MENTAL HEALTH ∙ 4 minutes read

Answered: can anxiety cause erectile dysfunction? 

By Ashton Sheriff | Medically reviewed by Dr Jon Eriksson

The modern world is accelerating at such a dizzying pace that it’s almost impossible not to feel anxious. Whether your anxiety is caused by modern-day job hunting, social media, existential anxiety or society’s diverse pressures, it can have a significant effect on your sex life. 

Anxiety can make it difficult to get and maintain an erection. Both general anxiety and more specific kinds of anxiety like performance anxiety (the worry that you won’t be able to sexually satisfy your partner) can tank your sex drive and make it harder to get aroused. 

But don’t worry. If anxiety is interfering with your erections, there are a number of things you can do. Before we get into those, though, let’s find out how anxiety causes erectile dysfunction in the first place. 

What is anxiety?

Anxiety is a profound feeling of worry, panic, or fear. It can be experienced acutely or mildly, but regardless of its intensity, it can interfere with many aspects of your daily life - including your sex life.  

Anxiety symptoms

Symptoms of anxiety may include: 

  • Feeling nervous, restless or tense.
  • Feeling as though danger, panic, or doom may present itself at any moment. 
  • Rapid breathing (hyperventilation). 
  • Being unable to think about anything else but the source of your present worry.
  • Sweating.
  • Trembling. 

Can anxiety cause erectile dysfunction?

In short, yes. Anxiety, stress, and worry kick the sympathetic nervous system (SNS) into action. This induces what is more commonly known as the “fight or flight” response. 

The fight or flight response increases heart rate, dilates (widens) the airways in the lungs, and increases the supply of blood to the muscles. This is great for survival, but less helpful when it comes to sex. This is because redirecting the flow of blood to the muscles comes at a cost. And the cost is that less blood is supplied to the penis. 

An unrestricted flow of blood to the penis is important for getting and maintaining erections. If blood flow is reduced, achieving a strong erection becomes much harder - and in some cases, impossible. 

The triggers for anxiety-related erectile dysfunction can be numerous and depend on the individual. However, a common trigger of anxiety-related erectile dysfunction is performance anxiety

But what exactly is performance anxiety? Let’s find out. 

Performance anxiety

Performance anxiety (also known as sexual performance anxiety) is the fear that you won’t be able to perform well enough in the bedroom to satisfy your partner. This fear can be so profound that it makes getting and/or maintaining an erection difficult or unachievable. 

Performance anxiety can be caused by a variety of factors, including:

  • Previous negative sexual experiences. 
  • Confidence issues.
  • Low self-esteem.
  • Feelings of guilt.

If you have ever experienced sexual performance anxiety, you’re not alone. In fact, it’s quite common. A study in the International Journal of Stress Management highlighted performance anxiety as a main factor related to sexual dysfunction in men. It also contributes to sexual dysfunction in women, too. 

To combat sexual performance anxiety, it’s important not to think of sex as a performance. Thinking of it as a performance can trigger feelings of anxiety that might make it harder to get an erection. 

Instead, staying mindful during sex and focusing your attention on the present moment (rather than on thoughts of self-doubt) can help to keep feelings of anxiety at bay. Focusing on things such as the sounds and sensations of the present moment can divert attention away from thoughts that would otherwise make you anxious. With a bit of practice, this will become easier and easier to do until you find it second nature to stay in the present and enjoy truly intimate sex. 

We understand, though, that this is easier said than done. While mindfulness can grant succour from anxiety, putting it into practice can be tricky. But it’s certainly worth a try. 

If performance anxiety is something you experience regularly before or during sex, see how you feel once you bring your attention to the present. If you find your mind wandering back to unpleasant thoughts, allow yourself to gently come back to the present moment. You could focus on your partner’s touch, the sound of their voice, or the smell of their perfume to help you do this. 

Trying it is free and there are virtually no downsides or risks. At the very worst you’ll feel no different. At the very best you’ll find it easier to relax into sex and make the most of the wonderful time spent with your partner. 

There are also other things you can do to effectively treat anxiety, as well as sexual performance anxiety. We’ve listed some of the most common methods below.

Treating anxiety-related erectile dysfunction

There are a number of effective ways to reduce your levels of anxiety and restore normal erectile function. Some popular methods include: 

  • Mindfulness-based therapy: mindfulness is essentially awareness of the present moment, and calmly acknowledging your present thoughts, feelings, and sensations. 

Studies have shown that mindfulness-based therapy (which consists of breathing exercises and mindful meditation) is a moderately effective way to treat anxiety. 

It is believed mindfulness helps to combat anxiety by allowing the mindful individual to simply observe emotions that might otherwise trigger bouts of anxiety with a non-judgemental, accepting air of calmness - thus reducing levels of anxiety. 

  • Cognitive behavioural therapy (CBT): CBT is a talking therapy that focuses on correcting negative patterns of thinking and behaviour that exacerbate feelings of anxiety. 

There is a wealth of evidence that suggests CBT is successful in treating anxiety disorders, including panic disorders, which is why courses of CBT has been made available on the NHS

Its efficacy lies in its ability to break down overwhelming problems (which cause anxiety) into smaller, manageable chunks. This could be especially useful to those who feel overwhelmed by thoughts of frustration and low self-esteem when experiencing erectile dysfunction. 

  • Psychiatric medication: although psychological treatment is usually recommended before trying medication, medication can also be an effective way to treat anxiety. This is best decided and managed with your doctor. 

To learn more about the effects of the various types of medication used to treat anxiety, check out Mind.org’s page on anxiety and panic attacks. 

  • Erectile dysfunction medication: erectile dysfunction medications such as sildenafil, tadalafil, or Tadalafil Daily can relieve erectile dysfunction symptoms and stimulate stronger erections. This may be helpful if you find it hard to generate an erection before or during sex. 

ED tablets won’t address the root cause of your anxiety (therapy is the best course of action for that) but if the fear of not being able to sustain an erection causes you not to be able to get one, then erectile dysfunction treatments can make it easier to achieve one when it’s needed, dispelling the fear. 

The bottom line

Anxiety causes erectile dysfunction by activating the sympathetic nervous system (SNS). This redirects blood away from the penis, which can result in ED. However, anxiety-related erectile dysfunction can successfully be treated by treatments and therapies that reduce anxiety, such as mindfulness, cognitive behavioural therapy, and in some cases, medication.  

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