Can Psychological Problems Cause ED And Libido Problems?

Yes, psychological issues can indeed cause erectile dysfunction and a reduced libido.

These mental problems can take on many forms such as anxiety, fear, depression, guilt, low self-esteem, bipolar disorder, etc., but they all have something in common:

They occupy your mind and fill it with negative thoughts.

Which means less space remains for normal thoughts and desires. Such as healthy sexual thoughts.

Psychological problems can also cause hormonal or chemical imbalances, which can directly cause erectile dysfunction and libido issues.

Let’s understand the most common psychological problems.

Can Psychological Problems Cause ED And Libido Problems?

The Most Common Psychological Problems

A psychological problem is characterized by a disturbance in an individual’s thinking process, mental functions or emotions, which in turn causes a ‘dysfunctional’ behavior. 

An example of ‘dysfunctional’ behavior can be a situation where you have difficulties living a satisfactory social life. 

Or it can be a situation where you cannot maintain family relations. Or where you are unable to perform your tasks at work.

In other words, it is first when your behaviour becomes distorted, that a psychological problem arises.  

Let’s take a look at some of the most common psychological problems.

The Most Common Psychological Problems

Severe Stress Disorders

A little bit of stress is not a psychological problem, neither is the stress you may experience at work from time to time.

But there are certain severe forms of stress that can be classified as psychological problems. Because they become so intense that they distorts your normal behaviour.

Acute stress disorder is one. This is classified as severe stress after exposure to a traumatic event. A traumatic event can be an accident, loss of a loved one, loss of income / wealth, etc.

When suffering through acute stress disorder, you will often experience vivid flashbacks, selective memory, overwhelming sadness and overthinking.

This disorder is closely linked to post-traumatic stress disorder.

Man Suffering From Severe Stress Disorder

However, post-traumatic stress disorder (PTSD) is often a more severe disorder. It normally happens after you have experienced actual or near death, serious injury, or sexual violence. 

When struggling with PTSD, you often play the episode in your mind over and over again. As you do, your perception of the event may grow in intensity. You may also start shutting out certain memories, emotions and try to avoid anything that reminds you of the stressful incident.

Another stress disorder is called adjustment disorder. This normally occurs as a response to a sudden change in your life. Such as loss of a partner, family member, breakup, loss of job or similar. 

When suffering from adjustment disorder, you will normally feel intense sadness. You will typically cling to the past and yearn for it to come back. And you normally feel that your current situation is far inferior to the old one.

These are just a few of the several severe stress disorders.

Man suffering from post-traumatic stress disorder

Anxiety Disorders

We are all anxious from time to time. This is normal. However, when you feel excessive and persistent anxiety, fear and worry that is impeding your daily life, we are talking about a disorder.  

This anxiety often arises as a result of a potential future threat. This can be a real threat, or it can be imaginary. 

Anxiety can come in many different forms. One form is social anxiety disorder, which is intense anxiety or fear of being judged, negatively evaluated, or rejected.

Another forms are fear of heights, fear of certain animals or insects (spiders for instance), separation anxiety (fear of being separated from a certain person for instance), and obsessive-compulsive disorder (recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors).

Anxiety Disorders

Sexual Performance Anxiety

Sexual performance anxiety is also a form of anxiety. But in this context it deserves its own section because it is a common cause of erectile dysfunction.

What is sexual performance anxiety?

It is anxiety or fear that you will: 1) not be able to ‘get it up’, or 2) ‘go soft’ during sex. 

Let’s say you are with your partner and you are getting intimate. You sense this is leading to sex. If you now start thinking: “Am I getting hard.. or no? I wonder if I am able to get an erection if we try to have sex..?”

Or if you during sex start thinking: “I’m I still hard..? Or am I about to go soft..?”

Then you are causing yourself problems..

Sexual Performance Anxiety

Why?

Because you are now taking focus away from enjoying the moment. You stop enjoying the foreplay or the sex. 

Instead you start to worry. And this normally almost instantly kills your erections.

In other words, if you fear that you will not ‘get it up’ (erectile dysfunction), this can by itself lead to erectile dysfunction.

