Experts assess the psychological aspect of erectile dysfunction

In this interview, Mark S. Allen, PhD, highlights the recent article, “The Psychology of Erectile Dysfunction,” which was published in Current Directions in Psychological Science¹ and highlighted in a recent news release.² Allen is the lead author on the publication and a psychologist and health scientist at Leeds Trinity University in the UK.

Mark S. Allen, PhD

Could you discuss the background of this literature review?

We had published a number of articles on the biological causes and treatment options for erectile dysfunction but noticed that psychological factors are often overlooked both as a cause and in the treatment of erectile dysfunction. Men are often reluctant to discuss erectile problems with their GP [general practitioner], often citing embarrassment as a major contributing factor. A review article aimed at both an academic and a general audience seemed like an excellent way of increasing awareness of the psychological impact of erectile dysfunction on individuals and their partners.

What were the main findings from this review?

Our review highlights the main psychological factors that contribute to erectile problems, including personality traits, work life stress, and sexual performance anxiety, and how erectile dysfunction can affect the psychological states of affected individuals—including feelings of emasculation and embarrassment. Erectile dysfunction can also substantially affect the psychological states of the affected individual’s sexual partner, such as feelings of being unattractive, feelings of frustration, and lowered self-esteem. Our review also found that psychological treatments such as couples therapy can be beneficial, not only for improving the psychological states of couples, but also for improving erectile function.

What research in this space is still needed?

A considerable amount of research is still needed in understudied populations, such as people who identify as nonbinary, transgender, or asexual. Interventions that combine multiple treatment options appear to show the greatest benefits. Medications can have helpful immediate benefits for some individuals, but it is important to remember that such medications are ineffective for about 60% of men and do not target the underlying cause of erectile dysfunction. Standard age-related erectile dysfunction is most commonly caused by a weakened cardiovascular system, and long-term physical activity interventions appear to show the greatest benefits to erectile function. Of course, psychological factors will also play a big role, and a useful next step in research progression is to explore how long-term changes in lifestyle—to strengthen the cardiovascular system—can be combined with psychological interventions, and potentially medication, to have the greatest benefit for affected individuals.

Is there anything else that you’d like to add?

Erectile dysfunction is a common problem affecting individuals of all ages. Psychological factors often have an important role, and psychological treatment options are available that have been found to improve outcomes. Affected individuals should aim to have open discussions with their sexual partner about erectile problems and also not be afraid to discuss sexual difficulties with their GP.

References

1. Allen MS, Wood AM, Sheffield D. The psychology of erectile dysfunction. Curr Dir Psychol Sci. Published online September 8, 2023. Accessed October 3, 2023. doi:10.1177/09637214231192269

2. Psychological aspects of erectile dysfunction deserve more attention, health scientists say. News release. Association for Psychological Science. Published online September 27, 2023. Accessed October 3, 2023. https://www.newswise.com/articles/psychological-aspects-of-erectile-dysfunction-deserve-more-attention-health-scientists-say