The Psychology of Erectile Dysfunction

madman

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Abstract

Erectile dysfunction is a major chronic condition affecting hundreds of millions of individuals worldwide. This review provides a concise overview of research on the psychological experience of erectile dysfunction. There is evidence that psychological factors such as personality, depression, stress, and cognitive interference (e.g., performance worry, and shifts in attentional focus) contribute to erectile problems. There is also evidence that the experience of erectile dysfunction can have negative psychological effects, including feelings of emasculation and humiliation, decreases in self-confidence and feelings of self-worth, feelings of isolation and loneliness, increases in depression, and decreases in subjective well-being. Effects on the affected individuals’ sexual partner include feelings of being unattractive, feelings of rejection, feeling unloved, decreases in self-esteem, and frustration. Psychological interventions (particularly multimodal interventions) show promise for treating erectile dysfunction, but more research is needed to help establish their effectiveness. We present a brief research agenda of critical areas in need of further study. This review should be of interest to the general public and also to researchers looking to develop a program of research in sexual health psychology that focuses on the psychological experience of erectile dysfunction.




Erectile dysfunction is most commonly defined as a consistent or recurrent inability to attain or maintain an erection that is sufficient for sexual satisfaction (McCabeet al., 2016). The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders also considers that symptoms need to persist for more than 6 months and be causing significant distress in order to qualify as erectile dysfunction (American Psychiatric Association, 2013). This definition serves as a useful generalized description of the condition, but it is worth noting that it might be based on heteronormative assumptions, and it is unknown whether this definition is useful for individuals who identify as transgender or nonbinary (see Whitney et al., 2022). Erectile dysfunction is a major chronic condition affecting hundreds of millions of individuals worldwide. Indeed, in healthy populations, the risk of erectile dysfunction increases across the adult life span, with prevalence rates at approximately 20% before age 30 years, 25% at age 30 to 39 years, 40% at age 40 to 49 years, 60% at age 50to 59 years, 80% at age 60 to 69 years, and 90% in individuals above 70 years of age (Allen & Walter, 2019; Geerkens et al., 2020). Erectile dysfunction is often classified as biological in origin (e.g., caused by injury, drug use, or cardiovascular damage) or psychological in origin (e.g., caused by life stress, depression, or intrusive thoughts during sexual activity) but most often reflects a combination of both biological and psychological factors (Shamloul & Ghanem, 2013; Yafi et al.,2016). Until recently, relatively little attention had been paid to the psychological aspects of erectile dysfunction. This review aims to provide a succinct overview of contemporary research that has explored psychological processes in the experience of erectile dysfunction.





*Psychological Outcomes


*Psychological Contributors


*Interpersonal Psychological Outcomes


*Psychological and Multimodal Interventions


*Research Agenda




Conclusions

Erectile dysfunction is a major chronic condition that can have substantial implications for the well-being and quality of life of both the affected individual and their partner (Elterman et al., 2021). There is evidence that psychological factors such as personality, depression, stress, and cognitive interference (e.g., performance worry, and shifts in attentional focus) contribute to erectile problems. There is also evidence that the experience of erectile dysfunction can have negative psychological effects, including feelings of emasculation and humiliation, decreases in self-confidence and feelings of self-worth, feelings of isolation and loneliness, increases in depression, and decreases in subjective well-being. Effects on the affected individuals’ sexual partner include feelings of being unattractive, feelings of rejection, feeling unloved, decreases in self-esteem, and frustration. Psychological interventions show promise in their ability to contribute to the treatment of erectile dysfunction, but more research is needed to help establish the efficacy of these treatments. We hope this review will benefit researchers aiming to develop a program of research in sexual health psychology that focuses on the psychological experience of erectile dysfunction.
 

Attachments

Fig. 1. A general model illustration of key psychological contributors and outcomes of erectile dysfunction (ED).
1706324961752.webp
 

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Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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