What is Psychological ED: Causes and Treatments

Erectile Dysfunction (ED) or impotence is a Sexual Dysfunction.

A person with ED cannot achieve and maintain a firm erection to engage in sexual intercourse.

Some psychological and physical factors can induce this dysfunction.

Difficulty in getting an erection due to psychological factors is psychological ED.

This article will give you a deep understanding of psychological Erectile Dysfunction. We will also discuss the factors that cause it.

What is Psychological ED

Psychological ED is also known as psychogenic Erectile Dysfunction. 

As mentioned, it is an inability to get and hold an erection due to psychological reasons.

An individual can encounter three types of erection.

  • Psychogenic (audiovisual stimulation)
  • Nocturnal (during sleep)
  • Reflexogenic (a result of physical arousal)

To get any of these erections, one will need the involvement of:

  • Blood vessels
  • Hormones
  • Muscles
  • Nervous system
  • Emotions

Disturbance in any of these can lead to impotence.

Mental health conditions can interrupt the signals sent by the brain to the penis during sexual intercourse.

These conditions include Depression, Anxiety, and stress.

This interference can prevent the smooth muscles in the penile region from relaxing. As a result, it will lead to a failed erection.

Causes of Psychological Erectile Dysfunction

Psychogenic Erectile Dysfunction can be due to many causes. Such as Anxiety, Depression, low-self esteem, guilt, and trauma. 

Exposure to excessive pornographic content and relationship issues can also lead to ED.

Let us look at these causes to get a deeper understanding.

Causes of Psychological Erectile Dysfunction
Tensioned Couple


The sympathetic and parasympathetic nervous systems control the penile erection.

To get an erection, the parasympathetic tone should be high as it controls the vasodilation process.

And the sympathetic tone should be low as it inhibits an erection.

The parasympathetic nervous system turns on only when a person is calm and relaxed. Thus, in a stressful situation, the parasympathetic nervous system will not turn on.

As a result, it will lead to an unsuccessful erection.

Stress can be a result of some life events, such as:

  • Job workload
  • Conflict with someone
  • Paying bills
  • Relationship issues


Anxiety Disorder and performance Anxiety can lead to an increased sympathetic tone.

And as mentioned above, an increase in sympathetic tone inhibits an erection.

Abnormal Anxiety levels might also impair sexual and emotional relations with your partner.

As a result, it can further cause communication issues, hindering your erectile functioning.

Additionally, Anxiety can cause reduced sex drive (libido). Decreased libido can interfere with brain signals sent to the penis. Hence, contributing to Erectile Dysfunction.


In a research study by The Journal of Sexual Medicine, impotence’s possibility increases by 39% in Depression patients.

There are various ways in which Depression can directly or indirectly lead to ED.

Depression can drop confidence levels and build up negative thoughts. As a result, it will lead to performance anxiety while engaging in sexual intercourse.

And as mentioned above, performance Anxiety can lead to erection problems.

The study also states that Testosterone levels are low in Depression patients. These low Testosterone levels can lead to the development of Erectile Dysfunction.

Additionally, a study observes that patients with Depression release high amounts of Norepinephrine. This can lead to poor vasodilation and eventually to psychological ED.

Norepinephrine: It is an organic chemical that acts as a neurotransmitter and hormone.
Vasodilation: It is the process of dilation of blood vessels. This dilation happens due to the relaxation of smooth muscles. 

Relationship issues

Relationship issues can induce psychological Erectile Dysfunction.

It can contribute to a lack of communication. As a result, it can lead to stress, low sex drive, Anxiety issues, and Depression.

The absence of emotional connection might lead to low sexual desire.

Relationship problems, if not resolved, can also lead to Anxiety and Depression.

These are separate factors for Erectile Dysfunction.

Low-self esteem

A person with low-self esteem might feel unattractive or not good enough for their partner.

This feeling can lead to anxiousness and low confidence.

As a result, a person might get sexual performance Anxiety or Depression.

Abnormal Anxiety levels and Depression are the leading causes of psychological ED.

Guilt or shame

Past sexual experiences can be responsible for the feeling of guilt or shame when having sex. 

