Erectile dysfunction (ED) often has a psychological cause, rather than a physical one. Therefore, a psychological treatment such as counselling or cognitive behavioural therapy may be the best option for you. Here we outline, some of the most common psychological causes of ED.
Stress and anxiety are a common cause of erectile dysfunction. Stress and anxiety can affect libido and how your brain communicates with the nerves and blood vessels involved in an erection. Experiencing stress and anxiety can also increase your chances of high blood pressure, heart disease and obesity. Anxiety and stress can be treated by counselling, sex therapy, cognitive behavioural therapy and other psychological treatments. In addition, a doctor may be able to prescribe medication to reduce your experience of anxiety.
Depression can involve a condition known as anhedonia. Anhedonia is an inability to feel pleasure doing activities you would normally have found enjoyable. This can also affect your sex drive and how you respond to sexual activity. Depression can be treated with psychological therapies and sometimes medication such as antidepressants.
Performance anxiety is feelings of anxiety surrounding sex. These worries can relate to sexual performance, satisfying your partner, sexual health, pregnancy, body image, self-esteem etc. If you’re worried about sexual health or the risk of pregnancy, you should talk to your partner about different contraceptive options. Using a condom or getting an STI check for both of you, may help put your mind at rest. Pregnancy can be prevented by a range of contraceptives for women, as well as condoms. If you discuss contraception with your partner, you may find that she is happy to take the pill, and you can use condoms as well, to further reduce your chances of unwanted pregnancy. If you’re concerned about your body-image or if you have low self-esteem, it may help you to speak to a counsellor, cognitive behavioural therapist or psychologist. These professionals will be able to give you the help and support you need and suggest ways for you to overcome these feelings. If you are worried about satisfying your partner and your sexual performance, these feelings are perfectly normal, especially with a new partner or if you have not had sex for a while. Being open with your partner about your nervousness can really help you feel more relaxed around them. But you should also remember that sex isn’t all about penetration. Making the most of foreplay can help you satisfy your partner, while also getting you in the mood. If you can, ask your partner what they like or get them to show you and guide your hands, this can help you make the most of your sexual relationship. You could also consider introducing sex toys or exploring some of your fantasies together.
Many medications used to treat psychological conditions can cause erectile dysfunction as a side effect. Antidepressants, anti-anxiety drugs and sedatives can cause temporary erectile dysfunction. If you think you are experiencing ED as a result of your medication, you should speak to your doctor about alternatives. They may be able to switch you to a different treatment or offer you ED drugs to help.