Health advice

Erectile dysfunction and your mental health

More erectile dysfunction information
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Erectile dysfunction can have a negative impact on your self-esteem

Erectile dysfunction can happen for a variety of reasons. Sometimes, feelings of low self-esteem or a lack of confidence can impact your ability to get and maintain an erection. If you feel like your mental health could be playing a role in your erectile dysfunction, there is treatment and support available.

Reviewed by: Connie Whewall, Pharmacist

Published: March 2024

Next review: March 2027

Photograph of Well Pharmacist.
Why does erectile dysfuntion happen?

Erectile dysfunction can affect you at any age.1 Although it can caused by physical conditions, there may also be psychological and social factors at play that can impact your ability to get and maintain an erection.1

Although you may feel attracted to your partner or are not experiencing relationship problems, feelings of anxiety, stress or depression could be impacting your performance.

It’s important to remember that erectile dysfunction is treatable and that you can talk to your partner, a sex therapist or counsellor for support. Your GP or pharmacist can also give you a medical perspective so that you can start to address any underlying physical or psychological triggers.

Performance anxiety

Erectile dysfunction can be triggered by performance anxiety. If you are nervous, anxious or worried about your performance before you have sex, your feelings can manifest as an inability to get or maintain an erection when you want to.2

Everyone can have these feelings from time to time, but if it is affecting your sex life regularly, speaking to your GP, a sex therapist or a sex counsellor might help.

What are the reasons for performance anxiety?

There are many reasons why you might have performance anxiety. Some common causes include:

  • Stress
  • Body image
  • Self-esteem
  • Sexual confidence2

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Mental health conditions

Your mental health can play a significant role in your life and impact your general wellbeing. This is also true for erectile dysfunction, where your mental health can limit your ability to get an erection.

There are some mental health conditions that might contribute to your erectile dysfunction.3

Man with a serious face looking away from the camera.

Depression

Erectile dysfunction can impact the way you feel about sex and limit the positive feelings you have towards it. People with erectile dysfunction are often more likely to develop depression as a result.4

In turn, people with depression are more likely to develop erectile. This happens because your brain blocks feelings of arousal or feeling ready for sex. This may make you feel like you want to avoid sex. 3, 4

If you think you might have depression, you should speak to your GP. They will provide you with a judgement-free environment so that you can discuss your thoughts and feelings openly. They can also prescribe treatments for any physical and psychological conditions that you have.

Learn more about depression
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Anxiety disorders

Living with an anxiety disorder can increase your chance of developing erectile dysfunction. Sometimes, people with anxiety disorders have other medical conditions including depression or alcohol addiction. These conditions are potential triggers for erectile dysfunction.3

Anti-depressants like SSRIs (selective serotonin reuptake inhibitors) are also associated with erectile dysfunction. This doesn’t mean that you should stop taking them without speaking to your GP first.3

Talk to your GP if you are concerned about how you can manage your erectile dysfunction while taking medicine for your mental health.

Learn more about anxiety
Pornography-induced erectile dysfunction

Pornography is readily available to watch and use.

It can help boost your sexual confidence and help your relationship with your partner. However, overconsumption, or watching too much, can harm your mental health.4

It is possible to develop erectile dysfunction from watching too much porn. This erectile dysfunction trigger is highly prevalent in men aged between 18 and 35. 4

Porn can trigger satisfaction pathways in your brain that can make it difficult to quit. If you need support for porn addiction, your GP will be able to recommend services like sex therapy to help you cope.5

How can a sex therapist help me?

If you live with erectile dysfunction, a sex therapist can help you understand the emotional and mental reasons for your inability to get an erection. During their sessions, your therapist will talk to you about the causes of your erectile dysfunction and may give you exercises to help you improve your symptoms.6

You can attend the appointments with your partner if you think it will be helpful. Your close, intimate relationships can be affected by the way you feel. So, learning alongside your partner may help in improving your erectile dysfunction.6

Your GP can refer you to a sex therapist if you need one. They can also help you understand the physical causes of your erectile dysfunction.

Man with a glass of water explaining his problems to a therapist.
Will medicines work for erectile dysfunction triggered by a mental health condition?

Medicines like Viagra (sildenafil) and Cialis (tadalafil) can help treat erectile dysfunction caused by SSRIs. It is a safe option if you are living with depression since there are no dangerous interactions between these medicines.7 Speaking to your GP or pharmacist before taking any new medicines will help ensure that they are right for you.

Where can I get more support?

Relate

An organisation that helps people access sex therapy.

Relationships Scotland

Relationship counselling services for people living in Scotland.

Mind

A mental health charity that helps people with low self-esteem and other mental health conditions.

NHS Website

Information and support for people living with erectile dysfunction.
References
  1. Erectile dysfunction (impotence). nhs.uk. Published November 13, 2017. Accessed February 12, 2024. https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/
  2. Allen MS, Wood AM, Sheffield D. The Psychology of Erectile Dysfunction. Curr Dir Psychol Sci. 2023;32(6):487-493. doi:10.1177/09637214231192269
  3. Allen MS, Wood AM, Sheffield D. The Psychology of Erectile Dysfunction. Curr Dir Psychol Sci. 2023;32(6):487-493. doi:10.1177/09637214231192269
  4. Porn Addiction Treatment: Reclaiming a Healthy Life | UKAT. UK Addiction Treatment Centres. Accessed February 12, 2024. https://www.ukat.co.uk/addiction/behavioural/porn/
  5. Jacobs T, Geysemans B, Van Hal G, et al. Associations Between Online Pornography Consumption and Sexual Dysfunction in Young Men: Multivariate Analysis Based on an International Web-Based Survey. JMIR Public Health Surveill. 2021;7(10):e32542. doi:10.2196/32542
  6. Jacobs T, Geysemans B, Van Hal G, et al. Associations Between Online Pornography Consumption and Sexual Dysfunction in Young Men: Multivariate Analysis Based on an International Web-Based Survey. JMIR Public Health Surveill. 2021;7(10):e32542. doi:10.2196/32542
  7. Nurnberg HG, Hensley PL, Gelenberg AJ, Fava M, Lauriello J, Paine S. Treatment of Antidepressant-Associated Sexual Dysfunction With Sildenafil. JAMA. 2003;289(1):56. doi:https://doi.org/10.1001/jama.289.1.56
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