You may feel sexual shame for not satisfying your partner or not performing well enough the last time.

These feelings can cause some severe issues. These issues include stress, Depression, performance Anxiety, and relationship problems.

These issues are individually responsible for the development of Erectile Dysfunction.


Sexual abuse or trauma can result in mental health problems.

You might develop Anxiety issues, Depression, and sleep disorders.

These issues can contribute to the inability to achieve a firm erection.

Porn-induced ED

Porn-induced ED is caused when an individual consumes excessive pornographic content.

Yet, porn-induced ED is still a topic of discussion as it doesn’t directly affect the penis’s function.

As per research, if it reaches a level of addiction, the risk of getting impotence increases by 60%.

As per other studies, porn exposure doesn’t cause a significant difference in erectile functioning.

Porn might affect your sexual desire toward your partner. You may not find them sexually attractive or less attractive than the actors in porn. 

Exposure to pornographic content can also lead to unrealistic expectations and insecurities.

This might indirectly induce difficulty in obtaining or sustaining an erection.

Porn combined with masturbation can reduce sexual performance while having sex with your partner.

Psychological Erectile Dysfunction treatment

You can treat psychological ED by treating psychological issues.

For example, anti-depressants might help with impotence caused due to Depression.

But getting a doctor’s consultation is essential. They will diagnose your condition and treat you accordingly.

They might recommend psychotherapies and relaxation techniques.

Psychological Erectile Dysfunction treatment
Therapy Sessions

Let us look at Psychological Erectile Dysfunction treatment individually.

Cognitive Behavioral Therapy (CBT)

CBT might help treat psychological Erectile Dysfunction. 

This therapy treats common mental health issues like Depression and Anxiety. And if you have ED due to either of these mental health problems, then CBT might help you.

Psychosexual therapy

Sex therapy primarily focuses on overcoming sexual dysfunctions. 

It also helps in improving the physical intimacy between you and your partner. 

Relaxation techniques

Relaxation techniques might reduce stress and calm your body. 

And as stress is one of the causes of psychological ED, relaxation techniques might help you treat it.

These treatments above might help you address your mental health problems. As a result, it might improve your erectile function.

But your doctor might also recommend you consume medications to treat Erectile Dysfunction.

Medications containing Sildenafil, Tadalafil, Avanafil, and Vardenafil treat ED.

Additionally, to overcome porn-induced ED, you need to stop watching porn. You might also need to see a sex therapist if you have insecurities due to exposure to porn.

Porn-induced ED recovery time depends on how long you have been exposed to porn. It might take 3 to 6 weeks for some people. But, it can also take as long as nine months for individuals who started watching porn at a very young age.


Psychological ED is caused due to psychological factors.

These factors include Anxiety, stress, Depression, Low-self esteem, porn consumption, and so on.

Treatment of psychological Erectile dysfunction is available in the form of therapies and relaxation techniques.

These therapies include Cognitive Behavioural Therapy (CBT) and sex therapy.

On the other hand, to reverse porn-induced ED, you need to stop watching porn.

However, your doctor might combine these treatments with Erectile Dysfunction medications.

Frequently Asked Questions

Is ED psychological?

Yes, both psychological and physical factors can induce ED.
Factors like Depression, Anxiety, stress, and low-self esteem can lead to psychological impotence.

Does psychological ED go away?

Yes, psychological ED can go away with the help of psychotherapy. These psychotherapies include Cognitive Behavioral Therapy and sex therapy. The treatment also includes relaxation techniques and medications. You should consult a healthcare provider to know which treatment is best for you.

How do I know if my ED is psychological?

Your ED is psychological when factors like Depression, Anxiety, or stress induce it.
You should get yourself diagnosed by a medical professional to know the root cause of it.

Can you reverse psychological ED?

Psychological ED might be reversible. But, It depends on the root cause of your Erectile Dysfunction.
You can reserve it with the help of Cognitive Behavioural Therapy or sex therapy.

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Natasha Patel

Natasha Patel is the senior writer for the women’s health edition at CheapMedicineShop.com. She worked as a primary care provider before joining the writer’s panel of the blog. She is also trained in routine obstetrics and continues to practice in Oklahoma, where she lives with her family.