if ED is physical or psychological?
Unfortunately, people are less aware that erectile dysfunction is also caused due to psychological issues. And this factor can even coexist along with other organic cause of ED.
One of the first critical steps in finding out the cause of ED is to consult with a registered health care provider.
The doctor will review your past medical history, make you undergo a physical examination, and ask you a series of questions to zero in on the exact cause of your ED.
Some of the questions the doctor may ask could be on your satisfaction level with intercourse, your ability to maintain erection, and achieve an orgasm.
Based on your answers to these questions and the lab test results, your doctor will find out the reason for your ED.
You can also do a quick self-analysis by trying to answer the following questions:
- How frequent are your erections?
- Do you get nervous before having sex?
- Are you going through a lot of stress due to personal or work-related issues?
- Do you experience erection in the morning?
If the majority of your answers to these questions is “YES,” then chances are high that your ED is related to some psychological issue.
Psychological causes of ED
Here are some of the most common psychological issues of erectile dysfunction.
1. Anxiety
This is one of the most common psychological causes of erectile dysfunction.
Sometimes psychological issues such as anxiety could directly influence various vital functions of internal organs such as blood pressure, heartbeat, blood circulation, etc.
An impact on these body functions may have an indirect effect on sexual performance.

2. Stress
If you are someone who carries a large load of stress on your shoulders, it could be the reason for your ED.
We live in an era where people are under stress for so many reasons. Unfortunately, this can also affect how your brain signals the physical response of your body. For example, having too much stress can interrupt your brain, signaling your penis to allow extra blood to flow.
3. Depression
Various chemical and hormonal imbalances may cause depression or other similar mental health issues.
However, unless anyone experiences it first hand, it can only be explained as some sort of sadness. But in reality, it can feel way more than that.
Sometimes it feels like a heavy anchor weighing down both the mind and body, affecting both the mental and physical aspects of your life.
Many men won’t recognize the symptoms of depression in order to seek medical help and remain unaware that this may be the cause of their occasional ED.
Fortunately though, in most cases, most men regain their normal sexual function after treatment.
4. Relationship problems
This is one of the important causes of ED. Having a troubled relationship with your partner can affect your sexual relationship.
Along with this, poor communication and arguments can also harm healthy sexual function.
Having healthy communication with your partner is one of the critical steps in resolving the issue. If you are having trouble with direct communications, you could seek out the help of a couple’s counselor.
5. Fear of sexual performance
Sometimes the fear of not being able to satisfy the partner can result in erectile dysfunction. This is called sexual performance anxiety.
In some instances, it is triggered by negative self-talk.
This can also happen if you are excessively worried about pleasing your partner, ejaculating too early, or achieving an erection.
6. Porn addiction
This is another important cause of ED that many fail to recognize. If you are someone who spends too much time watching pornographic videos, you might end up having fancy ideas about sexual relationships.
The medical name for this condition is called PIED or pornography-induced erectile dysfunction.
If you identify yourself as facing this problem, you will need to seek psychological counseling to manage it effectively
7. Low self-esteem
If you feel negative about yourself, it can manifest in several different forms. For example, many men who cannot successfully satisfy their partners get burdened with excessive guilt.
When guilt is combined with low self-esteem, it can result in a long-term aversion to sexual activity.
The good thing is that medical technology has advanced enough to give effective treatment and counseling in boosting self-confidence. Patients sometimes need to undergo a series of counseling and medications to feel self-worth, which will positively influence their sexual function.

References
Tahir M Khan,Syed A Sulaiman,Mohamed A Hassali,and Humera Tahir(8 Sept 2011)Clinical presentation of depression among Malaysian women in Penang Island. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3314277/ [Accessed 2 July 2021]
Qian Liu,Youpeng Zhang,Jin Wang,Sen Li,Yongbiao Cheng,Jialun Guo,Yong Tang,Hanqing Zeng, (27 June 2018)Erectile Dysfunction and Depression: A Systematic Review and Meta-Analysis. Available at https://www.jsm.jsexmed.org/article/S1743-6095(18)31007-5/fulltext [Accessed 2 July 2021]