By the way, I have been guilty of this many times. 😤

It can be difficult to get out of this spiral. But the key is to get your mind and body towards balance so that you start to function better sexually. Then as you demonstrate to yourself that you improve, you will gain confidence, and this anxiety normally fades away.

The key to the problem

Depression

Depression can be caused by a number of different factors.

It can be caused by a traumatic or negative event that happened earlier in life, it can be caused by self-esteem problems or feeling inadequate, by an ongoing negative family situation, loss of a family member or friend, social problems, medical condition, etc.

Depression is characterized by feeling sad, empty and without hope. In some cases, this emotional sadness is accompanied by physical discomfort. 

When you are depressed, you typically have less energy to live life, and you normally have less interest in activities that formerly interested you. 

Life and daily events may become dull or even be perceived as pointless.

Man with depression

Your behaviour therefore often changes. 

When you are depressed, you may also also have less interest in, as well as be less capable of forming, bonds with other people.

Low Self-Esteem

Low self-esteem is the feeling of not being good enough in one way or another. 

Put differently: Your view of yourself doesn’t match with how you want to see yourself. You may feel unaccomplished, not good looking enough, too poor, too old, not socially smooth enough, etc.

For instance, if you work in a job that is well below your skill level (let’s say you’re working as a cashier), while you have an engineering education, you may feel that your skills are not utilized.

Man working as cashier

This can easily lead to you having a low self-esteem. You may then feel you are not worthy of a girlfriend, friendships and other aspects of life.

This sense of being out-of-place can be useful as it motivates you to search for something better. However, if it takes over your mind and you think about it almost constantly, it becomes a problem.

Jealousy

Jealousy, when extreme, can be another mental problem. 

Some jealousy is normal, however it is when the jealousy becomes so intense that it alters your behaviour, that it becomes a psychological problem.

So what is jealousy?

Jealous person

Jealousy is when you compare what you have to what you wish you had, and this produces emotional discomfort.

You may compare your house to the amazing house of your neighbor, and feel jealousy. Or you may compare your career to that of your boss, thinking that you’ve been unlucky and feel sorry for yourself.

You can also be jealous of your partner, thinking that your partner is being unfaithful because he or she spends time with certain people.

You can also be jealous of another person’s sexual past. There are many forms of jealousy.

Guilt

Guilt is a sensation you normally feel when you do something that is against ‘the rules’ or ‘the norms’.

Man feeling guilty

You experience guilt when you do, or have done, something you ‘know’ you shouldn’t do. 

Let’s say you are a married family man, but you also have a secret lover. This is likely to produce the sensation of guilt.

Or perhaps you some time ago committed a serious crime. This may probably do the same.

This guilt will normally be present in the back of your mind as a negative emotion.

This will often take up a significant amount of mental space. It will often make you worry, think twice, be on guard, and make you feel dishonest.

Distrust

You may not trust anyone. Not your partner. Nor your friends. Nor your family. 

This will often be a result of your trust being severely abused in past. And particularly so if this happened more than once.

This can happen if your partner has a sexual affair, your best friend betrays you, or someone you trusted stole from you.  

When you experience severe distrust, you will normally be suspicious, doubt, not open up to people, overthink, second-guess, worry extensively, analyse, etc.

And when you are spending an unusually large amount of mental energy on this process, it can alter your behaviour.

It has then become a psychological problem. 

Distrust as a psychological problem

Personality Disorders

A person suffering from a personality disorder, has a rigid and unhealthy pattern of thinking, functioning and behaving.

This will often cause substantial problems and limitations in relationships, social activities, work, etc. 

Some of the most common personality disorders are: Paranoid disorder, antisocial disorder, narcissistic disorder, dependent disorder, bipolar disorder, multiple personality disorder, schizophrenia, and attention deficit-hyperactivity disorder.

Eating Disorders

If you have obsessive concerns with weight to the point where it influences your ordinary behaviour, this is also a psychological disorder.

Man With Eating Disorder

The two most common eating disorders are anorexia (restricted food consumption) and bulimia (self-induced vomiting or use of laxatives and diuretics). 

Similar to other mental disorders, eating disorders also hi-jack your mind and fills it with thoughts that should really not be there.

