Erectile dysfunction (ED) – Psychology

Sex requires both partners to be in good physical and psychological health. For this reason mental health issues can have adverse effects on a person, including one’s sense of well-being. It therefore makes sense that erectile dysfunction problems (DSM-5, sexual dysfunction) can impact on sex life. The reason being is that mental health problems tend to cause chemical and structural changes in the brain too. These problems can include but are not limited to:

  1. Chronically anxious men could experience ED due to performance anxiety.
  2. Depression or low mood can have a negative impact on desire and libido. Depression also happens to be the most common cause of ED in young men.
  3. Stress leads to an overactive fight or flight response, which can negatively impact on overall health, from cardiovascular functioning to mental health. Daily stress is more likely to cause premature ejaculation than ED.
  4. Vasomotor disorders are more likely to cause ED in older men.
  5. Men are more prone to erectile problems if they aren’t as interested in sex; and are more prone to loss of libido if they have erectile problems.
  6. Problems in a relationship can affect erectile function as well. Unhappiness, anger, and communication breakdowns may fuel the frustration and depression associated with ED.

Many men are extremely uncomfortable discussing erectile dysfunction or any other issue that has the potential to disrupt their sense of themselves as men. As such, men resist disclosing any experience of erectile dysfunction for fear of being mocked or ridiculed and it is not a topic that they would likely discuss with family or friends.

Recent studies have shown the impact of sexual dysfunctional beliefs, negative cognitive schemas, negative automatic thoughts, and depressed affect on male erectile dysfunction [April 2010, Volume 7, Issue 4, Part 1, Pages 1429–1437, Pedro J. Nobre, ISSM].

The inability to maintain an erection, often leads to feelings of shame or they are interpreted as a failure of male functioning and evidence they are not “real men”. Since 1998, the treatment for erectile dysfunction (ED) has improved tremendously with the advent of medications such as Viagra, Cialis, and Levitra. Over 75 percent of men taking these medications are able to restore erections.

However, for the remaining 25 percent of men, medical treatments are largely ineffective. ED is often strongly linked to performance anxiety.

Sufferers of psychological erectile dysfunction are encouraged to talk about the issue with their partners. Topics such as increasing sex frequency, personal likes and dislikes, etc., can have a profound effect on increasing satisfaction and performance. Slowing down the love-making process and focusing on your partner’s needs and desires can help shift the focus away from yourself (and your penis). Men should also endeavour not to become embroiled with pornography, which can numb the brain’s normal response to pleasure and should avoid unrealistic sexual fantasies as this can lead to unreasonable expectations (and disappointment) from their partners.

Watching porn(1) is addictive in the same way as opioids, with users building up a ‘tolerance’ for hardcore content over time that leaves them unsatisfied with real-life sexual activity. Frequent exposure to graphic images and films is de-sensitising men in their late teens and early 20s too.


 – Getting…help!

Even supplements can cause problems/side-effects. L-Arginine(2) can help but that really depends on your general health; this is based on L-Arginine side-effects.

Epimedium species (aka Horny Goat Weed) have been utilized for the treatment of erectile dysfunction in Traditional Chinese Medicine for many years. Icariin (ICA) is the active moiety of Epimedium species.

There is an interesting product found on line called “N.O. Pure” (NO – as mentioned in Part one as Nitric Oxide) – which contains Beta Alanine, Agmatine Sulfate (a derivative of the amino acid L-Arginine) and Icariin at 40%.

Worth also considering L-Citrulline. L-Citrulline is a non-essential amino acid. Your kidneys change L-citrulline into L-arginine and nitric oxide (all of which have been mentioned earlier).

The list of natural supplements is very long and in many cases it is not appropriate to take them unsupervised; this is due to potentially serious side effects that they can cause.

Being obese (or simply overweight) doesn’t help. Poor circulation will be encountered by anyone who has a poor diet, it is therefore especially common in those who suffer with obesity. Remove table salt, artificial additives from the diet, along with processed sugar and discontinue consuming bleached foods (e.g. white rice, white bread, white flour, white sugar). [Eliminate milk – it doesn’t do your body any favour].  By doing so, you should be eliminating all processed foods. A combination of good life style (exercises) and nutrition is a better, safe solution without seeking the “aid” (with side-effects) of pills. Hence, simply lose weight and keep fit by doing pelvic exercises(3).

Article by A B M Procaccini © – Counselling Psychologist, Naturopathist


  1. it has been shown that over-use of pornography may weaken the region of the brain known as the cingulate cortex. The cingulate cortex is responsible for moral and ethical decision making, it is also highly important in disorders such as depression and schizophrenia and plays a role in executive function and respiratory control.
  2. L-arginine is “an amino acid” – It is obtained from the diet and is necessary for the body to make proteins. L-arginine is found in red meat, poultry, fish, and dairy products. High consumption of red meat, poultry and dairy products can lead to health problems.
  3. Pelvic floor exercises improve the strength of the pelvic floor muscles and are more commonly known as Kegel exercises