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Could stress be causing your erectile dysfunction?
Feeling anxious about ED can make the issue worse. Here’s how to break the cycle and boost your confidence in bed.
We all know that stress can affect our mood, mindset and love life. For men, that can also translate to problems with erectile dysfunction (ED). This common problem affects 1 in 10 men in the U.S. on a long-term basis, according to the Cleveland Clinic. And while physical problems are often the underlying culprit, stress can also play a role.
But stress doesn’t have to wreck your erection, and ED problems don’t have to cause you even more stress. Here, we untangle the relationship between stress and ED — and ask experts how to manage the condition.
Why does stress impact erections?
Erections rely on an interplay of different processes in the body. The brain, nerves, hormones, muscles and blood vessels all interact to allow blood to flow to the penis and stay there to create and maintain an erection. Stress can interfere with that complex process by messing with your thoughts and emotions. In extreme cases, such as post-traumatic stress disorder (PTSD), stress can actually cause a change in body chemistry that triggers ED, research shows.
Stress and other psychological factors can often be the cause of ED in younger men especially. And guys with anxiety disorders have an even higher risk of developing ED.
The vicious cycle of stress and ED
The idea that you should always be ready for sex or easily aroused is ingrained in many men, says clinical psychologist Zoë Peterson, PhD. She’s a senior scientist at Indiana University’s Kinsey Institute in Bloomington. “Men can experience difficulty with an erection on a single occasion and then they start worrying about it, and that can snowball and come up over and over again,” she says.
It’s basically a vicious cycle: You stress out about whether you’ll be able to get an erection, and that makes it more difficult to achieve an erection. That in turn causes even more stress. (You see where we’re going with this.)
Should you get stressed about ED?
When should you worry if your erection isn’t firm enough to have sex? Experts agree: Having problems from time to time is entirely normal. That’s especially true if you’ve been drinking alcohol, are tired, or have been under pressure at work or in your personal life.
But you should make an appointment with a doctor or urologist if you’re dealing with chronic or frequent ED. That can be an early sign that you have an underlying health problem — such as heart disease, hypertension or diabetes — that needs treatment.
Getting fully checked out as early as possible is important to prevent ED from getting worse. For example, some medications can interfere with erections, including medications for depression. Be sure to tell your doctor about all your prescriptions. (Learn more about the diabetes medication metformin and ED.)
In any case, visiting a doctor can give you a clearer picture of your health and help you develop a better understanding of how to address ED.
How do you break the cycle of stress and ED?
If erectile problems are affecting your sex life, consider taking a medication that can safely address ED. Options include:
(Be sure to check out our guide to ED medications to find out how they work.)
Some men with chronic ED take these medications on a longer-term basis. But they can also be an effective short-term solution that gets you back on track when you’re stuck in a cycle of anxiety. “Even taking a pill just a few times helps,” Peterson says.
It can be a good fix, agrees urologist Richard Augspurger, MD. He’s the founder of the Urology Center of Colorado in Denver and a medical director at Optum. “I explain to men that they probably won’t need to use medication long term,” he says. “Mostly it’s talking them through it. Getting them to not feel so stressed about it.”
Stress, ED and your relationships
Losing your erection during an intimate moment can be embarrassing. It’s natural to wonder how your partner will react. No matter what you’re feeling, try having an honest conversation about it.
For one thing, talking about it can remove the unspoken feeling of “Is it me?” that your partner might have, says Dr. Augspurger. Reassure your partner that you’re attracted to them. And let the person know not to take it personally. (Read more strategies for partners here.)
Dealing with the issue as a couple is key. That could mean attending a doctor’s appointment together, talking about the problem with a couples therapist, or focusing more on foreplay in bed, Peterson says. And don’t be afraid to ask for a referral from your medical doctor to a mental health professional.
No matter what’s causing your ED, try to keep calm — and remember that help is available.
ED stats: Cleveland Clinic (2019). “Erectile dysfunction”
ED overview: Mayo Clinic (2021). “Erectile dysfunction”
Anxiety and ED: International Journal of Impotence Research (2021). “Erectile dysfunction in patients with anxiety disorders: a systematic review”