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Psychological Impotence (Erectile dysfunction)
In the past, most cases of Erectile Dysfunction (ED) were considered primarily psychological and/or psychiatric in origin. It is now well-recognized that organic, non-psychological causes of ED play a much more significant role in the development of ED. Most researchers agree that pure psychological (emotional) mechanisms cause 15% to 20% of cases, whereas physical causes are responsible for at least 80% of ED cases.
However, in most cases, the situation is "mixed," with significant secondary psychological and social components such as guilt, depression, anxiety, tension or marital discord being present in addition to one or more underlying physical causes.
The brain plays a big part in regulating sex drive. If a man loses his ability to process sexual thoughts in the brain and is unable to pass these signals along the spinal cord to his penis, it can result in erectile dysfunction. A man who has normal erectile responses during masturbation, or who regularly awakens with an erection, is likely to have a psychological basis for impotence.
Most men will experience psychological ED at least once in their adult life, so it's important to know that an occasional episode is not a diagnosis for on-going erection problems. In most cases, isolated episodes are more likely to be due to fatigue, stress or an over-indulgence in alcohol than an underlying physical cause. However, many men react to an occasional episode of erectile dysfunction by becoming more anxious, which results in further sexual problems, hence more anxiety. This is called the "impotence domino effect" of anxiety - failure - more anxiety - more failure.
The most common psychological causes of ED include:
- Stress: Stress can be job-related, money-related, or the result of marital problems, among 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 consistently cause ED.
- Guilt: A man may feel guilty that he is not satisfying his partner.
- Depression: Depression and anxiety can be both the cause and the consequence of ED. Depression affects a person physically and psychologically.
- Drugs used to treat depression may also cause ED and may also interfere with the effectiveness of the popular impotence pills, such as Viagra, Cialis and Levitra.
- Low self-esteem: 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.
- Fatigue: Fatigue drains mental and physical energy and can result in anxiety if the problem is not addressed. Like stress, once fatigue is reduced, normal sexuality is restored.