Erectile dysfunction is most commonly associated with nerve damage, endocrine disorders (deficiency of sex hormones, diabetes), increased lipids, and other organic disorders. However, somatic pathologies are not the only cause of this rather unpleasant male health problem. Many recent scientific studies confirm that psychological causes of erectile dysfunction are predominant among patients under 40 years of age.
The General Classification Of Psychological Causes
Currently, this type is divided into several subtypes of causes:
- intrapersonal - related to changes in a person's mental state (within his personality);
- relational - related to problems in the relationships between partners;
- experienced psychological traumas - an episode of erectile dysfunction, childhood trauma, or stress during the day.
Intrapersonal Causes
A person's mental state is closely linked to many physiological processes in the body. The possibility of forming psychosomatic pathologies of the gastrointestinal tract and the female reproductive system has long been known. Male sexual health is no exception - depressive states can not only cause erectile dysfunction but are also significantly associated with the severity of disorders.
Depressive disorder is characterized by the following symptoms, which may vary depending on each individual case:
- Decreased concentration - constant distraction does not allow full concentration on sexual activity and maintaining an erection until the end of sexual intercourse;
- Low self-esteem, constant feelings of guilt - insecurity in oneself and one's abilities reduces the desire to start sexual activity due to fear of insufficient erection;
- Feeling tired, lack of energy and weakness - both physical and psychological fatigue lead to erectile dysfunction;
- Loss of pleasure from things that previously brought it - this can relate to various usual hobbies, as well as to sexual acts;
- Depressed mood, lack of interest - without adequate desire, it is impossible to start sexual activity, which ultimately also leads to psychological erectile dysfunction.
Another most common intrapersonal psychological cause of erectile dysfunction is anxiety. Increased anxiety levels lead to excessive focus on the quality of erection and what the partner thinks about it. The resulting cognitive distraction negatively affects arousal and, consequently, the erection itself.
On the other hand, drugs used to treat depression and anxiety can also affect sexual health (e.g., SSRIs, lithium, and benzodiazepines). This fact is not directly related to the action of mental or psychological disorder, but is closely related to it.
Relational Causes
The relational component of sexual activity is related to the expression of relationships between partners. In this case, the disease has a bidirectional effect: as a deterioration in relationships in a couple can lead to the development of psychological erectile dysfunction, so directly the dysfunction itself, of any origin, ultimately leads to difficulties in relationships.
Unfortunately, studies specifically examining the relationship between partner interactions and erectile dysfunction in young men have not been conducted. Although many other studies involve young men, making their results theoretically applicable even in this group, the most common age of participating men is usually shifted towards the middle, not the younger age. It is quite possible that relationships in a couple differently affect the mental state of young men, as they may have specific aspects of sexual activity, including short-term relationships, lack of experience in both partners, fears of emotional problems, anxiety about unwanted pregnancy.
Experienced Psychological Traumas
After experiencing stress or failure, a man may develop a psychological block, causing erectile dysfunction in the future. Some of the most common causes of such a block:
- Fear of repeated failure. With certain personality traits (low self-esteem, tendency to worry and anxiety), an experienced episode of erectile dysfunction, which could be related to increased physical fatigue or external irritants, leads to the development of fear. The man tries to avoid further sexual activity, becomes irritable, and the partner may start blaming themselves for the beginning of the discord. All this does not lead to favorable relationships in the couple, which also continues to negatively affect the ability to maintain an erection.
- The presence of childhood trauma. It may be related to the nature of the parents' relationship, as well as to the negative beliefs instilled about sexual activity. Most often, this happens in deeply religious families that advocate the rejection of sexual activity in general.
- Stress experienced during the day leads to the development of fatigue, weakness, and further inability to maintain an erection throughout the sexual act.
Treatment of Psychological Erectile Dysfunction
Undoubtedly, the question of how to overcome psychological erectile dysfunction concerns all patients who have this disorder. This is especially due to the fact that there is no organic pathology in a person, so all changes are potentially reversible. For this, after consulting a psychologist, psychiatrist, or psychotherapist, the man is prescribed several therapy options:
- Cognitive-behavioral therapy - both individual and group;
- Sex therapy - can also be individual or for both partners;
- Hormone replacement therapy (HRT) - hormones can be prescribed for such patients, however, this remains controversial;
- Phosphodiesterase type 5 inhibitors - they lead to relaxation of the spasm of smooth muscle cells of blood vessels, which causes an increase in arterial blood flow;
- Temporary prescription of mood-regulating drugs - for some time they can worsen the condition, however, quality therapy in conjunction with a qualified psychologist will speed up recovery.
Treatment of psychological erectile dysfunction is quite a long and labor-intensive process, so one should not expect results after the first session with a psychologist.