Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 11/25/2022
Erectile dysfunction (ED), which is described a condition in which a man isn’t able to get or maintain an erection during sexual stimulation, can be incredibly frustrating and can mess with your quality of life. It often leaves many men contemplating a chicken-or-the-egg-type of situation: does erectile dysfunction cause stress, or can stress cause erectile dysfunction?
Of course, no one wants to be unable to seal the deal. So, getting to the bottom of what’s causing ED is usually a priority. Several physical conditions can cause ED — age, cardiovascular issues, heart disease, blood pressure issues, diabetes, obesity and more.
But there are mental conditions that can also lead to ED. Is stress one of them? You’ll have to keep reading to find out.
On top of contributing to things like blood pressure issues or cardiovascular diseases, stress can also affect you in the bedroom.
Research has shown common life stressors can cause anxiety and lead to ED. Unfortunately, this can cause a vicious sex-stress cycle to begin. You’re stressed, it leads to ED, then your ED makes you self-conscious and it leads to more stress.
Hence, the “chicken-or-the-egg.”
Another study from 2015 looked at 64 men with ED or premature ejaculation (PE). There was a significant connection found between ED and anxiety or depression.
In a majority of cases, the anxiety or depressive disorders started before the sexual dysfunction.
So, researchers in this study concluded that stress, anxiety and depression could be contributing factors to the sexual issues.
Wondering what’s happening biologically when you’re stressed?
When you get stressed, your body releases “stress hormones” like epinephrine, norepinephrine and cortisol, which are all “enemies” to an erection because they impact things like blood flow and hypertension.
And remember what we said above about how crucial blood flow is to a successful erection — without proper blood flow, your erectile function is compromised.
Now that it has been established that stress can indeed lead to ED, it’s helpful to know what kind of stress we’re talking about.
After all, there are many different types of stress — and they can all impact you in different ways.
Some types of stress that have specifically been linked to ED include:
Money and career woes are two very common stressors in life.
In fact, according to a study done by the American Psychological Association, 63 percent of people say they’re stressed about the economy.
The same study found that 64 percent of people report that work is a big source of stress.
Research published in 2020 also found that job loss or concerns over job loss can affect sexual desire — including ED.
The same study that found that job loss can impact sexual desire also found that resentment and frustrations in intimate relationships can also lead to ED.
If there’s stress in your relationship that’s affecting your sexual function (and thus, your level of intimacy with your partner), that lack of intimacy can eventually lead to more stress.
… Hence, the “chicken-or-the-egg.” See the pattern?
Up to 37 percent of men with ED also have an anxiety disorder.
It’s believed that anxiety can affect the sympathetic nervous system, which plays a crucial role in getting an erection.
Because of this, those with anxiety disorders may find themselves also navigating ED.
Another study found that men with post-traumatic stress disorder (PTSD) are more likely to experience ED, too.
Another type of stress that can lead to ED? Worrying you won’t be good enough in bed.
This stress is often called sexual performance anxiety.
Research has found that performance anxiety is closely connected to sexual dysfunction in men.
Performance anxiety can result in different types of sexual dysfunctions — including ED.
With performance anxiety, you may worry about getting hard, finishing early, your skills and more. All of this can make it tough to get an erection.
Watching porn can also lead to performance anxiety, which could then lead to ED. If you’re comparing yourself to a porn star, you may feel insecure and you could have a tough time getting hard.
If stress is causing ED, one way to potentially solve your sexual hardships (or lack thereof!) is to find ways to reduce stress.
Lucky for you (and your hard-on), there are a number of ways you can approach a less stressful lifestyle.
There’s some proof that a good workout can help you battle stress.
One 2014 study looked at the effects of physical activity on 111 healthy men and women who did and didn’t report regular physical exercise.
The researchers found that those who exercised as infrequently as once per week had a lower heart rate at rest than non-exercisers.
More importantly, they found that people who didn’t exercise reported a steeper decline in mood than those who did.
Research from 2006 also found that even though physical exercise can initially elevate your body’s stress response, the after-effects result in lower levels of cortisol and norepinephrine (the stress hormones we mentioned above).
How much exercise do you need? Your goal should be about 150 minutes of moderate-intensity physical activity a week. Or, you could opt for 75 minutes of high-intensity exercise.
You probably aren’t surprised to hear that meditation can lower stress. After all, that’s kind of the whole point of it.
A 2014 study found that just 20 minutes of mindful meditation can assist in decreasing stress and anxiety. The reason for this is thought to be that it temporarily reduces brain activity.
If you’re not sure how to meditate, no problem! There are plenty of apps that contain easy-to-follow guided meditations.
Cognitive behavioral therapy (CBT) is a great option for treating both stress and ED. You’ll be able to talk about things that stress you out, along with how your ED impacts your life.
In CBT, you will focus on patterns that may cause you stress. Then, you and a mental health professional will devise ways to change these stress-inducing behaviors and adopt more fruitful coping strategies.
If you think stress specific to sex is behind your ED, you could also try sex therapy.
In sex therapy, you may talk about your sexual history, past sexual health issues and issues you have during sexual activities.
It’s basic, but true: stress sucks.
Not only can it turn you into a mess of nerves and anxiety, it can also contribute to ED — which puts a major damper on sexual activities and your daily life.
Whether you’re dealing with stress from work, sexual performance anxiety or stress caused by mental health conditions like anxiety disorders, it can really hurt your sex life and your erectile function.
If you’re experiencing physical symptoms of erectile dysfunction, there’s hope. You can incorporate things like exercise and meditation into your treatment plan, as well as talk to a healthcare professional about trying erectile dysfunction medication (like sildenafil, tadalafil or avanafil).
All of these medications are in a class of medication called PDE-5 inhibitors and require a prescription. They work by opening up your blood vessels and boosting blood flow to your penis.
Before taking any new medication, a healthcare professional will likely take a medical history. They may also ask about any medical conditions you have or allergies. This way, they can try to ensure you won’t react poorly to whatever they prescribe you.
If you’re interested in speaking to someone about your sexual performance issues and ED in order to figure out what the right medical treatments could be, you can schedule an online appointment with a healthcare provider.