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Stress and erectile dysfunction: here’s what you need to know

Stress can impact our health and wellbeing in numerous ways – and this includes your sex life.

In fact, it’s well recognised that stress and erectile dysfunction (ED) or impotence, which means trouble getting or maintaining an erection, are linked, and Suks says stress, and other psychological causes, probably accounts for around 50% of all ED cases he sees. “Particularly in younger age-group men, where this can be a really important issue,” he adds.

Often, stress-related ED is a short-term problem (most men will experience an episode at some point). But, if you are struggling to get or maintain erections, how do you know if stress is the cause – and what should you do about it?

Why stress matters   

As Suks points out, stress is tricky to quantify and there’s no clear way of measuring it. But the issue here is how it’s affecting you, psychologically and physically – because both play a part when it comes to ED. If you’re going through a particularly tough time, it’s understandable that your sex drive might dip. But beyond this, stress can trigger hormonal changes which affect your erectile function too: As Suks put it, your “sympathetic nervous system can go into overdrive”, which is the same reason you can get other physiological ‘symptoms’, like palpitations and a sensitive digestive system, when you’re stressed.

How can you tell if stress is the cause?

There are a number of known causes of erectile dysfunction, including trauma, or underlying physical problems such as diabetes and high blood pressure, plus hormonal imbalances. There’s no test to determine whether your ED is down to stress, so often it’s a case of looking at what’s going on in your life, and any patterns occurring. “If somebody’s stressed and it’s causing erection problems, they may still find they’re waking up with erections in the morning, but having difficulty later on when they’d normally have sex,” says Suks. “Often there’ll be something circumstantial: it could be they’re under a lot of stress at work, or having relationship problems, or it might be linked with depression and anxiety. If it is something like work, men might find that when they go on holiday, they’re able to have sex again – but once they get back home and back at work, they’re not able to.”

But ruling out other causes can still be important

While it’s pretty clear stress is a big factor in erectile dysfunction, Suks highlights that if you’re experiencing ongoing impotence, it’s a good idea to discuss it with a doctor, rather than just self-diagnosing or putting up with it. They may want to investigate whether anything else is going on. “You might need some tests to look at metabolic factors, so checking things like cholesterol and blood pressure and hormone levels,” says Suks. “Metabolic Syndrome (a term used to describe people with a range of lifestyle-related conditions, including hypertension, high blood sugar and excess body fat around the middle, which is linked with an increased risk of things like stroke, type 2 diabetes and heart disease) is also a known cause of ED. It’s important to look at these things, or you might miss an opportunity to address them and help reduce the associated risks.” Your doctor would probably want to do a quick examination too, to check for any obvious physical causes.

If it is stress, what can you do about it? 

It’s not always possible to completely avoid stress, but there’s certainly lots you can do to help. If there are particularly stressful circumstances taking a toll, are there steps you can take to address these? Prioritising time for relaxation, enjoyment and leisure, plus regular exercise, also makes a big difference, as does “eating healthily, and reducing alcohol and smoking – two things that can make ED worse”, adds Suks. If the problem’s been going on for a considerable length of time and having a wider impact, counselling or psychosexual therapy might be very helpful. “Also, sometimes medication can be used to help restore mens’ sexual confidence, which can be an important step,” says Suks, so see your doctor to discuss the best steps for you.