Psychological conditions and their effects on sexual performance

Is it all in your mind?


 As a general rule we think of sexual performance in men as being their ability to achieve and maintain an erection long enough to take part in satisfactory sexual intercourse.

If this ‘performance’ is disrupted in some way, we refer to it as sexual dysfunction. There are many causes and conditions associated with erectile dysfunction but psychological disruption of sexual function may be the least well understood and is often dismissed as being ‘all in the mind’.

This is not the case and psychological factors are believed to be responsible for 10 - 20% of all erectile dysfunction cases and it may be a reaction to an underlying physical cause. It may also be that the psychological issues stem from childhood trauma or sexual abuse.

It is important to understand which type of psychological issue or combination of issues are impacting your ability to perform sexually. It is only then that the issue(s) can be addressed.

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Types of erections

The process of achieving an erection involves many processes including a healthy vascular system, good hormone balance, a healthy nervous system and psychological impulses from the brain. A relatively simple physical examination along with blood tests by your GP can rule out any associated physical causes of erectile dysfunction, however, psychological problems may not be so easily spotted. There are three types of erections:

  • Nocturnal erections occur during sleep
  • Reflex erections which occur as a result of physical stimulation
  • The psychological erection results from visual or mental images.

All three types of erection require healthy bodily functions such as hormone balance, muscles, blood vessels, nervous system and psychological outlook.

The psychological issues that may lead to ED

  • Stress


Having looked at all the evidence, I think that it is very clear that erectile dysfunction can be a result of psychological factors. If you find yourself in this position, having been reassured that there are no physical causes, it is important that you seek help through counselling. Your GP will be able to help with this.

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