Erectile Dysfunction: Effects On Mental Health And Treatment Options

Updated January 16th, 2025 by BetterHelp Editorial Team
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Despite being common, erectile dysfunction (ED) can cause significant challenges with relationships and self-esteem. Some people don’t know why it occurs, and symptoms may lead to distress about a person’s ability to satisfy their partner. Below, explore symptoms of this form of male sexual dysfunction, its possible causes, and treatment options that doctors may prescribe. 

A man in a white t-shirt sits on an unmade bed across from a woman in a blue shirt who is speaking to him and touching his knee.
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Address the mental health impacts of erectile dysfunction in therapy

How is erectile dysfunction defined, and what are its causes?

According to the Massachusetts Male Aging Study, which involved more than 1,700 men between the ages of 40 and 70, 52% of participants had experienced erectile dysfunction. Erectile dysfunction can be defined as the inability to obtain or maintain an erection for sexual satisfaction.

According to the National Institute of Diabetes and Digestive and Kidney Diseases, erectile dysfunction symptoms “include being able to get an erection sometimes, but not every time, being able to get an erection but not having it last long enough for sexual intercourse, and being unable to get an erection at any time.” This condition can be temporary and can stem from a variety of factors. Having one or two experiences of a lack of an erection may not mean that a person experiences erectile dysfunction. Only a physician can diagnose this condition, and when they do, there are treatments available that can lead to a satisfactory sex life. 

Causes of erectile dysfunction: High blood pressure, prostate cancer, and other health challenges

Erectile dysfunction can be frustrating in part because couples may not understand the cause. The following are some possible physical causes of erectile dysfunction.

High blood pressure causing lack of an erection

High blood pressure may cause erectile dysfunction in some men due to blockage of blood vessels that allow blood flow to the penis. Some men may not know they have high blood pressure until they experience erectile dysfunction. However, knowing your blood pressure can lead to early detection and treatment, which may address your health and erectile dysfunction simultaneously. 

Atherosclerosis

Atherosclerosis is a hardening of the arteries, often due to plaque buildup. This complication may happen as a result of high cholesterol, obesity, high blood pressure, smoking, or lack of exercise. As with high blood pressure, erectile dysfunction can sometimes be the first sign of atherosclerosis. Reaching out to a doctor can provide an opportunity for early treatment, which may prevent a heart attack or stroke

Prostate cancer or other problems

In some cases, surgery on the prostate, including for prostate cancer, may lead to erectile dysfunction. In addition, prescription medications for prostate cancer may lead to ED as a side effect in some people. 

Neurogenic causes

In some cases, a person may experience erectile dysfunction due to problems with nerve signals between the brain and the penis. Possible causes include radiation therapy, stroke, and spinal stenosis. 

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Health conditions that may lead to erectile dysfunction and difficulty having an erection 

Several health conditions may increase a person’s risk of developing erectile dysfunction (ED). The following are some common risk factors:

  • Type 2 diabetes
  • Sleep disorders like sleep apnea
  • Renal failure
  • Alcohol use and substance use disorders 
  • Priapism
  • Depression

How can erectile dysfunction be treated?

The proper treatment for erectile dysfunction may depend on the cause. A doctor may assess each individual for specific erectile dysfunction symptoms, underlying health conditions, and family medical history before determining the best course of treatment. This assessment may include questions about a person's medications, including prescription medications or illegal drugs. While some people may feel awkward answering questions about their sex life and substance use, these questions may help a doctor to recommend the best treatment. 

A doctor may recommend quitting smoking and limiting or quitting drinking (if needed) for someone with high blood pressure or cholesterol. They may also recommend cardiovascular exercise. However, this factor may depend significantly on a person’s specific situation. Someone with severely high blood pressure or high cholesterol may be asked to begin exercise slowly. 

In some cases, a doctor may provide a prescription medication for ED. Talk to a doctor before taking any medications for erectile dysfunction. There may be some side effects for people who take medication for blood pressure or other conditions. The BetterHelp platform is not intended to provide any information regarding which medication or medical treatment may be appropriate for you. The content provides generalized information that is not specific to one individual. Do not take any action without consulting a qualified medical professional.

Does sex therapy help with ED?

For some people, sex therapy may be recommended for erectile dysfunction (ED). A sex therapist may be able to help people understand underlying relationship challenges, personal fears, or other factors that could cause challenges during sexual relations. Sex therapists may also be able to help individuals or couples understand some of their intimate desires and ways to communicate them with each other.

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Address the mental health impacts of erectile dysfunction in therapy

How a mental health professional might help 

Erectile dysfunction can sometimes cause emotional and relational challenges that a mental health professional can help address. ED can also be caused by depression. Therapists often use evidence-based techniques like cognitive-behavioral therapy (CBT) to treat depression alongside treating erectile dysfunction mental health-related symptoms. In some cases, CBT may be helpful for the mental health impacts of living with erectile dysfunction. 

Some people experiencing erectile dysfunction may be hesitant to engage in traditional in-office therapy. For these people, speaking to a therapist online may be more comfortable. With online therapy through a platform like BetterHelp, people experiencing ED can connect with a therapist from home or anywhere with an internet connection. They can also choose from a communication method that’s comfortable for them, whether audio, video, or live chat. Online therapy also allows individuals to reach out to their therapist anytime through in-app messaging, and their therapist will respond when they have a chance. Some people may find this option valuable if they experience challenges with intimacy between therapy sessions, as they don’t have to wait until their next session to communicate what they’re feeling. 

A number of studies demonstrate the effectiveness of online therapy for various mental health conditions. One study published in 2020 suggests that online therapy may even be more effective than in-person therapy for depression. In some cases, this treatment option may alleviate symptoms of erectile dysfunction or relieve anxiety as a person receives medical treatments, such as medication therapy. 

Takeaway

Although erectile dysfunction is a common condition, it can be a complex subject to discuss. This condition can lead to embarrassment, low self-esteem, and various relationship challenges. However, there is help available through doctors, sex therapists, and mental health professionals. A therapist may be able to help address challenging emotions surrounding this condition, which may lead to less anxiety. If you’re experiencing challenges related to intimacy, know that you’re not alone. Consider reaching out to a therapist online or in your area for support.
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