Mental Health and Erectile Dysfunction: How are they Linked?

Mental Health and Erectile Dysfunction: How are they Linked?

Up to 30 million men in the United States deal with erectile dysfunction (ED), or the inability to get or maintain an erection firm enough for satisfactory intercourse. As one of the most common sexual health problems among men of all ages, ED can leave you with an unfulfilled sex life and cause a disconnect between you and your partner. 

But for as distressing and disruptive as ED can be, it’s also highly treatable.   

As men’s health experts specializing in ED and sexual dysfunction, our seasoned team at Mike Hsieh, MD, in La Jolla, California, knows that the key to effective ED treatment — and eventual resolution — is finding and addressing its underlying cause. 

Read on as board-certified urologist Dr. Mike Hsieh and certified physician assistant Jose-Luis Ruiz explain how psychological factors can contribute to the development of ED. 

The mechanisms behind an erection

Male sexual response is a complex process involving interactions between desires, thoughts, emotions, hormones, nerves, blood vessels, and muscles.  

During male arousal, the brain signals the cavernous nerves to release chemicals that activate the erection process. As blood flows into the penis’s spongy erection chambers (corpus cavernosum), the surrounding smooth-muscle erectile tissue traps it there to attain and maintain an erection. 

Essentially, increased blood pressure within each erection chamber causes the penis to “get hard,” resulting in an erection. Upon orgasm, different nerve signals prompt the erectile tissue to relax, releasing blood back to the body and diminishing the erection. 

Basic facts about erectile dysfunction 

Anything that interferes with any part of the arousal/sexual response processes can lead to erection problems. But while most men experience the occasional erection problem from time to time, a persistent ED problem is more concerning. 

ED is defined as not being able to get an erection or sustain an erection that’s firm enough for complete sexual intercourse. You may have ED if you:

For women and men alike, successful arousal, intercourse, and completion require the mind and body to work together. For men, this means both physical and emotional problems can give rise to erection problems.  

What is psychogenic erectile dysfunction? 

A variety of health conditions and lifestyle factors can impair the physiological mechanisms behind a healthy erection — ED is a frequent consequence of diabetes, hypertension, heart disease, and low testosterone; it’s also more common in men who don’t exercise and those who use tobacco, drugs, and alcohol.  

But for about two in five (40%) men with ED, the problem is psychogenic, meaning it’s mostly a result of psychological factors. Mental health concerns and emotional issues that can give rise to ED or make existing ED worse include:

Mental health concerns and ED often have a bi-directional relationship: Just as stress, anxiety, and depression can give rise to ED, persistent ED can exacerbate existing stress, anxiety, and depression.    

Sometimes, ED is a product of multiple factors. For example, an alcohol habit may slow your sexual response, sparking anxiety about sustaining an erection. This can prompt even greater anxiety over sexual performance that perpetuates or worsens existing ED.      

Ready to resolve erectile dysfunction?

ED isn’t a normal part of the aging process; any time it becomes a persistent problem, it should be evaluated and treated by an expert. Luckily, ED is highly responsive to treatment — once you know what’s causing it.  

Our team conducts a comprehensive evaluation aiming to rule out serious underlying health concerns as it uncovers the factors contributing to your ED problem or worsening it. Then, we tailor our treatment plan to your specific needs, addressing each factor equally.  

Remember: Psychological causes of ED are as real and as valid as any physical or medical cause of ED — and there’s a way to lessen their effects on your sexual health. If you’re ready to resolve ED, our team at Mike Hsieh, MD, can help. Call 858-216-2561 to schedule a visit at our office in La Jolla, California, today.

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