Gambling Disorders And Addictions

A gambling disorder arises when you have an unhealthy relationship to gambling, to the point where it negatively affects your normal behaviour. 

In other words, if you think so much about gambling that this makes it difficult to function normally, this is classified as a psychological problem.

With a gambling disorder, you often gamble with large amounts of money, and you are not able to fully understand the negative consequences this could potentially have.

Gambling addiction

Addictions can be similar. There are many ‘things’ that can cause addiction. You can be addicted to drugs, alcohol, sugar, sex, porn, etc. 

When this desire gets so strong that you keep satisfying these desires despite negative consequences, this has become a psychological problem.

How common are these psychological problems? Maybe a lot more common than you think.

Let’s take a quick look at how common psychological problems are worldwide.

The Prevalence Of Psychological Problems

Chances are high that you know someone who suffers from a psychological problem.

Well, sometimes you may not know that a certain person suffers from such a problem, because it’s something people are not always open about.

But the likelihood is very high still, because according to a research report that analyzed 174 surveys across 63 countries, 17.6% of people had a common mental disorder during the last 12 months.

That is almost 1 in 5 people. And we are not just talking about people that had suffered from a mental problem at some point in their life. We are talking about the current situation.

So if this finding is representative for people at large, it is fair to say that approximately 1 in 5 people are currently struggling with a psychological problem. Worldwide.

Now that we understand how common psychological problems are, let’s better understand how they can cause erectile dysfunction and libido problems.

Psychological Counseling

How Psychological Problems Can Cause ED And Libido Problems

Although you physically have sex with your penis, your brain is the most important sexual organ you have. 

Therefore, if there are problems in your brain, your sexual functions may start to work less well. Or may even stop working all together.

There are 3 main reasons why psychological problems can cause erectile dysfunction and a weak libido:

  • Crowding out of positive thoughts
  • General imbalances in brain and body
  • Changes to key agents such as dopamine, testosterone, prolactin, etc.
How Psychological Problems Can Cause ED And Libido Problems

Psychological Problems Can Crowd Out Positive Thoughts

If you suffer from a psychological problem, let’s say depression, your mind will typically be preoccupied with negative thoughts.

You will probably spend a large amount of time thinking these negative thoughts. You may even go in circles, repeating the same dark thought process over and over. 

As a result, there will be less space for happy and healthy thoughts.

And therefore also for healthy sexual thoughts.

Let’s look at an example: 

Let’s say you’re depressed. And that you walk down a street on a warm and sunny summer evening. A gorgeous woman passes you on the sidewalk.

Beautiful woman walking on sidewalk

In normal times, she would have probably gotten your attention. You probably would have looked at her, maybe even turned around. You might have even started undressing her in your thoughts. 😂

But since you are depressed, chances are that you already think about something negative as she walks by. Hence your brain probably doesn’t care about her. Your brain has other priorities.

Therefore, she will probably pass you by as you continue your negative thought process.

That’s how psychological problems can dampen, or even extinguish, your sex drive.

The same can happen to your ability to get and maintain erections. 

Because in order to get erections your mind needs to be interested. And if your mind is not interested in sex, the whole erection process may simply not commence.

Man not able to get an erection

Let’s look at an example:

Imagine you’re in bed with an amazing woman. You are kissing and about to get naked. 

But you are depressed and your thoughts are somewhere else. You think about how you will pay your endless bills.

Since your thoughts are somewhere else, you are likely to have problems getting an erection.

And even if you are able to focus on the sexual process at this very moment, it may still be difficult to ‘get it up’. 

The reason? 

If you are in a negative state over time, this may cause several imbalances in your brain and body.

negative state causes imbalances in your brain

Psychological Problems Can Cause Chemical Imbalances In Your Brain

Let’s say you struggle with anxiety. And let’s say you have struggled with this for several months.

This lengthy struggle is likely to cause several imbalances in your body and brain. 

Scientific research has shown that this may result in hormonal imbalances for instance. Meaning, you may produce more of some hormones than you should, and less of others.

Research has also shown that psychological disorders can make your body produce more free radicals.

And research has demonstrated that a psychological disorder can also change the composition of neurotransmitters in your brain.

