Does Anxiety and stress cause erectile dysfunction? a scottsdale, az intimacy therapist weighs in
Does stress and anxiety cause erectile dysfunction?
Yes. Stress and anxiety can contribute to erectile dysfunction, and past relationship trauma can play a role, too. If childhood relationships taught you that closeness isn’t safe, intimacy may bring up fear or pressure, even with a partner you trust. That can make it harder to get or keep an erection. ED can also have physical causes, so it’s worth getting checked if it keeps happening.
If you have gotten a medical examination and your doctor has cleared you of medical causes, it’s worth exploring your relationship history with a trauma-informed sex therapist to understand what the root of the problem may be.
How erectile dysfunction impacts men emotionally
Men experiencing erectile dysfunction often express feeling broken, defective, weak, despair, humiliation, failure, and feel like less of a man. In severe cases when the penis is compromised, a man or penis owner can be suicidal. For most of the men that I work with, loss of penile function is so much more than just a loss of having sex.
Contrary to popular belief that men are not communicative, my experience is quite the opposite. Although they may not verbally express what they are feeling, men often express their distress and emotions through their penis. In sex therapy, we call this “penis wisdom.” Losing an erection can sometimes be your body’s way of telling you that something feels stressful, unsafe, or unwanted, even if you can’t understand why or can’t identify what’s causing the feelings.
How is erectile dysfunction treated?
There are many different treatments for erectile dysfunction, including vacuum pumps, penile injections, urethral suppositories, prosthetic implants, and oral medications like Viagra and Cialis. Most ED treatments can be painful and invasive. Oral medications are the least invasive and provide the most natural erection, but less than half of viagra prescriptions are ever refilled. In the words of Kay Redfield Jameson: “To treat even to cure is not necessarily the same as to heal.”
What is performance anxiety?
Performance anxiety was first coined by Master’s and Johnson in the 1960’s when sex therapy was being developed. Sexual performance anxiety is a stress response where worry, fear, or embarrassment about your ability to please your partner physically interferes with sexual arousal and pleasure.
It goes something like this, a man may have difficulty getting an erection, he gets panicked about it, which takes him out of his body to where he is judging his performance, which increases anxiety, which stops sexual arousal, which then makes it difficult for him to maintain an erection the next time he goes to have sex. This can become a vicious cycle, but performance anxiety is only a symptom of the underlying problem.
In fact, most men experiencing ED usually have a history of good sexual functioning and report being able to get and maintain an erection up until the moment of penetration. So what is happening that is causing men with overall healthy sexual functioning to lose their erections suddenly?
How early relationship trauma plays a role in erectile dysfunction
Early childhood relationship trauma can affect you even if you don’t remember it clearly. Forgotten trauma is stored in the body, and will reveal itself in some sort of physical expression. This is why you may notice your body reacting before you understand it. Stress, fear, or tension can show up during intimacy even if you love your partner and can’t explain why. The penis speaks and can be a clue that something much deeper needs care and attention.
If you grew up feeling unsafe or alone in close relationships, or you’ve been rejected, abandoned, or controlled by someone you trusted, getting close to a new romantic partner may bring up those old fears. Erectile dysfunction, when there is no known medical cause, will often show up when a relationship deepens and becomes more committed, and vulnerability increases.
If closeness has felt unsafe before, doesn’t it make sense that an erection might fade during the most vulnerable moment of sex—penetration. For some men, that response may be a way the body tries to protect itself from getting hurt or experiencing emotional pain again.
How can sex therapy help me overcome erectile dysfunction?
Trauma-informed sex therapy starts by understanding and creating a timeline of your relationship history and pinpointing when the erectile dysfunction or performance anxiety started. The symptom often isn’t the problem or the focus, in fact, very little time is spent talking about penises and sex. Treatment is focused on the Big T’s and even more frequently the little “t’s” of trauma.
