Although erectile dysfunction usually has a physical cause, thirty percent of impotence cases are of chemical or psychological origins. The cause may be as simple as an adverse reaction to medication. In spite of the long-standing belief that erectile dysfunction is “all in your mind,” only ten to twenty percent of impotence causes are psychological.Antidepressants and Other Prescription Drugs
Erectile dysfunction may be caused by a long list of prescription drugs, including common antidepressants and antihistamines. MAO inhibitors (MAOIs), SSRIs (selective serotonin reuptake inhibitors), lithium and the various tricyclic antidepressants have all been linked to MED.
Sedatives, antipsychotic drugs, hypertension medications and corticosteroids have also been known to cause erectile dysfunction. Simply altering the prescribed dose or switching medications often resolves the problem.
Smoking, Alcoholism, and Drug Use
Substance abuse can cause long-term damage to the nervous system, which can in turn lead to erectile dysfunction. Smoking hardens arteries, affecting proper blood flow. Changes in blood flow can affect the penis’s capacity to store blood. Long-term alcohol abuse damages the nervous system and interferes with nerve signals necessary for maintaining an erection. Certain illicit drugs are also known to cause erectile dysfunction. These include heroin, marijuana and anabolic steroids.
Men with low testosterone levels can usually maintain an erection. Although low testosterone levels significantly lower a man’s sex drive and cause a loss of libido, the condition is not the same as erectile dysfunction and requires different treatment.
Depression and Other Psychological Considerations
Sexual performance can be affected by certain psychological factors. Of these, depression and anxiety appear to be the most common causes. Depression causes erectile dysfunction by affecting the brain’s ability to become aroused, effectively stopping an erection before it even starts. A certain level of relaxation is necessary to become aroused, so anxiety and stress can also prevent erections.
Some men become very anxious and worried about their sexual performance. This creates a vicious cycle. They worry that their sexual performance will not satisfy their partner, which prevents arousal and causes erectile dysfunction. This “failure” only makes them worry more about their sexual ability, and so on.
Secondary Psychological Conditions
Depression, anxiety and stress often present in men with erectile dysfunction. However, in many cases the psychological problems are the result of impotence, and not the actual cause. Erectile dysfunction puts a man under enormous stress and often leads to depression. Care must be taken to determine whether the emotional disorder is the cause or consequence of erectile dysfunction.
Fatigue is a common cause of impotence. A man who is run down physically and mentally is unlikely to be very interested in sex. Fortunately, most cases of fatigue-based impotence are temporary: resolve the fatigue and the impotence usually disappears. Many medical conditions can cause fatigue, so consulting with your doctor is essential.
Difficult or stressful relationships can also cause impotence. Resentment, anger or guilt directed towards your partner can cause erectile dysfunction, as can a lack of sexual interest in your partner. Generally, therapists prefer to treat both partners and work towards a solution for the couple.
A man may try to hide his impotence from his partner, who wonders why he no longer seems sexually interested. Difficult though it can be to admit to erection difficulties, being honest with your partner can help both of you avoid misunderstandings