Psychological Problems Can Cause Chemical Imbalances In Your Brain

The body is an incredibly delicate and fine-tuned system of millions of parts. So if you have any of these imbalances, this may cause certain systems or functions to stop working optimally.

We don’t always understand which imbalances impact what functions. Because we simply don’t have full understanding of the human body. 

However, it is possible that such imbalances may provoke erectile dysfunction and libido issues.   

Psychological Problems Can Directly Impact Sexual Agents

When you have chemical imbalances (as referred to above), this may cause erectile dysfunction and libido problems.

And particularly:

When this alters the production of chemicals, such as dopamine, testosterone and prolactin. 

Because these chemicals are all crucial in the sexual process.

Let’s say you were to suffer from a mental disorder, which caused your dopamine level to fall. 

This is very likely to make you struggle with erectile dysfunction and a weak libido.

This is simply so because dopamine is essential in order to get erections, and also to have a healthy sex drive.

The same goes for testosterone:

If your testosterone production falls because of a psychological disorder, this is also likely to have a negative effect on your sexual functions.

Because testosterone, as the primary male sex hormone, is simply necessary in order to get erections and to have a sex drive. 

Also, if your prolactin level is out of balance, this can disturb your normal sexual function. 

Prolactin is the hormone released immediately after you have an orgasm. This is what brings you back down to planet earth. 😊 

Prolacting puts you in the state where you no longer are interested in sex, nor capable of getting an erection.

Now that we know the 3 key ways in which mental problems can cause erectile dysfunction and libido issues, let’s look at what percentage of ED cases is caused by psychological disorders.

A poor diet can cause erectile dysfunction

What % of ED Cases Are Caused By Psychological Problems?

So we have just learned that approximately 1 out of 5 men and women currently struggle with some kind of psychological disorder.

Which leads me to the following question:

Out of 100 erectile dysfunction cases, how many of these are a result of psychological problems?

Let’s look at what the researchers say.

If we look at this research report, and also the research studies that this report cites, we find that approximately 10-20% of ED cases are caused by psychological disorders.

Meaning that up to about 20% of all men that struggle with ED, have a psychological problem as the underlying reason.

What % of ED Cases Are Caused By Psychological Problems?

Let’s get personal.

Let me share two episodes of my life where I struggled mentally, and how this impacted my libido and my ability to function sexually.

My Experience With Psychological Problems

I think most people underestimate the effect that psychological issues can have on sexual functions.

My experience is that they can be devastating. 

When I have gone through periods of severe psychological issues, my sex life has suffered big-time.

Getting erections have been much more difficult, and my sex drive has barely been breathing.

Let me tell you about two of these and also share how this impacted me sexually.

Let me first say that it doesn’t normally take much psychological stress for me to start having sexual problems. 

All it takes is 2 or 3 days of significant worries or anxiety.

I also don’t think I am special in this regard. Meaning, I would think there are lots of men out there that are just as sensitive to this as I am. 

On to my encounters: 

The first episode was a period of severe sexual performance anxiety. The other was a time in my life when everything important to me failed at the same time.

My Story With Sexual Performance Anxiety

I struggled with erectile dysfunction for more than 10 years. And during these years, I very often had severe sexual performance anxiety.

Meaning, I doubted my own sexual abilities. 

Why?

Because I had already failed so many times. I had experienced seemingly countless episodes of not being able to ‘get it up’, and also losing my erections during sex.

So when sex was about to happen, I would often ask myself: “Am I hard? Am I hard enough? Am I going to be able to have sex now?”

I questioned myself during sex

And often during sex, I would often ask myself: “Am I still hard?” or “Am I about to go limp again?”

Needless to say, having these thoughts did not help me! It made it much more difficult to get erections in the first place. And it also made it more challenging to keep my erections. 

Why? 

Because it took my mind away from enjoying sex, and instead put my mind through worries. 

In fact:

When I had these thoughts, it was almost impossible to have sex.

But at the same time, it was very difficult not to have these thoughts. Because I was worried.

Sexual performance anxiety made me worried about sex

Then how did I get out of it?

