Can’t Get It Up-It May Just Be In Your Head If the mind is crazy….the penis can be lazy!

When I went to medical school, the party line was that most men with impotence had a psychological cause of their inability to engage in sexual intimacy. Now, the situation is reversed and most men have ED or impotence as a result of physical causes, i.e., decrease in the blood supply to the penis, hormone deficiencies, or nerve problems. However, 10-20% are still due to emotional causes.

Emotional causes are often a secondary reaction to an underlying physical cause. In some cases, the psychological effects of ED may stem from childhood physical abuse or sexual trauma. However, the most common psychological causes of ED include:

Stress can be job-related, money-related, or the result of marital problems.

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 lead to ED.

A man may feel guilty that he is not satisfying his partner.

A common cause of ED, depression affects a person physically and psychologically. Depression can cause ED even when a man is completely comfortable in sexual situations. Drugs used to treat depression may also cause ED.

Low self-esteem 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.

Indifference to sexual intimacy may come as a result of age and a subsequent loss of interest in sex, be the result of medications or stemming from problems in a couple’s relationship.

Let the truth be told: all men at one time or another will experience ED. Only if the problem becomes persistent, i.e., occurs more than half the time — or becomes a source of distress for you or your partner should you be concerned and consider seeking medical advice and treatment. Most men with ED due to either psychological or physical causes can be helped and even cured. I suggest you have a discussion with a doctor if you are “striking out” more than half the time. I can’t promise you a home run every time, but I can tell you that you can be helped.


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