PTSD and Erectile Dysfunction: Understanding the Link and Finding Solutions

Post-traumatic stress disorder (PTSD) is a mental disorder that affects an estimated 13 million Americans and 4 out of every 100 men at some point in their life.1 As the name implies, PTSD is caused by experiencing or witnessing a traumatic event, usually one that threatens your life or that of other people. 

The most well-known symptoms of PTSD include flashbacks, anxiety, depression, and mood swings, but PTSD also is linked to a less talked about problem: erectile dysfunction. According to research, men with PTSD are more likely to experience erectile dysfunction than those without the disorder. 

In this article, we'll take a look at the connection between PTSD and erectile dysfunction, the possible causes, and the available treatments. Read on to discover more about this connection and what you can do to get rid of ED that’s caused by PTSD.

What is PTSD?

Post-traumatic stress disorder (PTSD) is a mental health condition that can happen after experiencing or witnessing something traumatic, such as natural disasters, military combat, physical or sexual assault, and accidents. 

PTSD can be a debilitating disorder that can impact a person’s quality of life and cause a lot of suffering, not only for the person who has it but also for spouses and close family members. People who suffer from PTSD can have flashbacks, nightmares, anxiety, depression, and insomnia, and they avoid triggers that might bring back unpleasant memories of the traumatic event.

Anyone can suffer from PTSD, but it happens more often in people who have:

• Gone through more than one traumatic event

• A history of mental health disorders

• A family history of PTSD. 

A mental health professional can diagnose the disorder and treat patients with therapy, medication, or a combination of both.

Not everyone who experiences a traumatic event develops PTSD. Although about 70% of people will experience a traumatic event in their lifetime, only 20% of these people develop PTSD.2 

Common PTSD Symptoms 

PTSD symptoms can vary from person to person. 

Symptoms of PTSD can include:

• Flashbacks or nightmares of the traumatic event

• Avoidance of triggers associated with the trauma

• Hypervigilance or feeling on edge

• Anxiety and depression

• Difficulty sleeping

What is Erectile Dysfunction?

Erectile Dysfunction (ED) is a type of sexual dysfunction that affects a man's ability to achieve or maintain an erection during sexual activity. Stress, anxiety, depression, and underlying health conditions such as diabetes, high blood pressure, and heart disease are some of the things that can cause ED.

ED can impact sexual functioning over the short term or long term, and men of all ages can develop the disorder. While it's more common in older men, younger men can also experience ED. Whatever your age, ED isn’t a fact of life as healthcare providers can treat it with medication, therapy, or lifestyle changes.

Erectile Dysfunction Symptoms

Symptoms of erectile dysfunction can include:

• Difficulty achieving or maintaining an erection

• Reduced sexual desire

• Premature ejaculation

• Inability to achieve orgasm

The Connection between PTSD and Erectile Dysfunction

Studies have shown that men with PTSD are more likely to experience erectile dysfunction than those without the disorder. A study in the journal Urology found that male combat veterans diagnosed with PTSD had a higher rate of sexual dysfunction than combat veterans without PTSD.3

In 44 male veterans with PTSD, the International Index of Erectile Function (IIEF) score was significantly lower compared to the 46 male combat veterans without PTSD.3 

In that study, patients with PTSD had worse scores on overall satisfaction and orgasms and trended toward worse scores on intercourse satisfaction and erectile function.3 No statistically significant difference was observed for sexual desire. In the combat veterans with PTSD, 85% had erectile dysfunction, while only 22% of controls had ED.3 Moderate to severe ED occurred in 45% of the veterans with PTSD and in only 13% of the controls.3 

In other research, men with PTSD had a greater chance of developing ED.4 In addition, one recent review of medical studies found that PTSD was associated with increased risk of experiencing at least one sexual dysfunction.5 PTSD was most clearly linked to sexual problems like poor overall sexual function, low sexual desire and sexual satisfaction, and sexual distress.5 There were mixed results for sexual arousal, ability to have orgasms, erectile dysfunction, and premature ejaculation.5

How Does Post-Traumatic Stress Disorder Affect Erectile Function?

PTSD can trigger changes in the brain that can cause sexual problems. For example, the stress hormones associated with PTSD can cause blood vessels to narrow, reducing blood flow to the penis and making erections difficult. 

Additionally, the anxiety and depression associated with PTSD isn’t exactly good for sexual function. People with PTSD can at times be irritable, angry, or sad, which can impact relationships with sexual partners and leave you not in the mood for sex. 

Erectile dysfunction can worsen symptoms of PTSD. Men with erectile dysfunction may feel ashamed, embarrassed, and anxious about their sexual performance. These feelings may cause you to avoid sex and keep you socially isolated. This leads to a vicious cycle, where ED worsens symptoms of PTSD, such as depression and anxiety, which in turn makes ED worse and affects sexual functioning.

Medications for PTSD and Sexual Dysfunction

Many medications used to treat PTSD symptoms may cause sexual difficulties. Many—but not all—studies suggest that antidepressant medications, which are often used in people with a mental health diagnosis like PTSD, can lead to sexual dysfunction. 