When I found the solution to my erectile dysfunction, and when I practiced the principles that enabled me to function well sexually, it almost happened automatically.

Because as I started functioning better sexually, my confidence grew, and the performance anxiety simply faded away.

If you are keen to learn how to overcome ED naturally and permanently, you can read this guide.

My Story With Overwhelming Anxiety

My second episode of heavy psychological problems happened when everything in my world went against me, at the same time.

As a result, I was suffering from extreme anxiety and probably clinical depression.

It was horrible. 🥵

Normally when there is one serious problem in my life, I can deal with it. 

If there are two, I can normally also handle it but my mood tanks. When there are three, I suffer.

At this point I had five big problems hitting me at the same time. It almost felt as if I got punched in the stomach every day from multiple angles. 

It was beyond painful. 

My girlfriend and I had just broken up and I felt incredibly alone. I had lost my best friend.

Man feeling alone after breakup

Two days later, I got kidney stone. It’s the absolute worst physical pain I have ever had in my life.

So at this time, I was an emotional wreck after the breakup, and I was in intense physical pain from the kidney stone.

But there was more:

I lost about half of my financial wealth. Hence, all of a sudden I felt a lot less financially secure.

But there was even more financial trouble: 

Because I also lost practically all my income. Not just my wealth, but income as well. 

And I lost about three months of very hard work. Deleted. Gone.

So..

Now I stood face to face with five big, intense and negative forces pulling me apart.

It was difficult. I cried.

Even though I am a grown-up, independent and see myself as being relatively strong emotionally, I cried a lot. Not just for a day or two, but for about three months.

And it was particularly over the loss of my girlfriend. 

It was an immensely tough and challenging time. Three months of total agony, and then another five months of emotional rollercoasters.

I was broken, beaten and in pain in so many ways. 

Man in clinical depression

Many days, after I had woken up and had breakfast, I just put on my shoes and went walking. For hours. To try to walk off the mental agony.

During this time, I hardly ever thought about sex. I had close to no sex drive. I just didn’t want it much. 

And my erections were nowhere near what they used to be.

Instead I felt guilty, sad and lonely.. These emotions occupied my mind.

But I got out of the rut in the end.

How did I get out of it?

I spoke to a lot of people. Not necessarily about my problems, but I found that having conversations gave my mind a lift.

Man and woman walking and talking

And I tried as best as I could to be appreciative for the good things that I still had in my life. 

And in the emotional chaos, I also tried hard to think logically.

Easier said than done, I know. But it did work.

So what is my approach to these problems today?

My Approach To Psychological Issues Today

Sometimes you get hit by unforeseen events that can cause mental problems. You can’t control the outside environment, hence this may just happen.

But you can to some degree control how your mind reacts to external events.

So if you can learn how to take control of your mind, instead of letting the mind run away, you can (to some extent) control how you feel.

This is what I attempt to do every day. I try not to react instinctively to events (without reflection), but I rather try to first evaluate the situation, and then react to it with a contemplated response.

That puts me in control.

That said, there are events that simply make you sad, give you anxiety and worries. 

And when these moments arrive, I have learned that there are a few actions that work for me: It is to communicate with other people and strengthen my bonds with these people, to be appreciative for the many good things I have in life, and to try to approach the situation with logic instead of emotions.

How You Can Overcome Psychological Problems

I am by no means a psychologist. I have no formal education in psychology.

So I can only speak from my personal experience.

But here are a few ‘things’ that I have learned.

Sometimes you are in a negative circle. The same thoughts repeat themselves in your head again and again and again. 

I have learned that it is essential to cut this circle. 

It is a must to get out of this loop. Otherwise the loop can get stronger and stronger, more intense and more hurtful.

What I did was to forcefully break the circle. Meaning that when the same thought came up in my head, I did not permit myself to let it carry me down the same alley. I refused to give the thought attention, and found something else to think about.

In addition:

To get back up on my feet again, there are three actions that worked well for me, and which may work well for you as well.

Firstly, to speak to lots of people. About anything and everything. Including the pressing problems. This can get your mind somewhere else, and normally in a healthy place. So you get sanity at least for the duration of the conversation. And then you can also take that with you when you leave.

