Mental Health Problems: Hidden Risk for Erectile Dysfunction

As recently as a few decades ago, erectile dysfunction (ED) or impotence was thought to arise from mental health problems such as anxiety. Today, experts recognize the many biological aspects of ED, and this change in focus has now pushed mental health from the limelight. Combine this push with the reluctance of many men to discuss how they feel, and it shows why poor mental health is a hidden risk for erectile dysfunction.


If you suffer with anxiety, you are more likely to suffer with ED. Anxiety is able to distract from sexual thoughts and your body’s biological response to anxiety means that erection can be prevented.

Once anxiety prevents an erection, it becomes a vicious circle, as fear of failure, or even thoughts of inadequacy can cause you to focus mentally on yourself, increasing the chance of erection failure once more. If you suffer with anxiety, you may also fear scrutiny from partners, contributing even further to ‘performance anxiety’.

If you suffer with anxiety:

  • Do not expect perfection
  • Try to talk about your anxieties
  • Avoid turning to drink or drugs as a way of dealing with anxiety


There are many symptoms of depression, including problems with forming and maintaining intimate relationships. One study showed 35% of depressed 28 to 35 years old suffered with impotence and that sexual dysfunction occurred more in those who were receiving drug treatments. Another study concluded that in a specific population (medical students), that better erectile function and confidence in intimate relationships were associated with lower risk of depressive symptoms.

In aging men studies, results show correlations between ED and reductions in quality of life, substance abuse and impaired occupational or social functioning.

Unfortunately, if you do suffer with depression, a number of treatments for depression (and other mental health disorders) can themselves cause ED. However, specific ED treatments such as sildenafil (Viagra) can be effective in men suffering with depression.

If you suffer with depression and ED:

  • Speak to your doctor to see if there is an alternative treatment for your depression that may improve your ED, or whether you can reduce the dose, or even take a drug ‘holiday’
  • Ask about the option to take additional medications such as Viagra for ED


Although many men suffer with stress caused by the workplace, it can also arise from problems at home, such as marriage or financial problems. Stress, like other mental health problems can affect blood circulation to your penis, as well as altering nerve impulses in your brain – both of which can prevent an erection.

If you are suffering with stress:

  • Focus on positive goals, such as ‘I am intelligent, and I can complete this by Thursday’, rather than criticizing yourself and saying, ‘I’m useless, I’ll never get this finished’.
  • Try to eat a balanced diet as this helps the body resist stress
  • Exercising regularly can help to reduce stressful feelings such as hostility, helplessness and anxiety. Stretching muscles during exercise also helps to relieve headaches, shoulder and neck tension.

Obesity and Psychological Problems

It is well established that obesity and the hormonal disturbances associated with obesity contribute to erectile dysfunction, and if you are obese, you may have a poorer quality of life and psychological disturbances. These psychological disorders may also cause further hormonal disturbances, reducing the effectiveness of typical ED management.

If you are obese:

  • Consider working with your doctor and other professionals on a weight loss and fitness program.

Social Norms

There are still many strong social norms around the role of men and women in a relationship. Research shows that men who are no longer the ‘breadwinner’ in the home are more likely to take medications for erectile dysfunction, compared to men that are the breadwinner. Stay at home dads often report that they’re less happy in their marriage and there are higher rates of infidelity and divorce in marriages where a man is unemployed. Although it does now seem that social norms are less rigid for younger men, for many men, not meeting social expectations can be very distressing.

If you have concerns about ‘your place’:

  • Consider opening dialogue about your feelings with your partner
  • Look for local support groups specifically for men

Posttraumatic stress disorder (PTSD)

PTSD develops in response to psychological trauma, and affects both mental and physical functioning. If you suffer with PTSD, a common sexual dysfunction is ED, and because you may be on medications such as antidepressants, your ED can become even worse. One study of war veterans found that erectile dysfunction was more frequent in those with PTSD and those without, backing up findings from similar studies carried out in a number of countries.

If you live with PTSD:

  • Educate yourself about your condition; there are many different types of treatment available that can make living with PTSD easier
  • Try and exercise to relieve tension
  • Try to do one enjoyable thing each day – such as watch a favorite TV show, or walk to the park with your children

Be Confident and Speak Out

Trying to deal with mental health disorders alone is never a good idea. With around one in four people suffering with some type of mental health problem, it is much more common than you may think. It is important that you seek professional support if you think that you may be suffering with anxiety, depression, stress or any other type of mental disorder. If you feel able to, you may also consider talking to your partner, a family member or a friend.

As well as pharmaceuticals to help manage many types of mental or mood disorder, there are also self-help groups and other types of counseling services available. Lifestyle improvements, such as losing weight, and exercising regularly can also contribute to a healthier mind, and having a healthier mind is a positive step forward in reducing the risk of erectile dysfunction.


  • Pierce L, Dahl MS, Nielsen J (2013) In sickness and in wealth: psychological and sexual costs of income comparison in marriage. Pers Soc Psychol Bull. 2013 Mar;39(3):359-74
  • Vesna Antičević and Dolores Britvić. (2008).Sexual Functioning in War Veterans with Posttraumatic Stress Disorder. Croat Med J. August; 49(4): 499–505.
  • Piotr Kocełak, Jerzy Chudek,Beata Naworska,Monika Bąk-Sosnowska,Barbara Kotlarz,Monika Mazurek,Paweł Madej,Violetta Skrzypulec-Plinta,Piotr Skałba,and Magdalena Olszanecka-Glinianowicz (2012). Psychological Disturbances and Quality of Life in Obese and Infertile Women and Men. Int J Endocrinol. 2012: 236217.
  • Giovanni Corona, Edoardo Mannucci, Luisa Petrone, Valdo Ricca, Giancarlo Balercia, Roberto Giommi, Gianni Forti and Mario Maggi. (2006). Psycho-Biological Correlates of Free-Floating Anxiety Symptoms in Male Patients With Sexual Dysfunctions. Journal of Andrology, Vol. 27, No. 1, January/February
  • James F. Smith, Benjamin N. Breyer, Michael L. Eisenberg, Ira D. Sharlip, and Alan W. Shindel (2010). Sexual Function and Depressive Symptoms among Male North American Medical Students.J Sex Med. December; 7(12): 3909–3917.
  • David S Baldwin (2001) Depression and sexual dysfunction. Br Med Bull, 57 (1): 81-99.
  • Stuart N. Seidman (2002) Exploring the Relationship Between Depression and Erectile Dysfunction in Aging Men. J Clin Psychiatry. 63 (Suppl 5): 5-12.

Last Reviewed 14/Mar/2014


Related Posts

The following two tabs change content below.
Whilst wielding a couple of dumbbells in a gym class in 2003, Kate experienced an epiphany around the lack of accepted best practice guidelines when it came to staying well and avoiding disease. Kate realized that she had no chance of slowing her own aging process unless she became better educated about her options.

Latest posts by Kate Marie (see all)