Psychogenic erectile dysfunction is the inability to get or maintain an erection during sex due to psychological factors. These factors can include stress and anxiety, depression, guilt, low self-esteem, or relationship problems. About 40% of erectile dysfunction (ED) cases are considered psychogenic. While erectile dysfunction can affect men at any age, many cases of psychogenic erectile dysfunction occur in young men.

This article will discuss the symptoms, causes, diagnosis, and treatment of psychogenic erectile dysfunction.

laflor / E + / Getty Images


Not having an erection on occasion is not uncommon or a major cause for concern. But when a person has trouble getting and maintaining an erection during sex at least half the time, it could be erectile dysfunction.

Symptoms of erectile dysfunction can include:

  • Inability to have an erection
  • Difficulty getting an erection
  • Loss of erection before the end of intercourse
  • Premature or delayed ejaculation
  • Interest in sex, but difficulty playing

It is important to keep in mind that symptoms can vary from person to person. Being aware of the symptoms and impact of erectile dysfunction on sexual performance can help facilitate conversations with a healthcare professional.


Erectile dysfunction can be caused by an underlying medical condition. To determine if erectile dysfunction is psychogenic, a healthcare practitioner will seek to explore and rule out any medical conditions that could be causing the problem.

After ruling out the medical conditions, a doctor or mental health professional may want to discuss and assess psychological factors that may impact a person’s sexual function.

Psychological causes that can contribute to erectile dysfunction include:

  • Stress and anxiety: When a person is anxious or stressed, becoming aroused can be a challenge.
  • Performance anxiety: Worries about sexual performance or the ability to satisfy a partner can lead to anxiety, which impacts the ability to get and maintain an erection.
  • Depression: Depression can cause a lack of interest in activities, which can include sex. Depression can make it difficult to connect with other people, including in sex.
  • Relationship issues: Conflict in relationships can cause emotional stress and create distance between partners, which can affect sexual performance.
  • Feelings of guilt: Whether it’s related to past performance, emotional stress, or other issues, guilt can lead to depression and anxiety and, ultimately, erectile dysfunction.
  • Low self-esteem: This can be related to performance during previous sexual activity and can lead to feelings of inadequacy or shame.
  • Cultural or religious beliefs: A person’s attitude towards sex can be influenced by their religious or cultural beliefs.
  • Trauma: A history of sexual abuse or trauma can cause an emotional reaction during sex and in sex. Treating them with a mental health professional is essential to recovery.

The psychological reasons causing a person’s inability to get and maintain an erection during sex are as real and valid as any other medical reason for erectile dysfunction. Working with a health care provider or mental health professional can help find out what psychological factors are at play and how they can make erectile dysfunction worse.

The cycle of psychogenic ED

Psychogenic erectile dysfunction can operate in a vicious cycle. Anxiety or depression can precede erectile dysfunction and create problems when a person engages in sexual activity. Or, a person with erectile dysfunction may develop symptoms of anxiety or depression due to their dysfunction.


To determine the root cause of any type of erectile dysfunction, consult a healthcare practitioner. They will do a thorough assessment, looking at the person’s medical and sexual history, past substance use, as well as general health and vital signs.

Healthcare providers can use a variety of tests and tools to investigate the cause of erectile dysfunction, including, but not limited to:

  • Blood tests: Helps identify potential underlying causes that may contribute to erectile dysfunction, such as heart problems, anemia, or hormonal abnormalities, including testosterone, which is the basis of erectile dysfunction. These can also check kidney and liver function.
  • Nocturnal Penile Tumescence Test (NPT): Measures erectile function during sleep.
  • Urine tests: May check for the presence of diabetes as an underlying condition.
  • Thyroid tests: The thyroid helps regulate sex hormones. A thyroid deficiency could be the cause of erectile dysfunction.

Once all other medical explanations are ruled out, a mental health professional may be called upon to determine if psychological factors are involved. There may be a combination of things causing ED.

A mental health professional will do a psychological assessment to determine if there is a psychological reason that is causing or is related to the person’s ED.


Psychogenic erectile dysfunction is treated by addressing the psychological factors involved.

The main methods of treating psychogenic erectile dysfunction include:

  • Psychotherapy: Therapy can help patients identify their thoughts and feelings related to sexual activity and impotence. Through therapy, patients can develop balanced thoughts about themselves, their relationships and their sexual performance.
  • Couple consultation: This can create an opportunity for partners to improve communication about intimacy and sex, examine their sexual relationship, and better understand and understand each other’s sexual functioning.
  • Relaxation techniques: Implementing breathing, meditation or visualization strategies can promote calm and relaxation.
  • Medication: A health care provider may prescribe drugs to physically help a patient achieve an erection (for example, Viagra), or drugs to manage psychological symptoms, including antidepressants or anti-anxiety medications.

Heal body and mind

If an individual’s erectile dysfunction is caused by both physiological and psychological factors, a healthcare professional may recommend a combination of medications, lifestyle changes, and mental health care to treat erectile dysfunction.

A word from Verywell

Sexual health and function is an important part of a person’s life. Erectile dysfunction, whether due to psychological factors or not, is a very personal condition. Don’t be afraid to seek help and share your concerns with a healthcare professional. It can help you identify the cause of your erectile dysfunction and create a tailored treatment plan to improve your psychological and sexual well-being.