Urology Austin

psychological factors

We’re all familiar with television commercials featuring middle-aged men in bathtubs coping with Erectile Dysfunction.  Erectile Dysfunction (ED) is the inability to achieve or maintain an erection sufficient for sexual intercourse. ED is a condition that affects men of all ages and is primarily associated with physical and psychological factors. Physical conditions such as coronary artery disease, hypertension, low testosterone, thyroid problems, neurologic issues, and diabetes can cause or worsen this condition. However, psychological difficulties can also be an underlying cause—particularly among younger men. Of the 15 to 30 million American men experiencing ED, approximately 10% is psychological in nature.

Psychological factors of ED

The psychological aspects of ED are multifaceted, and generally fit within the categories of psychogenic, chronic or temporary psychological disorders, psychological disorders tied to health issues, or a combination thereof. When ED has its origin in the mind or is due to a chronic mental condition, it is characterized as psychogenic. Examples of psychogenic causes include:

  • Performance anxiety
  • Inhibitions
  • Sexual phobias
  • Prior sexual abuse
  • Failing relationships
  • Anhedonia―The inability to experience pleasure from activities that are usually enjoyable
  • Chronic mental issues such as depression, generalized anxiety disorder, post-traumatic stress disorder
  • Psychological effects of long-term alcohol or drug abuse

In today’s fast-paced, high demand society, ED can also be triggered by temporary factors such as job stress, job loss, and financial or social status changes. Equally significant are the mental effects associated with the death of a loved one, divorce, mid-life transitions, and having to care for a sick child, spouse, or parent. Unfortunately, physically healthy men may not correlate daily life stressors with ED, so they either fail to seek assistance, or refuse to believe that their condition isn’t physical in nature.

Emotional responses tied to health issues can also initiate or worsen ED. Both the stress and physical symptoms associated with thyroid problems, genital trauma or surgery, mechanical conditions such as Peyronie’s disease, stroke, nerve damage, Multiple Sclerosis or Parkinson’s disease can all contribute to on-going psychological responses that inhibit men’s sexual responsiveness.

Advanced pharmaceuticals and the development of penile implants have greatly enhanced ED therapy, but oftentimes a psychological analysis and/or lifestyle change is in order. Although it might appear to be a difficult or embarrassing conversation to have, men suffering with ED should talk to their urologist about what they are experiencing. Men need to know that encountering performance difficulties (on occasion) is normal, but experiencing ongoing or long-term sexual difficulties is not. By means of a frank conversation, comprehensive health history and a physical assessment, the origins of ED can be determined­.  Once the underlying causes are identified, appropriate steps can then be taken to treat what can be a very distressing condition for men.

If you are experiencing erectile issues, contact Urology Austin to schedule a consultation with one of our providers.