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How to Know if My ED is Physical or Psychological

Erectile dysfunction can be frustrating to deal with, especially if you aren’t sure why it’s happening. Is it all in your head? Is there an underlying physical cause you could treat to put this all in the past? Understanding what is going on and how to fix it is the first step in getting your sex life back on track.

Is the cause of your ED physical, psychological, or both? Here’s how to know if ED is physical or psychological and how your problem can be solved.

Understanding Erectile Dysfunction

Before you can better understand what is causing your ED and whether your erectile dysfunction is psychological or physical, you first need to understand the basics of an erection and how dysfunction can occur.

What Is Erectile Dysfunction?

Essentially, ED happens when the signals between your brain and penis are out of whack. Typically, when you become physically or mentally aroused due to a touch, thought, or something you’ve seen, the nerves in your brain send various chemical messages to your penis. Once this happens, the arteries in your penis begin to open up, allowing for a rush of blood that results in your penis expanding in size and becoming hard. 

Once a physical or psychological disruption to this process takes place, ED is the result. 

Since many factors can cause your ED, trying to self-diagnose your problem will be difficult. So instead, you need to overcome your embarrassment, realize that plenty of young and older adults experience ED, and schedule an appointment with your doctor to discuss what’s happening.

Why Is it Important to Determine the Cause of Your ED?

Until you find out exactly what is causing your ED, chances are it won’t be going away anytime soon. For example, if you are in good physical health, your ED is probably more likely psychological than physical. 

Even if you believe you are in excellent health, that does not mean there is no way an underlying medical condition could not be the reason behind your ED. Various health conditions that often go undetected can cause or contribute to ED. Visiting your doctor can uncover any physical causes and allow you to receive appropriate treatment.

Unfortunately, the longer you put off talking with your doctor about your ED, the longer you’ll continue to deal with it day after day. But, whether your ED is ultimately diagnosed as physical, psychological, or a combo of both, addressing it as soon as possible will help you and your sex life return to normal.

The Symptoms of Erectile Dysfunction

Whether your ED is physical, psychological, or a combo of the two, you’ll start to notice a variety of symptoms that include:

  • Problems getting an erection
  • Troubles maintaining an erection
  • Having a “soft” erection

Even if you are highly aroused before or during sex yet still have erection issues, a physical problem may be the reason for your ED, meaning you need to speak to your doctor immediately. It’s also important to remember that ED can occur during masturbation and when you are having sex with your partner, so keep this in mind.

Even if your erectile dysfunction is physical in origin, if you have had one bad experience with ED while with your partner, the thought of being unable to satisfy your partner a second time sexually may create a vicious cycle within your mind that leads to further embarrassment, guilt, and shame. This is why figuring out the cause of your ED can get complicated.

The Physical Causes of Erectile Dysfunction

There can be many physical causes of erectile dysfunction that you may not even realize could be causing or contributing to your sexual problems. Some of the most common are:

  • Low testosterone and hormonal imbalance
  • Heart disease
  • Diabetes
  • High cholesterol levels
  • Smoking and tobacco use
  • Obesity
  • Sleep disorders
  • Alcohol or drug use

High blood pressure, medical conditions such as multiple sclerosis and Parkinson’s disease, and various prescription medications may also be causing your ED. Other examples include hormonal imbalances, injuries, and nerve damage.

There can be many physical causes of ED, so you should meet with your doctor to understand how to treat physical ED based on your individual situation. 

The Psychological Causes of Erectile Dysfunction

Because it is so easy to assume that having obvious physical erectile dysfunction symptoms means your problem is purely physical, you may overlook that your ED may be purely or mostly psychological. Some of the most common psychological causes of erectile dysfunction include:

  • Chronic stress
  • Anxiety
  • Depression
  • Relationship difficulties
  • Unrealistic expectations

With many men who suffer from psychological erectile dysfunction symptoms, the problem can often be traced to their regular viewing of pornography. 

Commonly referred to by doctors as “porn-induced erectile dysfunction,” this leads to unrealistic expectations when having sex with your partner. When your sex life fails to live up to the artificial standards you usually seek out from watching pornography, you may find that you lack adequate stimulation when compared to the fantasy pornography has created.

Psychological ED can also develop as a result of physiological ED, leading to a cycle of decreased sexual confidence and performance anxiety.

How to Determine the Causes of ED

Determining the cause of ED can be difficult, even for the most experienced doctors and health professionals. Trying to figure out the psychology of erectile dysfunction and how psychological impotence and emotional erectile dysfunction combine with various physical symptoms can take time, which is why it is crucial that you not delay seeking treatment for your ED. 

