Anxiety and ED – Can Anxiety Cause Erectile Dysfunction?
Whether you’re suffering from an anxiety disorder or sexual performance worries, here’s how these psychological issues impact your sex life—and what to do about it.
Last Updated: 08/30/2023
Anxiety and erectile dysfunction (ED) often go hand in hand. It’s not easy to perform sexually if you’re distracted by anxious feelings. In this blog post, we’ll dive into the different types of anxiety and how they impact your sex life.
What Is the Difference Between Stress and Anxiety?
Stress and anxiety are two different types of psychological factors. According to the American Psychological Association, stress is caused by an outside trigger. Maybe you’re under a lot of pressure at work, or you’re taking care of an elderly relative, or experiencing financial stress. Those types of personal and professional stress are all external triggers.
Stress is linked to symptoms like:
Anger
Irritability
Muscle pain
Fatigue
Sleep loss
Digestive problems
On the other hand, the main hallmark of anxiety is ongoing, over-the-top worry about something specific or general even when you don’t encounter an external stressor. Symptoms are similar to those caused by stress:
Irritability
Muscle tension
Insomnia
Fatigue
Having a hard time concentrating
Both stress and anxiety can cause ED and low sexual desire, as well as affect other aspects of sexual health and sexual activity.
Sexual Performance Anxiety or Something More Serious?
There are two types of anxiety we’re going to address in this blog post. Each of these is capable of affecting sexual health:
Anxiety disorders
Sexual performance anxiety
Anxiety disorders are mental health conditions that a doctor can diagnose. These psychological factors often get in the way of performance at work or school or impact personal relationships. There are a lot of different types of these disorders, but some of the most common include:
Panic disorder
Generalized anxiety disorder
Agoraphobia
Social anxiety disorder
Post-traumatic stress disorder (PTSD)
Obsessive-compulsive disorder (OCD)
The National Institute of Mental Health estimates that 14.3% of men suffer from one of these disorders.
Anxiety and Erectile Dysfunction
Men with anxiety disorders often experience erectile dysfunction, which gets in the way of a healthy sex life.1
A review of medical studies that was published in the International Journal of Impotence Research found that men with anxiety disorders are at high risk of developing ED symptoms, especially mild to moderate erection trouble.2
The scientists looked at studies that investigated the prevalence of erectile dysfunction in men with PTSD, obsessive–compulsive disorder, social phobia/social anxiety disorder, and panic disorder.
The prevalence of erectile dysfunction varied considerably among the different disorders but averaged around 20%. In men with PTSD, the prevalence of ED ranged from 3% to 85%. In panic disorder, the prevalence ranged from 2% to 36.2%. In men with OCD, up to 20% of the men suffered from erectile dysfunction.
Anxiety Disorder Medications and Erectile Dysfunction
Certain medications used to treat anxiety can cause sexual dysfunction. These medications include the benzodiazepines class of drugs, including Xanax, Ativan, Klonopin, and Valium. One study found that men taking this type of medication had a two to three times greater risk for erectile dysfunction.3
Other Treatment Options
If your anxiety disorder is moderate to severe, then your treatment plan will likely include medications and seeing a professional therapist.
Another possible treatment option for mild forms of anxiety disorders is addressing lifestyle factors such as:
• Eating a healthy diet
• Exercising
• Meditating
• Getting enough sleep
Paying attention to these lifestyle factors should lead to improvements in both your anxiety and ED. Visiting a professional therapist is also helpful.
Reducing your anxiety may in and of itself resolve your erectile dysfunction, but if you need more help, your doctor can treat erectile dysfunction with pills like Viagra or Cialis.
Anxiety Disorders and Cardiovascular Disease
Stress and anxiety increase the risk of other health conditions linked to erectile dysfunction such as coronary heart disease and high blood pressure.4
Anxiety disorders are associated with the onset and progression of cardiac disease.4 There’s also a connection between these types of mental health issues and adverse cardiovascular outcomes—in other words, death from cardiovascular disease.4
The reason for the connection may be due to both physical and behavioral reasons. Physical reasons why anxiety disorders may lead to cardiovascular problems include:
Dysfunction of the autonomic nervous system, the part of the nervous system that regulates involuntary processes such as heart rate, breathing, and sexual arousal.
Inflammation
Endothelial dysfunction, which is damage to the blood vessel lining
Increased platelet aggregation (“sticky” platelets), which interferes with blood flow
Behavioral reasons why someone with an anxiety disorder might be more likely to develop cardiovascular disease include:
Lack of exercise
Poor eating habits
Not getting enough sleep
The link between anxiety disorders and cardiovascular health is important to erectile function because erectile dysfunction is a red flag for heart problems. Erectile dysfunction often develops two to three years before cardiovascular disease and is an indication of poor blood flow through the blood vessels, including those in the penis.5
Your doctor can perform a physical examination, order blood tests, and if you have cardiovascular issues, suggest treatment options. They might also refer you to a specialist, who may recommend additional medical treatment.
