No one likes to be told that a problem is “all in their head.” We want to know exactly what is causing the problem and how to fix it—not that we’re making it up or have the wrong attitude. And that’s just as true for sexual problems as any other kind. All in your head or not, erectile dysfunction (ED) is a real problem, and it demands real solutions. And understanding its cause is crucial to finding those solutions. Your erectile dysfunction (ED) is either psychogenic or physical in origin. Let’s discuss what those mean and their differences to get you started.

Psychogenic ED

Psychogenic impotence is where an erection fails due to thoughts or feelings rather than physical pathology. Up until the 1960s, the majority of ED cases were erroneously believed to stem from psychogenic reasons. According to WebMD, that number is closer to 10–20 percent.

That isn’t to say that thoughts and feelings can’t have an impact on arousal. The following can all impact your ability to achieve or maintain an erection:

  • Stress and Anxiety: Stress increases the amount of cortisol in your body, constricting your blood vessels and making it more difficult for blood to flow to your penis. If stress or anxiety becomes chronic, it can decrease your testosterone levels, impeding you further.
  • Guilt: Guilt, like stress and anxiety, can impede your ability to relax during intercourse. 
  • Depression: Studies have found a link between depression and reduced levels of arousal and sexual interest.
  • Post-traumatic Stress Disorder: In one study, veterans suffering from PTSD were found to have more than three times the risk of sexual dysfunction.

For men with serious cases of depression, anxiety, or other mental health conditions that frequently affect the ability to achieve or maintain an erection, a licensed psychologist or counselor can help. All it requires is taking the first step and asking for help.

What is physical ED?

The vast majority of erectile dysfunction cases stem from physical ED. As we’ve alluded to before, blood flow is the key to getting and maintaining an erection. As a man ages, his blood vessels weaken or become restricted. When that happens, blood flow to the penis isn’t adequate for erections, making intimacy difficult or impossible.

For most men, this is simply an unfortunate part of the aging process. However, there are many other physical conditions and illnesses that can exacerbate or speed the problem along: Smoking, alcohol consumption, and obesity all negatively impact your blood flow, as do diabetes, heart disease, and HIV. More often than not, if you are dealing with ED, you are dealing with another, larger health problem, and ED is just a symptom. Fortunately, it’s almost always treatable and even preventable, so long as you are addressing the deeper issue.

At Metro Men’s Health, we believe in finding those deeper issues and working accordingly. Psychogenic or physical, your ED isn’t going away on its own, but you can still overcome whatever is standing between you and a fulfilling sex life. If you have been struggling to conquer ED and are ready for a healthier, happier you, reach out to us today. We’re ready to help.

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