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Stress, anxiety and how it can cause ED

Don’t underestimate the effect stress, anxiety, and other negative emotions can have on your body. It can affect your digestion, your heart, your skin, your sleep, and many other important systems in your body. However, many men don’t realise that psychological factors can also affect their erections.

Psychological factors are a prominent cause of ED, affecting as many and if not more than 20% of men with the condition. Within that category, stress and anxiety are some of the most prevalent psychological causes. Unlike physical causes of erectile dysfunction like heart disease, high blood pressure, diabetes and high cholesterol, a clear cause of psychological ED can be more difficult to diagnose. This is especially true in men’s health, where discussions about men’s mental health is still often stigmatised.

In this article, we’re going to discuss what stress & anxiety do to the body and how it could be linked to impotence.

Medically reviewed by Dr. Caroline Fontana Written by our editorial team Last reviewed 04-10-2023

What is stress and anxiety?

Stress and anxiety are negative emotions generally caused by current and past environmental triggers. For most, these are acute conditions. However, for many others, these are chronic conditions that can significantly impede their quality of life.

These feelings are generally caused by an event or set of circumstances in your life. This may be due to past trauma, work stress, bereavement, relationship issues and many other factors.

Whilst both very common conditions, many underestimate how much of an impact they can have on the body.

 Man stressed while working on laptop.

What do stress and anxiety do to the body?

When you’re stressed or anxious about something, your nervous system sends a signal to your body to release certain hormones like adrenaline (epinephrine) and cortisol. These both affect your main regulatory systems, enhancing the ones that are helpful whilst restraining others that aren’t to conserve energy like digestion.

Occasional anxiety responses, while uncomfortable and tiring in the moment, won’t negatively impact your health. However, constant surges in these hormones can damage your blood vessels and lead to several health problems.

Stress, anxiety and how it can cause ED

Why do stress and anxiety cause ED?

In order to get and maintain an erection, your nervous system and circulatory system need to be functioning properly. This is because your nerves need to communicate properly to trigger an erection whilst your blood vessels need to be healthy to allow for more blood flow in the penis.

Stress and anxiety can impact erectile function because it interferes with your brain and nervous system. This means your brain might not be able to send the correct signals to your penis to cause an erection.

Chronic stress and anxiety disorders can also cause blood vessel damage. This inhibits blood flow, making it more difficult for a sufficient amount of blood flow to reach your penis and for your soft tissues to trap it to get hard.

Man holding cactus.

Unhealthy coping habits

Another way these conditions are linked to ED is the way they cause people to cope. One survey conducted in 2018 by the Mental Health Foundation found that when people are stressed: 46% overeat or indulge in unhealthy eating habits; 29% started drinking or drank too much and 16% started smoking or increased how much they smoke.

“Around one third of people who are stressed drink more to cope”

Smoking, eating unhealthily, illicit drug use and drinking can all impact your sex life. They can all damage your blood vessels, affect your neurochemistry, cause low testosterone and can result in erection problems in many ways.

 Close up of man in suit drinking alcohol and smoking.


Many who struggle with chronic stress or anxiety are on medication for it. Unfortunately, erectile dysfunction can be a side effect of some of these medicines.

Research Trusted source National Center for Biotechnology Information (NCBI) Government Source Biomedical Research and Literature Go to source has shown that certain antidepressants, most notably SSRIs (serotonin selective reuptake inhibitors) cause sexual dysfunction as they affect certain hormones and neurotransmitters. They can affect key hormones such as testosterone and dopamine which may affect arousal and orgasm.

What is sexual performance anxiety?

A specific kind of anxiety is known to specifically cause ED, and that is sexual performance anxiety (SPA). While the condition also affects women, it predominantly affects men. One study found that SPA was responsible for up to 25% of erection problems, including both psychogenic ED and premature ejaculation (PE).

“Performance anxiety is responsible for a quarter of erection problems”

SPA can occur before or during sex, and is usually caused by negative thoughts about several potential aspects surrounding sexual activity such as your ability to perform, lack of experience or how you look. It can also be linked to porn addiction and relationship issues.

Symptoms of sexual performance anxiety

As well as ED and ejaculation problems, sexual performance anxiety can also cause low sexual desire and difficulty orgasming. The issue can become cyclical as they can all cause the other.

You may have also negative thoughts about your body, your sexual abilities or doubts in your relationship. It can also link to other mental health conditions, including stress and anxiety.

 Couple lying in bed facing away from each other.

How can I treat psychological ED?

Impotence caused by stress and anxiety requires a specific treatment plan, as you may need to diagnose and treat the underlying issues before seeking prescription medicines such as Viagra (Sildenafil) or Cialis (Tadalafil). In fact, research Trusted source National Center for Biotechnology Information (NCBI) Government Source Biomedical Research and Literature Go to source has found a multidisciplinary approach for psychological ED to be very successful.

Stress management

There are a few simple ways you can naturally lower your stress levels:

  • do some exercise
  • try and control the source of your stress, if possible (e.g change your schedule)
  • talk to someone
  • take some time to relax or do something for yourself
  • avoid unhealthy habits

Research Trusted source PubMed Government Source Database of Biomedical Research Go to source has found that, when combined with an ED treatment, stress management tactics significantly reduced cortisol levels and improved erectile function.

Complementary therapies

Some people find that doing alternative or complementary therapies help with their stress and anxiety levels.

Therapies include:

  • acupuncture
  • massage therapy
  • yoga and meditation
  • hypnotherapy
  • mindfulness

Some people also seek herbal treatments for their stress, anxiety or their ED. While there is little evidence to indicate their benefits for these conditions, some people find them helpful.

When choosing an alternative therapy, ensure that the provider is licensed and legitimate. If you are in any doubt about a therapy or supplement, consult your doctor before starting it. They can also check if it's suitable for you.


For chronic stress and anxiety, you may benefit from psychotherapy.

There are several types of talking therapies and counselling available on the NHS, which is ideal if you struggle with negative thoughts or anxiety.

You may need a more specific type of therapy depending on the underlying cause. For instance, if you have relationship problems, you may benefit from relationship counselling. If you have SPA, speaking to a specialist in sex therapy may help with your symptoms.

The main takeaways

  • Stress and anxiety have a huge impact on your sex life.
  • Hormonal changes during stress response cause ED due to their effect on the nervous and circulatory systems.
  • A combination of therapy and prescription medicines is the best treatment for psychological ED

Further reading

Obesity as a cause of ED

Erectile Dysfunction Causes Obesity as a cause of ED

Reviewed by Dr. Caroline Fontana
Heart disease: the leading cause of erectile dysfunction

Erectile Dysfunction Causes Heart disease as a cause of ED

Reviewed by Dr. Caroline Fontana
How diabetes can cause erectile dysfunction

Erectile Dysfunction Causes Diabetes as a cause of ED

Reviewed by Dr. Caroline Fontana
How smoking can ruin your sex life

Erectile Dysfunction Causes How smoking can ruin your sex life

Reviewed by Dr. Caroline Fontana
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