Sexual Wellness

Is It Sexual Decline or Something Else?

Fact Checked

How can you tell if your sexual health problems are due to physical or mental causes? Here, we reveal some of the clues you may be dealing with psychological sexual decline.

Last Updated: 12/13/2022

Written by

Kimberly Wilkes

Sexual decline can happen to any man as he ages, but how do you know if sexual aging is really your problem or if it’s something else? After all, there are physical causes of sexual decline like heart disease and diabetes, but in some men mental causes are the reason why sex isn’t as easy as it used to be. About 40% of sexual decline cases in men are due to mental health factors.1

Causes of Psychological Sexual Decline

One way to suspect your sexual problems are due to mental causes rather than physical is to gauge whether you have any of the following symptoms:

  • Depression2

  • Anxiety

  • Stress

  • Relationship Problems

  • Traumatic sexual experience

  • Feeling guilty

  • Negative body image

  • Low self-esteem

  • Penis size

  • Too much porn

Sexual Performance Anxiety

A lot of these causes of psychological sexual decline, especially negative body image, low self-esteem, being overly focused on penis size, and watching too much porn, can lead to sexual performance anxiety, where a man becomes insecure in bed and worries about whether he is pleasing his partner.3 

How to Tell the Difference Between Mental and Physical Sexual Decline

Psychological sexual decline isn’t easy to tell apart from physical sexual decline, because they both have the same symptoms such as:

  • Inability to keep an erection

  • Can’t become aroused even when stimulated 

  • Low sexual desire

Clues Your Sexual Performance Issues are Mental

The best way to know the cause of your bedroom challenges is to visit a doctor. They can investigate whether you have any underlying physical causes or whether you have symptoms of depression. 

If your doctor sees signs your sexual performance issues are caused by mental factors, they may recommend you see a professional therapist. 

Here are some other ways to know if mental health is the reason for your underperforming in the bedroom:

  • You’re able to get hard and ejaculate when you masturbate but not when you’re with a partner.

  • You have erections when you’re sleeping or upon waking up. To tell if you’re having nocturnal erections, wrap a thin piece of tissue paper around your flaccid penis and hold it with a small piece of tape. If you’re having erections in your sleep the paper will break. Having erections in your sleep means you’re capable of having them, so any issues regarding sexual performance with a partner are likely psychological and not physical.  

If the cause of your sexual decline is physical, your doctor may recommend lifestyle changes like weight loss, eating a healthy diet, and exercise. They may also prescribe pills or recommend the use of Li-ESWT (acoustic soundwave therapy) either in a urologist office or using a similar Li-ESWT device in the convenience of your home.