Psychological causes of impotence

There are many physical causes of impotence but the psychological causes are just as important. These are often tied in to physical causes “ usually because a physical factor results in a form of psychological distress, e.g. depression.

Psychological causes include:

  • Anxiety
  • Depression
  • Guilt
  • Stress
  • Relationship problems
  • Sexual orientation problems
  • Sexual boredom

Most cases of erectile dysfunction are a combination of physical and psychological causes. Have a look through any of these to see if any of these apply to you.


This is often a problem for younger men especially teenagers who feel pressure ‘ to perform’. They are anxious about their performance and worry that their inexperience will show or are uncomfortable at using a condom.

Another major concern is that of causing an unwanted pregnancy.

Teenage boys are prone to peer pressure and feel compelled to have sex even if they don’t always want to in order to ‘ be one of the lads’. This causes stress and anxiety which then prevents them from achieving a successful erection.

Some young men have difficulty using a condom as they see it is unnatural or it causes them to lose their erection as soon as they put one on.


This occurs if a man is unable to get an erection or sustain one during sexual intercourse. This can affect his relationship with his partner, which over time, causes him to become frustrated and eventually depressed.

Many men see their erection problems as a reflection on their masculinity. They feel ‘ less of a man’ which then impacts upon their confidence and self-esteem.

There is a link between depression and erectile dysfunction which is based upon a mind-body connection. An erection happens as a result of external impulses which cause the brain to send signals to the penis where they cause an erection.

But if these impulses are negative then they are unlikely to stimulate much if any arousal which prevents an erection from occurring. This causes frustration and anxiety which then results in a psychological form of impotence.

The problem with this is that it leads to further stress and anxiety which worsens the impotence which then causes even more anxiety and so on…

This results in a ‘ depression-erectile dysfunction cycle’which can be difficult to break out of. But it can be treated. The important thing is to recognise that one aspect “ the depression, is causing the erectile dysfunction and to treat both of these at the same time.


This may be experienced if the man is sleeping with someone other than his wife or is having a relationship which he is uncomfortable with. The guilt which arises from this can impact negatively upon his performance and cause impotence.

Feeling guilty about sex often causes tension and an inability to relax which then prevents the man from achieving an erection.


Excessive stress impacts upon both our physical and psychological health but also affects sexual wellbeing as well. A period of prolonged stress can weaken the immune system which leaves the body open to infection and disease. It also causes a person to feel ‘ run down’.

Stress causes adrenaline and noradrenaline to be released which narrow blood vessels and reduces nitric oxide. Nitric oxide is important as it helps to expand blood vessels and control blood flow. But low levels of this prevent it from doing so.

If blood vessels are narrowed this then restricts blood flow through them to the penis which prevents an erection.

Another problem is that stress often causes negative emotions such as anger, self-doubt and resentment which pre-occupy everyday thinking. This causes the sufferer to lose interest in sex or find it increasingly difficult to get or sustain an erection.

This fear of sexual failure comes to dominate the man over time and results in a vicious circle: he becomes tense during sex which prevents him achieving and erection and, satisfy his partner. This causes him to become even more stressed by this which increases the tension and further compounds the problem.

One answer to this is to look at ways of reducing stress levels and learning to relax.

Relationship problems

If a couple are experiencing difficulties with their relationship then this often spills over into the bedroom. A relationship in which one person is no longer interested in the other or conflict has arisen can cause sexual failure.

The man may feel that he is no longer able to satisfy his partner whereas she may feel that he is no longer interested in her or does not love her any more.

This leads to tension which then prevents the man from getting an erection or being able to sustain it long enough.

Both partners experience feelings of guilt for what they see as a failure on their part. Plus they may feel resentful towards each other, especially if one half of the couple is unable or unwilling to discuss this with the other person.

One answer is psychosexual counselling which is discussed further in our treating impotence section.

Sexual orientation problems

This refers to a situation in which the man may discover he is gay and is no longer interested in his partner. If this is the case then he is unlikely to desire sex with her and if he does, then this will be unsatisfactory.

This sexual orientation issue will impact upon sexual performance to the extent that he is unable to achieve an erection and satisfy his partner.

Counselling is an option in these cases.

Sexual boredom

If a couple find that sex has become a turn off or one partner is uninterested in the other then this will cause sexual problems. It can also be caused by boredom with the same routine and reluctance to engage in any new form of sexual activity.

The libido is reduced which also affects sexual arousal and the ability to get an erection. Alternatively, the man may find that he can get an erection but is not able to maintain it for successful penetration. This boredom results in impotence.

Whatever the cause of your impotence; if it is psychological in origin, like the examples mentioned above then seek medical help or counselling.

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