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Is My Erectile Dysfunction Physical Or Psychological?

    Erectile dysfunction (ED) is projected to impact as many as 322 million men by 2025, according to a study from the International Journal of Impotence Research. ED refers to the inability to maintain an erection required for sexual intercourse. ED can impact men of all ages, but traditionally affects older individuals. 

    The main cause of ED is physical health. But ‘Erectile Dysfunction does not always have a physical cause; sometimes it can be psychological.’ 

    Chief Pharmacist Stuart Gale from Oxford Online Pharmacy explains to, “However. in some cases, it can be an early warning sign of other health issues”’

    Read on to find out more about the physical and psychological causes of ED.

    Physical Causes of Erectile Dysfunction

    ED can be caused by a wide range of health complications. Health conditions can also be exacerbated by lifestyle choices like drinking or smoking.

    Some of the main causes include:

    Heart disease

    Up to 75% of individuals with heart disease report problems with erectile dysfunction. The cause of the ED may be due to the heart’s inability to pump enough blood to the penis, or related to the medication used to treat the heart disease. Individuals with heart disease can also be affected by psychological factors that cause ED.


    Individuals with diabetes may also have ED. This is because over time, diabetes can damage the supply of blood to the penis, as well as the nerves involved with the erection. Men experiencing low sugar levels can also suffer from ED as there is not enough blood flowing to the penis to cause an erection.

    High Blood Pressure, Cholesterol & Atherosclerosis

    High blood pressure, cholesterol and atherosclerosis (clogged arteries), can all impact the supply of blood that flows to the penis. High blood pressure can damage blood vessel walls, causing them to thicken, while high cholesterol and atherosclerosis block the blood vessels, restricting blood supply.

    Other Contributing Physical Factors Of ED

    Hormonal imbalances like low testosterone, as well as certain sleep disorders, can also contribute to ED. Excessive, smoking, drinking or alcohol intake are also contributing factors, and obesity has also been linked to ED. Spinal cord damage may lead to erectile dysfunction. ED can be an indication of more severe illnesses like Parkinsons or Multiple Sclerosis, and the use of prescription medication may cause ED.

    Psychological Causes Of Erectile Dysfunction

    If your GP has ruled out a physical reason for your ED, the cause may be psychological. This can be harder to identify, but some of the reasons may be:


    You don’t have to be under a serious amount of stress to suffer from erectile dysfunction. Anxiety over a particular event the next day may cause ED, while stressors like work can also cause erectile dysfunction. Reducing additional stressors over this period of time, like caffeine, can help reduce the effect of stress on ED.

    Mental Health

    Anxiety has a number of physical effects, including higher blood pressure or poor sleep – all factors that contribute towards ED. Those with depression may also experience erectile dysfunction – depression can be caused by or affect the hormones in your body, leading to low sex drive and potentially, ED. With treatment, those with depression can resolve ED over time. Seeking help for mental health is the first step to resolving ED.


    Are you and your partner having issues? If you find yourself frequently arguing, this may translate into your sex life and you may experience ED. Seeking the advice of a professional may help you and your partner to work through your relationship together and resolve the causes of anger or concern that led to ED.


    If you experience erectile dysfunction on one occasion, the fear of future issues may impact your ability to have an erection in future. This is due to the associated anxiety having a physical impact on your body. Low self-esteem and lack of confidence may also be linked to other conditions like depression.

    Psychological and Physical Causes Are Linked

    Conditions that affect the mind are inevitably linked to the body. Many of the physical causes of ED, like high blood pressure, can be induced by anxiety or mental health conditions. That’s why it’s important to seek help for your ED, even when your doctor rules out an underlying physical health issue. There are a number of tests available for determining whether your ED is psychological, which involves testing for erections during the night, while you are asleep.

    What Treatments Can Help With ED?

    The first point of erectile dysfunction treatment should always be your GP. Your GP may ask you questions which cover your sexual history, your health, and your current relationship. There may be follow up blood and health checks to rule out underlying conditions. When mental health is a factor, your GP may recommend you seek the help of a qualified therapist. 

    Depending on the health condition, men often find their ED is resolved after initiating the medication required to help their physical or mental health condition. Other treatments may include herbal supplements, penis pumps or certain hormonal therapies.

    Lifestyle Changes To Help With ED

    There are several lifestyle changes you can take which will help with your ED, like:

    • Exercising regularly – aim for 30 minutes of exercise 5 days a week
    • Maintaining a healthy weight for your body
    • Reducing alcohol and cutting out smoking
    • Getting enough sleep each night
    • Focusing on your mental health
    • Trying techniques to destress like yoga
    • Cutting out stressors like excessive caffeine 

    A healthy lifestyle can improve the physical effects of ED, particularly for issues linked to high blood pressure/ cholesterol or atherosclerosis. Exercise and cutting out unhealthy substances can also positively impact your mental health and improve the psychological aspects of ED at the same time.

    Seeking Help For Erectile Dysfunction

    Many men may find acknowledging they need help with their ED a challenge. However it’s essential to get the medical help you need, whether it’s medical treatment or seeking the advice of a therapist. We hope that this advice helps shed some light on erectile dysfunction, and gives you confidence in finding a solution for the condition.