Is Erectile Dysfunction Rooted in the Body or the Mind?

Updated on October 6, 2023
90% of erection issues are psychological and are much more prevalent, with one-third of men suffering from premature ejaculation and erectile dysfunction. It is a myth that erection issues happen only to older adults in their 50s and 60s. Even young men in their 20s and 30s have erectile dysfunction and will tell you why.
Is Erectile Dysfunction Rooted in the Body or the Mind
Table of Contents

90% of erection issues are psychological and are much more prevalent, with one-third of men suffering from premature ejaculation and erectile dysfunction. It is a myth that erection issues happen only to older adults in their 50s and 60s. Even young men in their 20s and 30s have erectile dysfunction and will tell you why.

How Does an Erection Happen?

Erection is not just a physical process; it is also a psychological process. And you don’t have to always think on the line of erectile dysfunction treatment. Keep reading to know more.

Let us first understand how an erection happens. The brain is where sex starts, and erection is a cascade of reactions that starts as you get sexually aroused. The process of getting an erection starts in the brain from sexual stimuli. This stimulus can be a touch, a thought, a visual, a fragrance, and more.

For example: if a man is watching porn or fantasizing (both sexually arousing visual stimuli), his brain receives the stimuli and generates happy hormones and neuron signals that get the heart to pump more blood; the extra blood then reaches the penis when an erection happens.

Now instead of sexual stimuli, if the brain is filled with anxious thoughts, then instead of happy hormones, stress hormones get generated, the body is in an alarm state because of the perceived threat, and extra blood that goes to the penis is drained out from there and goes to a man’s legs so that he can run.

  • Sexual ideas or sensual touch excites the brain
  • The brain sends nerve signals and hormone secretions to the heart
  • The heart pumps extra blood
  • As the blood vessels relax and blood comes into the penis, you get hard.

It sounds like a simple process; every part is connected, and one action results in the next, just like a chain reaction. So, if the brain does not get happy stimuli, the whole process of getting an erection fails:

Here is a real story as told by a man who approached us with an ED issue

My issue is that I think I fear sexual Intimacy. I don’t know why, maybe because women around me have so many expectations, and it has nothing to do with them. I think I made it big in my head only.

That’s why I’ve never had sex. Also because I think I won’t be able to last long!! 

I had intimate moments with females; I gave them pleasure but never had the courage to receive it. I masturbate when alone, but I get so conscious and worried with a partner that my penis doesn’t even get erect.

If a person has general mental stress or thoughts and fears around the erection, it subverts his erection. Any negative emotion like anxiety, depression, obsessiveness, or anger can negatively impact your erections. Stress about money, relationship problems, low self-esteem, and job loss can all interfere with your erections.

Particularly the anticipatory anxiety, “what if.” will interfere with your erection:

  • What if I cannot get it up
  • What if I fail in bed
  • What if she judges me

Any worry about sexual performance is a sexual poison.

Good sex is about positive anticipation, pleasurable physical experiences, and regular frequency of physical contact. Good sex is not anticipatory anxiety, tension about failed sexual performance, and embarrassment and avoidance.

When you view intercourse as a pass-fail test, you constantly fear being called an ‘impotent man.’ This is such an unfortunate narrative society has created around erections. ED is not impotence and should not be called so.

“Impotence” denotes a man’s lack of personal power or self-esteem. ED is a problem with your penis not being able to get up. It is just that. ED has no bearing on your whole life or your adequacy as a man.

And psychological ED can be overcome with the proper set of erectile dysfunction treatments that include counseling, lifestyle modifications, and teaching psychosexual skills.

Symptoms of erectile dysfunction

Before we get into the root cause of ED, here are some symptoms you should look up to understand.

  • Unable to get hard
  • Difficulty getting an erection
  • Penis gets soft before sex is over
  • Premature or delayed ejaculation
  • Interest in sex but can’t perform

It’s important to know that the symptoms may vary from person to person and be aware of it.

Is ED normal?

There are 3 types of erectile dysfunction, and knowing the right type is essential for the proper treatment. This is where most medical professionals in India fail to treat psychological, relationship distress, or lifestyle ED with medicines and surgical procedures.

3 Categories of Erectile Dysfunction

ED can be due to many causes. Before you decide on the erectile dysfunction treatments that work for you, you must know if the problem is psychological, physical, social, relational, etc. You don’t want to take cold relief pills for indigestion, right? That won’t work, and the same logic goes with ED.

