How much of erectile dysfunction is mental?

Erectile dysfunction is a very common condition, affecting around 4.3 million men in the UK, with experts predicting that 322 million men around the world will struggle with impotence by 2025. Lots of them will suffer in silence out of embarrassment, believing that their ED is a personal failure.

This blog will explain why that’s not the case. Erectile dysfunction happens to many people for many reasons, and there are also many ways to address the issue. Even if you struggle with premature ejaculation as well, there are treatments available that can help you to overcome your impotence.

When erectile dysfunction is psychological, it can be even more frustrating, because there’s no physical cause to treat. However, it’s possible to treat psychological ED, too – it just requires different methods. Read on to find out more about the mental causes of erectile dysfunction.

How much of erectile dysfunction is physical?

Individuals suffering from erectile dysfunction experience difficulties getting or maintaining an erection. This can result in psychological side effects like increased shame and anxiety. Since ED is a physical condition, it makes sense that there’s a physical cause for it 90% of the time.

It’s a common perception that erectile dysfunction happens when you get old, but it often affects people under 50 years old for reasons unrelated to age. There are lots of lifestyle choices, medicines, and recreational substances that can cause impotence. Possible physical causes include:

• Obesity
• Lack of exercise
• High blood pressure
• High cholesterol
• Diabetes
• Smoking
• Drinking alcohol
• Taking drugs
• Medications
• Pelvic trauma
• Tissue damage
• Irregular hormones

Individuals with impotence have a higher risk of heart failure or having a stroke, because erectile dysfunction is often a sign of problems with blood flow or the nervous system. That said, there isn’t always a physical reason for impotence – in fact, a mix of physical and mental causes is more likely to contribute to your ED. 

If you constantly struggle to get an erection or keep your penis erect for 3 months or more, regardless of the situation, then there’s likely to be a physical cause. If you speak to your GP about it, they can refer you for tests to identify the cause of your ED and treat it.

What are the mental causes of erectile dysfunction?

As you may have figured out from the statistic above, there’s a purely mental cause for erectile dysfunction only 10% of the time. There is less research into this area because mental distress commonly occurs with ED as a result of the condition, so it may not be seen as the cause itself.

Similarly, if you have a chronic mental illness like depression or anxiety, the medication that you take to treat this condition could inadvertently cause ED – so it’s indirectly a mental cause and directly a physical cause. Possible emotional causes of impotence include:

• Depression or anxiety
• Pressure at work, school, or home
• Stress from relationships or cultural conflicts
• Lack of physical attraction or interest in sex
• Addiction to pornography
• Sexual abuse or childhood trauma

Experiencing erectile dysfunction can create a cycle of low self esteem and relationship problems, worsening the mental causes. If you only experience this problem in particular situations, such as during sexual activity, but you still get erections in the mornings or during masturbation, then it’s likely that there’s a psychological reason behind it.

There’s also the issue of performance anxiety, when someone worries so much about being unable to get an erection or sexually satisfy their partner that this ends up happening anyway as a result. This is often related to social factors as well as psychological, like the ways you’ve learned to perceive body image and sexual roles and relationships.

Who to talk to about erectile dysfunction?

It’s important to speak to your GP about your impotence if it continues to happen and is having a negative impact on your life. Tests can determine whether there’s a physical cause with an appropriate solution. This could be switching medications, exercising more, losing weight, no longer smoking or drinking alcohol, or simply taking pills for erectile dysfunction (like Viagra).

If they believe that the cause is mental, they can help you to find appropriate emotional therapy providers. This could be CBT (Cognitive Behavioural Therapy), psychotherapy, or couples counselling with your partner. There are innovative treatments like MyHixel that combine physical and mental therapy to train yourself to maintain an erection for longer.

As many cases involve both physical and mental causes for ED, you might find that you need a combination of physical and mental treatments. If you need an alternative treatment to oral medications, you could try penile injections or topical creams. If you’re interested in ED treatments like this, speak to an andrology specialist, who can give you expert guidance.