Secondly, to be appreciative of the good ‘things’ one still has in life. Because there are always some good things. You are alive, for starters.

And thirdly, to use logic instead of emotions. I found it helpful to look at the big picture, understand that the world wasn’t out to hurt me, that things would get better, etc.

Emotions can be hard to deal with sometimes, but logic can help get you back to being rational again.

Final Words On Mental Problems

If you do a few online searches about the causes of erectile dysfunction or libido problems, you will see many articles with the same answers: Age, cardiovascular problems, diabetes, low testosterone and stress. And a few other ‘physical’ causes.

And this is true.

However, erectile dysfunction and a tepid libido can also be caused by factors residing predominantly, or entirely, in the mind.

Enter psychological problems.

It is estimated that about 1 in 5 people struggle with psychological problems, at any given time.

Research also indicates that 10-20% of all ED cases have a psychological source.

However, the mind can be a tricky thing, and it is not necessarily easy to understand it. We are after all using the mind itself to try to understand the mind. 

It is also difficult to measure and diagnose ‘things’ happening in the mind. It’s not as simple as taking a blood test to measure your testosterone level. 

Therefore, it is often much more difficult to get to the bottom of the mental problems that may cause erectile dysfunction and libido issues. 

And many men who suffer from erectile dysfunction and libido problems as a result of a mental problem, will have no idea that a mental problem is the culprit.

But a key point we should not forget:

Although psychological problems can cause conditions such as erectile dysfunction and libido problems, this goes both ways. 

Because erectile dysfunction and libido problems can also cause stress, depression, anxiety, etc. In fact, it often does. 

So one side of the equation can influence the other, which again can influence the first, etc., which can lead to a vicious cycle of problems.

And lastly:

Although you have sex with your penis and your body, the pleasures experienced from sex are experienced in your brain. 

In fact, the most important organ for functioning sexually is your brain.

Research Studies

Althof SE, Leiblum SR, Chevret-Measson M, Hartmann U, Levine SB, McCabe M, Plaut M, Rodrigues O, Wylie K. Psychological and Interpersonal Dimensions of Sexual Function and Dysfunction. J Sex Med. 2005 Nov; 2(6):793-800.

Barlow, DH. Causes of sexual dysfunction: The role of anxiety and cognitive interference. Journal of Consulting and Clinical Psychology, Vol 54(2), Apr 1986, 140-148.

Cera N, Di Pierro ED, Ferretti A, Tartaro A, Romani GL, Perrucci MG. Brain networks during free viewing of complex erotic movie: new insights on psychogenic erectile dysfunction. PLoS One. 2014 Aug 15; 9(8):e105336. DOI: 10.1371/journal.pone.0105336.

Chou PS, Chou WP, Chen MC, Lai CL, Wen YC, Yeh KC, Chang WP, Chou YH. Newly diagnosed erectile dysfunction and risk of depression: a population-based 5-year follow-up study in Taiwan. J Sex Med. 2015 Mar; 12(3):804-12. DOI: 10.1111/jsm.12792.

Derogatis LR, Meyer JK. A psychological profile of the sexual dysfunctions. Archives of Sexual Behavior. May 1979, Volume 8, Issue 3, pp 201-223.

Dunn KM, Croft PR, Hackett GI. Association of sexual problems with social, psychological, and physical problems in men and women: a cross sectional population survey. J Epidemiol Community Health 1999; 53:144-148 DOI:10.1136.

Fadzil MA, Sidi H, Ismail Z, Hassan MR, Thuzar K, Midin M, Nik Jaafar NR, Das S. Socio-demographic and psychosocial correlates of erectile dysfunction among hypertensive patients. Compr Psychiatry. 2014 Jan; 55 Suppl 1:S23-8. DOI: 10.1016/j.comppsych.2012.12.024.

Forbes MK, Schniering CA. Are sexual problems a form of internalizing psychopathology? A structural equation modeling analysis. Arch Sex Behav. 2013 Jan; 42(1):23-34. DOI: 10.1007/s10508-012-9948-0.