Sexual Performance Anxiety and Erectile Dysfunction
Sexual performance anxiety, although one of the most common sexual dysfunctions, is not recognized as a medical diagnosis or considered an anxiety disorder.6 It’s a form of psychological erectile dysfunction, where erection problems are caused by mental health issues rather than physical causes. Excessive worry about performance in bed is one of the most common psychological causes of ED.
In this type of performance anxiety, a man worries about his sexual performance and whether he is pleasing his partner, which can lead to erectile dysfunction.
Suffering from erectile dysfunction can also lead to worry over sex. If you’ve had even one sexual encounter where you haven’t been able to perform, you may start to worry that it’s going to happen again and erectile dysfunction becomes a self-fulfilling prophecy.
Other causes of sexual performance anxiety include:
Self-esteem issues
Poor body image
Concern about penis size
Relationship issues
Watching porn
Being under stress
In addition to erectile dysfunction, sexual performance anxiety may lead to other types of sexual dysfunction, such as premature ejaculation and an inability to reach orgasm.
Overcoming Sexual Performance Anxiety
If you suffer from this problem, there are several possible solutions.
Avoid Creating a Vicious Cycle
Many men experience a frustrating sexual experience from time to time. That doesn’t mean it’s going to happen again.
Maybe your encounter with erectile dysfunction was due to being overly tired and not getting enough sleep. Or perhaps you were under a lot of stress at work. These and other factors can affect your sexual performance. Don’t dwell on what has happened in the past and stay hopeful about your sexual performance in the future.
Concentrate on the Sexual Activity
Allow the pleasant sensations of sex to distract you from your anxiety. Focus on the way your partner looks and feels rather than on your anxious feelings.
Exercise
Physical activity can reduce stress and anxiety and improve erectile function. Research shows that aerobic exercise of moderate-to-vigorous intensity works better than other types of exercise to improve erectile dysfunction.7
Seek Out a Professional Therapist
Professional therapy can also help resolve performance anxiety that involves fear or worry over sexual intercourse. This type of therapy can help build self-esteem and self-confidence, teach ways to cope with stress and anxiety, and reduce sexual dysfunction.
For other ways to overcome sexual performance anxiety, read our blog post, Solutions for Overcoming Sexual Performance Anxiety.
Frequently Asked Questions About Anxiety and ED
Can Anxiety Cause Erectile Dysfunction?
Erectile dysfunction, especially mild to moderate ED, is common in people with anxiety disorders such as PTSD, obsessive–compulsive disorder, social phobia/social anxiety disorder, and panic disorder.
The benzodiazepines class of drugs, including Xanax, Ativan, Klonopin, and Valium, used to treat anxiety also may cause erectile dysfunction.
In addition, people with these types of mental health conditions are more likely to develop cardiovascular problems and these types of problems are associated with erectile dysfunction.
Does Sexual Performance Anxiety Cause Sexual Dysfunction?
Sexual performance anxiety, while not an anxiety disorder, is a common sexual health problem that can cause erectile dysfunction. Men who become anxious about their ability to satisfy their partner can develop sexual dysfunction such as premature ejaculation or ED.
How Can I Overcome Erectile Dysfunction from Anxiety?
The answer depends upon whether you suffer from an anxiety disorder or sexual performance anxiety.
Mild anxiety disorders may improve with lifestyle changes like exercise, meditation, eating healthy, and getting enough sleep, along with seeing a professional therapist. At the same time, these strategies may treat erectile dysfunction.
On the other hand, your doctor will likely recommend treating moderate to severe anxiety disorders with medication and therapy sessions.
Performance anxiety related to sex may go away by not dwelling on past frustrations in the bedroom, focusing on your partner and the sensations of sex, and getting enough exercise. A professional therapist may also help resolve your anxiousness over sex and pinpoint why you are having those feelings.
Do I Have ED or Am I Just Stressed?
Chronic stress and anxiety are common psychological factors that can cause erectile dysfunction. Even increased stress at work or home over the short-term can affect your sexual activity and cause temporary erectile dysfunction. Relationship issues also can interfere with sexual function.
Try stress management strategies or work on resolving relationship issues, and the ED will likely go away as you reduce stress.
Is Erectile Dysfunction Caused By Anxiety Temporary?
Anxiety can cause ongoing ED, but the erectile dysfunction can often be temporary. Treating anxiety disorders like post-traumatic stress disorder, panic disorder, generalized anxiety disorder, and OCD can cause erectile dysfunction to go away.
ED caused by performance anxiety also can go away if you take steps to feel more relaxed about sex. In addition, professional therapy can teach you effective coping mechanisms.
Sources:
https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8964411/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3834242/
https://pubmed.ncbi.nlm.nih.gov/27671918/
https://pubmed.ncbi.nlm.nih.gov/26049392/
https://www.issm.info/sexual-health-qa/what-is-sexual-performance-anxiety-and-how-can-one-manage-it