ED in Men: A Closer Look
Erectile dysfunction (ED) can feel isolating, frustrating and confusing for men of all ages. The truth is, ED is much more common than people thinkand it can come from many different causes—both physical and emotional. In my practice as a men’s therapist specializing in relationships and stress, I see many men struggling with ED who often feel alone or ashamed of it.
But addressing ED doesn’t have to be a solo journey. Treatment, combined with other lifestyle changes or medical interventions, can make a substantial difference. Let’s look at seven common reasons why ED can occur and how treatment can help.
1. Stress and anxiety
It’s no surprise that stress and anxiety can get in the way of intimacy. Whether it’s work stress, financial worries or just everyday life, high levels of stress can reduce the body’s ability to perform.
Stress, especially performance stress, can turn what should be an enjoyable experience into a high-pressure test. Therapy helps by providing tools to manage stress and shift the focus to connection and relaxation.
2. Relationship Issues
Relationship dynamics play a huge role in sexual health. Unresolved conflicts, lack of communication, or past hurts can lead to tension and even resentment, which often translates into the bedroom.
Through couples therapy or even individual therapy, you can address these issues, improve communication, and rebuild trust and intimacy, making it easier to reconnect with your partner.
3. Depression
Depression isn’t just “feeling down”—it’s a whole-body experience that affects mood, energy, and bodily responses, including sexual arousal and function. Often, ED is both a symptom of and contributes to depression, leading to a frustrating cycle.
Therapy can provide tools to manage the symptoms of depression, helping to remove some of the emotional burden that affects libido and sexual performance.
4. Poor sleep
Sleep may seem unrelated, but poor sleep is an important factor in overall health, including sexual health. Lack of sleep can lower testosterone levels, increase anxiety and lead to fatigue – all of which affect sexual performance.
Through therapy, you can develop habits to improve sleep, as well as address any underlying anxieties or thoughts that may be disrupting your rest.
5. Body image and self-esteem issues
Feeling self-conscious about your appearance or physical ability can lead to avoidance behaviors and low self-confidence. When you don’t feel good about yourself, it’s harder to be present and enjoy the moment.
Therapy can help you decompress these feelings, change your perception of yourself, and begin to see yourself as worthy and desirable. Over time, this change in mindset can positively affect the way you experience intimacy.
6. Use of Substances
Alcohol and other substances may seem like a quick way to relax, but they can actually affect sexual performance. Alcohol, for example, is a depressant that can make it harder to maintain an erection.
Medicines and drugs can also affect sexual function. Therapy can help you explore healthier coping mechanisms and help you navigate the process of reducing or changing your substance use patterns if that is the goal.
7. Health Conditions and Medicines
Conditions such as diabetes, high blood pressure or heart disease can all contribute to DM. Medications for these conditions can also have side effects that affect sexual performance. In cases like these, therapy provides emotional support and strategies for coping with the psychological impact of living with a health condition.
Additionally, therapy can be a safe space to work through any frustration, anger, or sadness around physical limitations.
How therapy can help, in combination with other approaches
When it comes to ED, there is no “one size fits all” solution and that’s a good thing! Therapy can be a powerful piece of the puzzle, often working best alongside other lifestyle or medical approaches. See how therapy plays a unique and supportive role in treating DM:
- Managing expectations and relieving stress: Therapy offers a space to talk openly about experiences and normalize the fact that ED is common and treatable. It helps release some of the pressure to “perform” and instead shifts the focus to enjoying intimacy and connection.
- Development of Communication Skills: Whether it’s individual therapy or couples therapy, learning how to communicate openly with a partner can be a game-changer. When both partners understand and can talk about ED, it often reduces shame and opens the door to new ways to experience closeness.
- Working on Underlying Emotional Health: Therapy is incredibly effective at addressing underlying emotional issues that may be affecting sexual function, from anxiety and stress to self-esteem challenges. Often, addressing these issues immediately helps relieve some of the blocks that contribute to ED.
- Encouraging lifestyle changes: Sometimes, ED can benefit from simple lifestyle changes. Therapy supports these changes by creating a space to talk about the challenges and barriers to making healthier choices, whether it’s cutting back on alcohol, getting more sleep, or making time for stress-relieving activities.
- Connection with additional support: In some cases, treatment can help determine when medical intervention may be necessary. As a therapist, I often work with doctors, nutritionists, and other professionals to create a holistic support system for my clients.
If you are struggling with ED, know that you are not alone and that help is available. Therapy can be a critical part of this journey, empowering you with tools to manage the emotional and relational aspects of ED.
By addressing these factors, you’re on the road to better emotional and physical health — and a more fulfilling intimate life.
