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Can Stress and Anxiety Cause Erectile Dysfunction?

Can anxiety cause erectile dysfunction (ED)? For some—it sure can. 

Not everyone develops ED for the same reasons. Some have a physiological condition that increases their risk. Others experience ED mainly due to psychological factors (like anxiety). And for some, it’s a combination of both.

If you’re having frequent erectile issues, it’s a good idea to talk to your doctor. It could be a sign of an underlying medical condition. Your doctor can help you get medical treatment if necessary. 

We also know that psychological stressors can have real physical impacts, including sexual dysfunction.

And people who struggle with erectile dysfunction often feel a lot of anxiety around having sex. After all, it’s more than a little frustrating when your body isn’t responding the way you want it to.

Today we’re untangling the web that links together stress, anxiety, and erectile dysfunction. And when you can understand what’s happening in your body and mind, you can stop the anxiety in its tracks and get back to enjoying sex.

Performance Anxiety and Erectile Dysfunction 

Performance anxiety is a type of performance-based stress that can make it difficult to relax and enjoy sex. 

Performance anxiety looks like worrying about:

  • Whether you can maintain an erection
  • If and when you will reach orgasm
  • How you look
  • What your partner is thinking
  • What sex “should” look like

When performance anxiety crashes the scene, worry, doubt, and self-consciousness set in. And suddenly, the party’s over. 

Performance anxiety hinders the arousal process and can absolutely keep you from getting and maintaining an erection. Sex turns into a stressful event that you’d rather just get it over with. 

The worst part is—it triggers a vicious cycle of anxiety leading to shame and embarrassment in bed. And this shame leads to more anxiety about having sex. Sound familiar?

We know from researchers that performance anxiety can be a culprit in many types of sexual dysfunction.(1) Researchers have also found that performance anxiety can spiral into less sex, reduced intimacy, and distance between partners.(2)

Anxiety Disorders and Erectile Dysfunction

If you struggle with other types of anxiety in your life—like general anxiety or social anxiety, these could also contribute to sexual issues. Research has shown that individuals with anxiety disorders have a higher risk of developing erectile dysfunction.(3)

Let’s take a closer look at general anxiety. Someone who struggles with general anxiety often worries excessively about everyday things. 

Their anxiety may be rooted in work responsibilities, health, or the well-being of one’s family. They may not struggle with sexual performance anxiety, but these other anxieties can still contribute to issues with erectile dysfunction. How?

When you experience anxiety, your body goes into fight-or-flight mode. This triggers the release of cortisol, the body’s stress hormone. Think of it like your body’s natural alarm system. 

You have anxiety, your body senses a threat, and that alarm starts blaring. 

This response is great for situations when we need to be alert and ready for action—like when we need to run from a poisonous snake. But it does not bode well for sexual arousal. 

Stress and Erectile Dysfunction

Everyone experiences stress from time to time. Feeling stressed is not the same as having anxiety disorder. But it can still affect our lives in negative ways. When you’re stressed out, cortisol also gets released.

And—you guessed it, in times when we are under a lot of stress, sexual desire tends to wane.

It can be a routine stressor like financial, work, or childcare responsibilities. Or a sudden change such as a job loss, move, or birth of a child—times of high stress can disrupt our sex lives. 

So, what can you do?

Tips for Managing Anxiety and Erectile Dysfunction 

Healthy Stress-Reduction Habits

Incorporating healthy habits into your life like mindfulness meditation, eating well, and regularly exercising may help keep stress at bay. 

Regular exercise can also lower stress hormones like cortisol and help boost your mood and aid in relaxation. Research has also found that those who engage in more physical activity are less likely to experience erectile dysfunction.(4)

So start by checking in with yourself and find ways to help mitigate any stress in your life.

Go Slow

If performance anxiety hits each time you have sex, you may need to slow things down. Remove the expectation to have penetrative sex all the time. 

Explore different types of intimate touch beyond intercourse. Bring things down a notch until you feel relaxed and ready. 

Instead of putting pressure on yourself to have mindblowing penetrative sex, see what it feels like to touch your partner everywhere except the genitals. Give your partner a foot rub. Or take a hot shower together. 

Giving your partner a slow, sensual massage can feel a lot less daunting than having sex. 

Re-establish that intimate connection. Then you can start feeling relaxed while being sexually intimate with your partner. 

Focus on the Physical Sensations

Now that you and your partner feel relaxed and comfortable engaging in some form of intimate touch, keep your focus on the physical sensations. 

The brain likes to keep busy. It thinks. It analyzes. 

It asks questions like: 

“Am I doing this right?” 

“Are they enjoying this?” 

And the worst one of all: “Is this normal?”

It’s natural for your brain to want to do the thing it does—but you don’t need to listen to it. When those thoughts start to creep back in, refocus on the physical sensations. 

How does it feel when you touch your partner? How does it feel when they touch you?

This refocusing can help you stop the cycle of performance anxiety by returning you to the intimacy of the moment.

Psychotherapy

Stress is a part of life, but in times when stress becomes overwhelming, it can take a toll on your body and mind. If stress is the main culprit behind your erectile dysfunction, managing stress in healthier ways may help resolve the issue. 

Sometimes stress and anxiety become too much to manage on our own.

Talking to a therapist or counselor can help you understand and work through underlying issues that are causing you distress and disrupting your erectile function.

Sex Therapy

Sex therapy is a form of psychotherapy that focuses on sexual concerns. 

The advantage of seeing a specialist in sex therapy over a general mental health therapist is that the sex therapist is trained in both sexual issues and therapy. 

A sex therapist can offer individual therapy to help get to the root causes of ED and alleviate the symptoms. Some sex therapists are also trained couples counselors. 

Couples therapists work to help partners open up about their sexual performance anxiety and figure out ways to connect intimately. Couples and sex therapists understand and address sexual issues within the context of your relationship. 

Is Anxiety Causing You Erectile Dysfunction?

For many, the topic of erectile dysfunction is taboo. It’s a subject that’s often shrouded in shame, which can make it difficult to bring up with a doctor or partner. But it’s one of the most common sexual problems, and it can be treated.

Whether it’s due to stress, performance anxiety, or an underlying anxiety disorder—it’s never too late to overcome your erectile struggles and start having great sex.

At The Center for Couples & Sex Therapy, we understand how stressful it is when it feels like your body is working against you. And our sex therapists are here to help you manage your anxiety, overcome your performance concerns, and reach your sexual goals.

Contact us here to get connected with a therapist and back to a fulfilling sex life.

References:

  1. https://psycnet.apa.org/record/2006-01347-006 
  2. https://pubmed.ncbi.nlm.nih.gov/12825100/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8964411/ 
  4. https://www.nature.com/articles/ijir201115
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