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Erectile dysfunction: Psychological causes

Erectile dysfunction (ED) is very common, affecting around half of all men between 40 and 70 at some stage.

There may be medical reasons for ED, including high blood pressure or diabetes, but many men experience erectile dysfunction for psychological reasons. These include:

  • Stress: Stress can be job-related, money-related, or the result of marital problems, amongst 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 may consistently cause ED.
  • Guilt or relationship problems: A man may feel guilty that he is not satisfying his partner. 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.
  • 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. ED may come as a result of age and a subsequent loss of interest in sex, it could be the result of medication, or stem from problems in a couple’s relationship.

Learning to relax

Some men find relaxation techniques may help with symptoms of ED. These include:

  • Rhythmic breathing: Take long, slow breaths. Inhale slowly then exhale slowly. Count slowly to five as you inhale, and then count slowly to five as you exhale. As you exhale slowly, pay attention to how your body naturally relaxes. Recognising this change will help you to relax even more.
  • Deep breathing: Imagine a spot just below your navel. Breathe into that spot, filling your abdomen with air. Let the air fill you from the abdomen up, then let it out, like deflating a balloon. With every long, slow exhalation, you should feel more relaxed.
  • Visualised breathing: Find a comfortable place where you can close your eyes and combine slowed breathing with your imagination. Picture relaxation entering your body and tension leaving your body. Breathe deeply, but in a natural rhythm. Visualise your breath coming into your nostrils, going into your lungs and expanding your chest and abdomen. Then, visualise your breath going out the same way. Continue breathing, but each time you inhale, imagine that you are breathing in more relaxation. Each time you exhale imagine that you are getting rid of a little more tension.
  • Progressive muscle relaxation: Switch your thoughts to yourself and your breathing. Take a few deep breaths, exhaling slowly. Mentally scan your body. Notice areas that feel tense or cramped. Quickly loosen up these areas. Let go of as much tension as you can. Rotate your head in a smooth, circular motion once or twice. (Stop any movements that cause pain. Roll your shoulders forward and backward several times. Let all of your muscles completely relax. Recall a pleasant thought for a few seconds. Take another deep breath and exhale slowly. You should feel relaxed.
  • Relax to music: Combine relaxation exercises with your favourite music in the background. Select the type of music that lifts your mood or that you find soothing or calming.
  • Mental imagery: Mental imagery relaxation, or guided imagery coaches you to create calm, peaceful images in your mind and combat negative thoughts.
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WebMD Medical Reference

Medically Reviewed by Dr Rob Hicks on March 03, 2017

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