Five Psychological Causes Of Erectile Dysfunction

Sometimes it’s all in your head—but you’re not alone

Credit: Peggy Anke / Unsplash

Disclaimer: Your healthcare provider is the best source of health and medical information. Articles written by UPGUYS are informed by peer-reviewed studies and research, as well as governmental health authorities and agencies—but they cannot replace advice from a healthcare professional. Talk to your healthcare provider about any physical or mental health concerns you might have. 

Hall of Fame Yankee catcher Yogi Berra once said of his sport “Baseball is 90 percent mental, the other half is physical”. The math might not quite add up, but the sentiment holds true—psychology frequently trumps physiology. This is certainly true when it comes to men who regularly experience erectile dysfunction (ED). 

Broadly speaking, there are two kinds of ED: physical and psychological. Of the former, conditions like diabetes, hypertension, some cancers, and physical trauma can all play a role in the body’s inability to get and maintain an erection. But there are perhaps even more mental causes for erectile dysfunction. This article will explore five of them. 


A demanding or unrewarding job, worry about paying the bills, relationship troubles, or a once-in-a-lifetime pandemic can all disrupt your internal harmony and lead to periods of high stress. Not only has stress been linked to numerous medical conditions, it can impact men’s ability to achieve and maintain an erection. Obviously, finding a new job, making more money, fixing a relationship, and overcoming a global-health crisis aren’t simple fixes. But making sure you get enough sleep, regular exercise, a healthy diet full of whole foods, practicing yoga or meditation can all help reduce levels of stress. This, in turn, might produce some knock-on benefits in the bedroom. 


Around 3 million Canadians—more than one-in-ten reported—they suffer from mood or anxiety disorders, according to Health Canada. More than a quarter say these conditions have had a moderate-to-severe impact on their lives. With respect to ED, feelings of anxiousness about being unable to perform sexually is often called “performance anxiety”. Erectile dysfunction affects between 5-20% of Canadian men, but its relative commonness doesn’t make it any easier to deal with. Experiencing an instance of ED with one sexual partner, and then worrying that it will happen again with another can have a detrimental effect on erectile function. Practicing mindfulness and focussing on healthy thought patterns are two strategies for combating performance anxiety as recommended by the National Social Anxiety Center (NSAC).  


Feelings of embarrassment from an inability to get and maintain an erection can be compounded by feelings of guilt. Healthy sex is about having a shared pleasurable experience, and men may feel guilty about being unable to please their partner when erections become hard to come by. Communication can play an important role in overcoming feelings of guilt. Let your partner know ED is something you’ve experienced and are trying to work through. You should also keep in mind that sex doesn’t have to focus exclusively on sexual intercourse—there are other ways to please your partner. 


Anxiety’s close-relative depression can also play an important role in erectile function issues. In a study of 64 men, about 40% experienced either depression or anxiety, both of which predated their run-ins with ED. It is widely accepted that erectile dysfunction can be caused by depression, and can also lead to depression—a nasty tangle of webs to be sure. Adding another complication to an already complex problem, Selective Serotonin Reuptake Inhibitors (SSRIs), a widely-used class of drugs to treat depression, can cause a dulling of genital sensations and a decreased sex drive—both of which can lead to ED. Fortunately, erectile dysfunction treatments like Viagra (sildenafil citrate) have been shown to be effective in SSRI-related erectile dysfunction. 

Low self esteem

Coming face-to-face with erectile dysfunction can put a serious damper on men’s self-esteem. A virile man who’s always ready to perform sexually is a picture often painted by traditional perceptions of masculinity. And while attitudes might be changing, many men continue to place unrealistic expectations on themselves. Like all issues on this list, there’s no quick fix for low-self esteem. But it’s important to know that tens of millions (if not hundreds) of men worldwide will experience ED in their life. In other words: you’re not alone in this. Medications like Viagra, Cialis and Levitra can offer some support in restoring confidence and improving self-esteem by reliably improving erectile function. 

What You Can Do About It

If you’re experiencing erectile dysfunction during more than half of your sexual encounters for a period of over three months, talk to a doctor to come up with a plan that’s right for you. Whether the underlying conditions are mental or physical, they will be your best resource in finding solutions. You don’t have to go it alone—support is out there.