Psychological factors are responsible for about 10%-20% of all cases of erectile dysfunction, or ED. It is often a secondary reaction to an underlying physical cause. In some cases, the psychological effects of ED may stem from childhood abuse or sexual trauma. However, the most common psychological causes of ED include:
Stress: Stress can be job-related, money-related, or the result of marital problems, among other factors.
Anxiety: Once a man experiences ED, he may become overly worried that the problem will happen again. This can lead to "performance anxiety," or a fear of sexual failure, and consistently lead to ED.
Guilt: A man may feel guilty that he is not satisfying his partner.
Depression: A common cause of ED, depression affects a person physically and psychologically. Depression can cause ED even when a man is completely comfortable in sexual situations. Drugs used to treat depression may also cause ED.
Low self-esteem: This can be due to prior episodes of ED (thus a feeling of inadequacy) or can be the result of other issues unrelated to sexual performance.
Indifference: This may come as a result of age and a subsequent loss of interest in sex, be the result of medications or stemming from problems in a couple's relationship.
All men at one time or another will experience ED. Only if the problem becomes persistent -- occurs more than half the time -- or becomes a source of distress for you or your partner should you be concerned and consider seeking medical advice and treatment. For men whose erectile dysfunction is caused by psychological problems, therapy may be needed.