Erectile dysfunction (ED) is often assumed to be a physical problem, caused by a condition such as high blood pressure or heart disease. However, the causes can also be psychological. There are a range of complex mental health issues that could interfere with normal sexual function, including anxiety.

Anxiety is defined as a feeling of unease, and it can be both a mental and physical state. Mentally it is characterised by worry, fear, dread, or distress. It can also manifest physically in tense muscles, sweating, and an increased heart rate. Everyone feels anxious occasionally and it is a normal and natural human response to certain events.

However, for some people, the effects are especially severe or long-lasting, even when the cause of anxiety has been removed. Chronic anxiety is often accompanied by other negative emotions or states of mind, such as low-self esteem, restlessness, low energy levels, and depression.

Not all men with anxiety experience ED, and they may even find that sex helps them to ease their symptoms. However, many people find it difficult to become sexually aroused when their brain is consumed with other worries, or they may just not be in the mood for the closeness and intimacy that sex brings.

Chronic stress and anxiety also leads to elevated levels of cortisol in the body, which raises blood pressure and inhibits the production of testosterone, which is the hormone responsible for the male sex drive and sexual response system.

It may also interfere with the way the neurotransmitters in the brain send messages to the body, making it more difficult to achieve an erection. This is because when the body is in permanent ‘fight or flight’ mode, the sympathetic nervous system redirects the blood supply to the muscles, meaning that there is less blood available to flow to the penis.

Some men who do not have chronic anxiety may suffer from performance anxiety, which strikes when they attempt to have sex with their partner. It can often occur in new relationships, but it may also build up over time, especially if there are communication problems between a couple.

How is anxiety-related ED treated?

In the first instance, men who are experiencing problems with anxiety are encouraged to open up to their partner about the problem. Sometimes, this can be all it takes to put them on the path to recovery, as the relief from releasing all that bottled-up stress and tension is so great.

For men who are not in a relationship, opening up to a close friend or a doctor can work just as well. The recommended treatment may include some lifestyle changes, such as cutting back on alcohol, taking more exercise, and eating a healthy diet.

Mindfulness meditation, which encourages the person to focus on the present moment rather than worry about the past or the future, can also be an effective way to deal with anxiety. There are also medications that can treat ED such as cheap sildenafil, although it is advisable to tackle the underlying cause of the anxiety as well.