Big “T’s” are things like sexual trauma, experiencing or witnessing violence, natural disasters, war combat, serious accidents, or sudden unexpected death. Little t’s are things like emotional neglect, constant criticism, controlling parents, a parent with unpredictable moods, a parent relying or confiding too much in their child, divorce, or infidelity, etc.
EMDR can help you work through painful relationship memories and the feelings tied to them. As intimacy begins to feel safer, you may feel less anxious and more present with your partner, and the cycle of performance anxiety will slowly break.
Frequently asked questions about anxiety and erectile dysfunction
Can anxiety cause ED even if I’m attracted to my partner?
Yes. You can want your partner and still have trouble getting or keeping an erection. Worrying about your erection, your partner’s reaction, or whether sex will go well can make it harder to stay present and feel aroused.
If I can get an erection alone but not with a partner, does that mean it’s anxiety?
Anxiety may be part of it, but that pattern alone can’t tell you the cause. Sex with a partner can bring up different feelings and pressures. A doctor can help check for other factors, such as medications or health conditions.
Do I need to remember childhood trauma for it to affect my relationships?
No. You don’t need a clear memory of every early experience to explore how you learned to feel about closeness, trust, or rejection. Therapy can focus on what you feel and notice in your relationships now, without trying to force a memory or assume trauma is the cause of your ED.
How can I talk to my partner about erection problems?
Try bringing it up outside the bedroom, when neither of you feels pressured to have sex. You might say, “I’m attracted to you, but I’ve been feeling anxious when sex starts. I’d like us to take some pressure off and figure this out together.” An erection doesn’t have to decide whether you can still enjoy closeness.
Can EMDR cure erectile dysfunction?
EMDR can help you work through painful memories and fears tied to intimacy. If those feelings are contributing to your ED, addressing them may help you feel safer and less anxious during sex. It isn’t a guaranteed cure, and you may also benefit from medical care or other forms of sex therapy.
Overcome Performance Anxiety & ED with Sex Therapy in Scottsdale, AZ
We know how challenging it can be to discuss concerns like performance anxiety and erectile dysfunction. These struggles can impact not only your confidence but also your relationships and overall well-being. As an experienced sex therapist in Scottsdale, AZ, we are dedicated to providing compassionate, evidence-based care in a safe and supportive environment. Begin your journey with The Connection Couch by following these steps:
Schedule your first sex therapy appointment and begin the healing process
Uncover the life-changing benefits of sex therapy for individuals struggling with performance anxiety and erectile dysfunction.
Other Therapy Services Offered In The Scottsdale Area
I provide therapy for couples and individuals seeking to improve their intimacy. Additionally, I offer support for those recovering from painful sex, BDSM/kink, EMDR therapy for sexual trauma & PTSD, and first responder trauma therapy. Beyond Scottsdale, I also serve Paradise Valley, Phoenix, Tucson, Queen Creek, Gilbert, Salt Lake City, Park City, and Alpine, Utah.
About the Author: Holly Nelson, LPC, NCC – Sex & intimacy Therapist in Scottsdale, Arizona
Holly Nelson, LPC, NCC, is a licensed professional counselor based in Scottsdale, Arizona and the founder of The Connection Couch. Holly specializes in sex therapy, sexual trauma recovery, painful sex, performance anxiety, desire and libido discrepancies, sexless marriages, and couples intimacy therapy.
Holly is EMDR-certified and currently completing certification as a sex therapist. Her work focuses on helping individuals and couples heal from sexual trauma, reconnect with their bodies, and build shame-free, pressure-free sexual relationships.
Through therapy, education, and public outreach, Holly aims to normalize conversations about sexual health, consent, and intimacy so people can experience deeper connection, confidence, and wellbeing in their relationships.
Holly has been featured in major publications such as HuffPost,Stylist’s Strong Women, Well Beings News, and VoyagePhoenix. Through her practice, The Connection Couch, Holly offers compassionate, trauma-informed care that empowers clients to embrace their sexuality with confidence and ease.
For more information, visit The Connection Couch or reach out to schedule a session today.