What percentage of people taking antidepressants develop sexual dysfunction? It depends on the study and the type of drug used. According to one review of medical studies, 40% of people taking antidepressants developed some form of sexual dysfunction.6 

Another study found an overall incidence of sexual dysfunction in 58% of 344 study subjects who had a history of normal sexual function before they started taking a type of antidepressant known as selective serotonin reuptake inhibitors (SSRIs).7 In this study, sexual side effects happened most often in people taking the SSRI Paxil, otherwise known as paroxetine, (65%) and least often in people taking Prozac (fluoxetine, 54%).

One study of 1,022 people found that there was a 59.1% incidence of sexual dysfunction when all antidepressants were considered as a whole. However, some psychiatric medications used for depression had an incidence of sexual dysfunction of only 3.9%.8 

If you have sexual side effects after taking an antidepressant medication, talk to your healthcare provider about either lowering the dosage or switching to another medication. 

Risk Factors for Developing Post-Traumatic Stress Disorder and ED

Several factors lead to a higher risk of developing PTSD and erectile dysfunction.

Risk factors for developing PTSD can include:

• Exposure to multiple traumatic events

• A history of mental health problems

• A family history of PTSD

• A lack of social support

Factors linked to a greater risk for developing erectile dysfunction can include:

• Older age

• Underlying health conditions such as diabetes, high blood pressure, and heart disease

• Smoking or excessive alcohol use

• Psychological factors such as stress, anxiety, and depression

Diagnosing PTSD 

A mental health professional can diagnose PTSD through a clinical interview and by evaluating symptoms. If you’re diagnosed with PTSD and you have experienced symptoms of ED, bring it up to your healthcare provider, so they can offer some possible solutions. 

Treatment Options for PTSD and Erectile Dysfunction

Treatment options for PTSD and ED can vary depending on the severity of symptoms and underlying causes.

Treatment options for PTSD can include:

• Therapy such as Cognitive Behavioral Therapy (CBT) or Eye Movement Desensitization and Reprocessing (EMDR)

• Medications such as antidepressants or anti-anxiety medications

• Lifestyle changes such as exercise, healthy eating, and stress reduction techniques

Treatment options for erectile dysfunction can include:

• Medications such as sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra)

• Vacuum devices or penile injections

• Surgery in severe cases

However, the best way to deal with ED that’s linked to PTSD may be to address the PTSD itself in order to get at the root cause of the problem. After all, research found that ED drugs like sildenafil are only somewhat effective for sexual problems in men with PTSD.9

Coping Strategies for Dealing with PTSD and Erectile Dysfunction

Seeking professional treatment is the first step to healing. However, combining this treatment with coping strategies you can do on your own can be helpful.

Coping strategies for PTSD can include:

• Engaging in relaxation techniques such as deep breathing and meditation

• Seeking social support from friends and family

• Avoiding triggers associated with the situation that caused the trauma 

• Exercising regularly and eating healthy

The above strategies may improve your mental outlook and lead to healthy sexual function. Other coping strategies for erectile dysfunction can include:

• Communication with sexual partners

• Engaging in non-sexual intimacy such as cuddling and kissing

• Trying different sexual positions or techniques

• Seeking support from a healthcare professional or therapist

Frequently Asked Questions About PTSD and Erectile Dysfunction

Can PTSD Cause Erectile Dysfunction?

Post-traumatic stress disorder can wreak havoc on your sexual health in many ways, including by causing ED. Erectile dysfunction is really common in men with PTSD compared with those without PTSD. According to a study in the journal Urology, male military veterans suffering from PTSD were more likely to also suffer from sexual dysfunction compared with military combat veterans without PTSD.

What Kind of Trauma Causes Erectile Dysfunction?

Any trauma that leads to post-traumatic stress disorder can cause ED. Types of trauma that can cause ED include:

• Military combat

• Sexual assault

• Natural disasters

• Witnessing a violent crime

• Accidents

• Any stressful and traumatic situation

Is PTSD a VA Claim for Erectile Dysfunction?

Post-traumatic stress disorder is a primary disability for which military veterans can receive benefits from the U.S. Department of Veterans Affairs (VA). ED is a secondary condition, which is caused by or made worse by your primary disability of PTSD. 

When applying for VA disability benefits, it’s a good idea to list secondary conditions like ED so that while reviewing your claim, the VA can take into account all your disabilities.10 

ED itself may be eligible for VA benefits if you can show that it’s related to a disability that’s connected to service, such as when ED occurs secondary to PTSD or if the ED is a side effect of a medication used to treat a condition related to military service such as depression or anxiety. 

Sources:

• https://www.ptsd.va.gov/understand/common/common_adults.asp

• https://www.therecoveryvillage.com/mental-health/ptsd/ptsd-statistics/

• https://pubmed.ncbi.nlm.nih.gov/12429320/

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8480081/

• https://pubmed.ncbi.nlm.nih.gov/37057456/

• https://pubmed.ncbi.nlm.nih.gov/10926052/

• https://pubmed.ncbi.nlm.nih.gov/9292833/

• https://pubmed.ncbi.nlm.nih.gov/11229449/

• https://pubmed.ncbi.nlm.nih.gov/16855464/

• https://www.seankendalllaw.net/blog/va-disability-for-erectile-dysfunction.cfm