Your doctor will likely use several diagnostic techniques to decide whether your ED is physical or psychological. These include various medical exams and tests, such as checking your blood pressure and cholesterol levels. In addition, should you report having a low or reduced sex drive, your doctor will also want to test your testosterone levels

As a preemptive strike, you could test your testosterone and other male biomarkers at home to understand where you stand hormones levels-wise. Scheduling a doctor’s appointment after getting the test results is the wise thing to do, as you will learn a lot about your body, how to take advantage of its strengths, and how to approach its weaknesses so you enjoy better sex life and overall health. 

A thorough physical exam and psychological evaluation may also be performed, especially if you think stress and anxiety may contribute to your ED. Finally, although you may find it embarrassing, your doctor will also ask you detailed questions about your medical and sexual history to help them determine which direction to take regarding your treatment. 

During this discussion, expect your doctor to ask you about any prior surgeries or other medical procedures you have had, your sexual relationships, and your level of satisfaction within your current relationship. Being completely honest with your doctor will make it easier for you to receive the proper treatment for your ED.

What Treatments Are Available for ED?

As more has been learned about the various ED causes, the good news for you is that several treatment options are available to help solve your problem, whether physical or psychological issues determine it. Both types of ED can be treated, and treatment plans may involve a combination of lifestyle changes, medication, therapy, and in some cases, surgery.

Treatment Options for Physical ED

Once your doctor has determined your ED is due to physical causes, the treatment options can vary substantially. 

As you may have guessed, oral prescription medications are often part of men’s treatment plans. Sildenafil is the most common prescription medication used to treat physical ED, although prescribing it for psychological ED is also quite common. Other common treatment options for physical ED include:

If you are overweight or regularly use tobacco products or alcohol, your doctor may also recommend making lifestyle changes as part of your treatment plan for physical ED. For example, eating a healthier diet and exercising regularly may surprise you just how quickly ED may disappear. 

Should you take various prescription medications for high blood pressure or cholesterol, your doctor will also want to ensure these medications will continue to be safe and effective for you if other ED medications are deemed necessary. 

Treatment Options for Psychological ED

Just as it is when treating physical ED, your doctor will have several options available to help you overcome psychological ED and get you and your sex life back on track. Remember, it is conservatively estimated that at least 20 percent of all men have dealt with psychological ED at some point in their lives, so you are not the only one who is frustrated with what’s happening to your sex life.

The most common treatment options for psychological erectile dysfunction include the following:

  • Mental health counseling
  • Psychotherapy
  • Couples therapy
  • Meditation
  • Guided imagery
  • Medications

When you are experiencing extreme feelings of guilt and shame due to your ED, psychotherapy sessions with a trained professional can often work wonders since this will allow you to discuss your feelings in a safe environment with someone who understands your situation. 

Meditation and guided imagery are increasingly proving effective in treating psychological ED. Using guided imagery techniques taught to you by a therapist or by listening to audio recordings, you can learn how to use a sequence of visualizations to help your brain regain control of your body.

Combo Treatments

More often than not, most men who end up dealing with ED do so due to both physical and psychological issues. When this is the case, expect your doctor to use a combination of various treatments. For example, your doctor may prescribe Sildenafil or suggest you make certain lifestyle changes while at the same time having you visit a therapist to learn how to fix psychological ED.

Seeking Help

Though you may find discussing your sex life with your doctor embarrassing, doing so can often be a key step in helping you overcome the problems associated with ED. Whether your problem is physical, psychological, or a little of both, seeking help for ED can lead to you seeing tremendous improvements quickly. From getting tested for low testosterone to having an honest discussion with a therapist, these steps may soon help you tackle your ED problems.

FAQs

1. Can my ED be psychological?

The ED you are currently experiencing may, in fact, be purely psychological. If you are under tremendous stress at work or home, are depressed, or are nervous about your sexual performance, psychological treatments for your ED may be what is needed.

2. How do I know what type of erectile dysfunction I have?

Since learning whether your ED is physical or psychological can be difficult for even the best doctors, don’t assume you can make a completely accurate diagnosis on your own. 

Physical factors like injury, disease, or medication side effects can cause physical ED. Psychological factors like stress, anxiety, or depression can cause psychological ED. A doctor can diagnose the type of ED by conducting a physical examination, medical history, and various male health checks. However, many ED cases involve both physical and psychological issues, so speaking to your doctor as soon as possible is always your best option.

3. What does psychological ED feel like?

From a physical standpoint, psychological ED feels no different than its physical counterpart. However, the biggest difference you may notice is your thought process, including feelings of extreme shame, guilt, and embarrassment. 

4. What is the difference between physiological and psychological ED?

The major difference between physiological and psychological ED is that the physical version can be directly linked to a specific physical cause, such as a medical condition, low T levels, etc. However, psychological erectile dysfunction is linked primarily to anxiety, stress, and depression.