The Psychology of Erectile Dysfunction Part 1

In my first post I introduced you to the fascinating field of sex science and how studying the brain might help explain some of the big why questions that everyone has about their sex life. What I’d like to do now is come up with some answers to these questions, starting with what most men describe as their biggest sex-related fear…erectile dysfunction.

via GIPHY

For those of you who don’t identify as playing an “active” assertive role in sex, don’t exit the screen just yet, I promise you’ll be in the spotlight soon enough. But for now I’d like to focus on the penile partners. We’ve all been there, that moment when it seems like everything to do with sex is up except your penis. Or when you felt as though you were about to orgasm, but couldn’t climax regardless of how hard you focused. If any of these situations apply to you then you’re probably pretty…normal. That’s not to say that for some people erectile dysfunction is not a cause for concern. If erectile dysfunction is something that you live with each and every day, then you may want to refer yourself to a physician. Since erections are the result of coordination between various physiological systems, such as the nervous system and cardiovascular system, dysfunction may be a sign of another underlying problem. I’ll, however, leave that type of medical education to the urologists.

Alright, so let’s say that you have a hard time getting erect or maintaining an erection, some but not all of the time, why might this be the case? Let’s use what we have gained from neuroscience to answer this question.  Erections and ejaculation are the result of coordination between two divisions of our autonomic nervous system, the parasympathetic (rest or digest) and sympathetic (fight or flight), respectively. Initiation of an erection can be broadly categorized as reflexogenic (stimulation of the penis) or psychogenic (result of erotic stimuli that leads to top down control of an erection by the brain). Regardless of how an erection starts, the physiology behind them is a fairly complicated balance in the nervous system. Where I’d like to focus is on the psychological factors that might disrupt this balancing act that the male body is expected to perform.

Stress

Stress, a word that we all know too well, is our body’s way of coping with any kind of demand or threat from our environment. Interestingly, this threat does not necessarily need to be real but in many cases may also be imagined. As a reaction, our bodies natural defenses kick in, we activate the sympathetic (fight or flight) division of our autonomic nervous system and mount a stress response. How does this all relate to erections? Overstimulation of the sympathetic nervous system can inhibit blood flow to the penis. Honestly, it doesn’t take much psychological distress to interfere with sexual functioning. Feeling anxious, depressed, changes in your confidence level, doubt, disappointment, negative body image, unrealistic expectations regarding sexual performance, and adjustment to new living conditions to name a few can be stressful. The thing about depression is that one of its hallmark symptoms is anhedonia, or the lack there of pleasure, so it’s clear why living with a mental illness may interfere with our sex life. Interestingly, antidepressants may sometimes help with this and can many times interfere with sexual desire and performance as well. Did you know that even success can interfere with your sex life? If you were surprised, then you probably didn’t know that stress can also arise from things that we evaluate as positive as well.

Part 2 Continued here...