The nuances of ED are vast, and here, I categorize it into these 3 types.

  • Psychological ED: It happens when the brain fails to send the feel-good signals that drive the process. This is because you are hijacked by negative emotions such as perfectionism, inadequacy, and anticipatory failure. This can occur at any time when having sex. Because of this, your penis may soften though you started well.
  • Physical ED: Anything that can topple your health, like poor health habits like smoking alcohol, underlying medical problems like diabetes, high blood pressure, or side effects of any medication you take, can affect your erection response.
  • Relationship ED: Good sexual encounters need comfort, attraction, trust, and intimate cooperation between partners. On the other hand, relationship problems such as conflict, not feeling close, disappointment with a spouse, lack of couple time, and blaming can damage the interpersonal connection you need for erection confidence.

No matter the category you fall into, I know how embarrassing and depressing it is when you’re reading this. So, knowing the root cause is vital before you work on your ED issues. Many men can get it up when masturbating alone but not with a partner, while some men cannot get an erection under any condition.

There are many ways to deal with physical ED, so there’s no need to suffer in silence despite it being an awful experience. 

The most common physical cause of ED

Many different factors can contribute to ED, including:

  • High cholesterol
  • High blood pressure
  • Heart disease
  • Diabetes
  • Hormonal imbalance, like low testosterone
  • Parkinson’s disease
  • Multiple sclerosis
  • Side effects of certain prescription medications or recreational drugs
  • Narrowing of the penis blood vessels
  • Obesity
  • Pelvic floor issues (too tight or too weak)
  • Smoking or alcohol consumption(overly)
  • Sleep disorders
  • Any sports injury or damage to nerves or arteries

Besides what we mentioned, there can be other underlying health conditions.

How do you know if you have a Psychological ED?

Your ED is psychological or imagined if you go through the scenarios below.

  • You have discussed your ED with your doctor, who ruled out any physical causes.
  • You can obtain good erections while masturbating and in some other situations.
  • You had ED for a short duration, or once you had to depend on external help like porn to get an erection.

What are the primary causes of psychological ED?

There are several psychological factors to consider as to why you might be unable to get hard. A few are listed here:

  • stress and anxiety
  • relationship problems
  • mental health issues
  • depression
  • performance anxiety
  • Pornography use
  • Lack of sex education
  • Some guilt or shame
  • Low self-esteem
  • lack of self-confidence or body issues

The good news is that there isa permanent treatment for erectile dysfunction when it is psychological or imagined ED.

Which type of ED is more common: physical or psychological?

At Get Intimacy, we aim to make ED a topic that can be openly discussed and remove any associated guilt or shame.

Still, it’s challenging to determine with complete precision how many men are affected by ED and what is the ratio with whatever particular cause.

Overall, the information typically indicates that mental health problems are more commonly the root cause of ED for younger men, while physical factors are more common in older men.

Again, there can be a mix of reasons.

We advise not to generalize and to be specific about discovering personal issues and how to overcome them.

Other scenarios to reflect

I’m including this section to make you understand that besides physical and mental reasons for erectile dysfunction, this category is vital and must be discussed.

There are situations when you and your partner’s needs are different. For example, maybe you’re super kinky, and she’s super vanilla or the other way around, or you may feel insecure or uncomfortable between the sheets, or perhaps you know she cheated on you once, and you just really haven’t forgiven her.

The simple truth is that erectile dysfunction is often easy to identify, but sometimes, it’s not what it looks like. And that requires you to reflect on yourself and be brutally honest with yourself about what’s going on in your life that’s affecting your sex life.

Need a Supportive Community?

At Get Intimacy, we provide a community of experts and men who are conquering the issues of ED, and the best thing is that we keep the entire conversation private and confidential. You can discuss your problems as an anon as well. We also help you with erectile dysfunction natural treatment without any medication in our coaching sessions.

You can access our support and help from home comfort on your laptop or phone. 

Last reviewed on April 20, 2024

Learn more about our editorial process.




Sign up to our newsletters and we'll keep you in the loop with everything good going on in the creative world.

Related Blogs

How to stop premature ejaculation?

Here’s Everything You Need To Know And Understand About Performance Anxiety

What Does a Sex Counsellor Do?