Gralla O, Knoll N, Fenske S, Spivak I, Hoffmann M, Rönnebeck C, Lenk S, Hoschke B, May M. Worry, desire, and sexual satisfaction and their association with severity of ED and age. J Sex Med. 2008 Nov; 5(11):2646-55. DOI: 10.1111/j.1743-6109.2008.00842.

Hale VE, Strassberg DS. The role of anxiety on sexual arousal. Arch Sex Behav. 1990 Dec; 19(6):569-81.

Hartmann U. Erectile dysfunction: psychological causes, diagnosis and therapy. Ther Umsch. 1998 Jun; 55(6):352-6.

Hedon, F. Anxiety and erectile dysfunction: a global approach to ED enhances results and quality of life. Int J Impot Res. 2003 Apr; 15 Suppl 2:S16-9.

Huang SS, Lin CH, Chan CH, Loh el-W, Lan TH. Newly diagnosed major depressive disorder and the risk of erectile dysfunction: a population-based cohort study in Taiwan. Psychiatry Res. 2013 Dec 15; 210(2):601-6. DOI: 10.1016/j.psychres.2013.06.012.

Kalaitzidou I, Venetikou MS, Konstadinidis K, Artemiadis AK, Chrousos G, Darviri C. Stress management and erectile dysfunction: a pilot comparative study. Andrologia. 2014 Aug; 46(6):698-702. DOI: 10.1111/and.12129.

Latini DM, Penson DF, Colwell HH, Lubeck DP, Mehta SS, Henning JM, Lue TF. Psychological impact of erectile dysfunction: validation of a new health related quality of life measure for patients with erectile dysfunction. J Urol. 2002 Nov; 168(5):2086-91.

Latini DM, Penson DF, Wallace KL, Lubeck DP, Lue TF. Clinical and psychosocial characteristics of men with erectile dysfunction: baseline data from ExCEED. J Sex Med. 2006 Nov; 3(6):1059-67.

Laurent SM, Simons AD. Sexual dysfunction in depression and anxiety: conceptualizing sexual dysfunction as part of an internalizing dimension. Clin Psychol Rev. 2009 Nov; 29(7):573-85. DOI: 10.1016/j.cpr.2009.06.007.

Ludwig W, Phillips M. Organic causes of erectile dysfunction in men under 40. Urol Int. 2014; 92(1):1-6. DOI: 10.1159/000354931.

McCabe M, Althof SE, Assalian P, Chevret-Measson M, Leiblum SR, Simonelli C, Wylie K. Psychological and interpersonal dimensions of sexual function and dysfunction. J Sex Med. 2010 Jan; 7(1 Pt 2):327-36. DOI: 10.1111/j.1743-6109.2009.01618.

McCabe MP, Althof SE. A systematic review of the psychosocial outcomes associated with erectile dysfunction: does the impact of erectile dysfunction extend beyond a man’s inability to have sex? J Sex Med. 2014 Feb; 11(2):347-63. DOI: 10.1111/jsm.12374.

Melnik T, Abdo CH, de Moraes JF, Riera R. Satisfaction with the treatment, confidence and ‘naturalness’ in engaging in sexual activity in men with psychogenic erectile dysfunction: preliminary results of a randomized controlled trial of three therapeutic approaches. BJU Int. 2012 Apr; 109(8):1213-9. DOI: 10.1111/j.1464-410X.2011.10516.

Mourikis I, Antoniou M, Matsouka E, Vousoura E, Tzavara C, Ekizoglou C, Papadimitriou GN, Vaidakis N, Zervas IM. Anxiety and depression among Greek men with primary erectile dysfunction and premature ejaculation. Ann Gen Psychiatry. 2015 Oct 29; 14:34. DOI: 10.1186/s12991-015-0074-y.

Quek KF, Sallam AA, Ng CH, Chua CB. Prevalence of sexual problems and its association with social, psychological and physical factors among men in a Malaysian population: a cross-sectional study. J Sex Med. 2008 Jan; 5(1):70-6.

Rajiah K, Veettil SK, Kumar S, Mathew EM. Psychological impotence: Psychological erectile dysfunction and erectile dysfunction causes, diagnostic methods and management options. Scientific research and essays. 03/2012; 7:446-452. DOI: 10.5897/SRE11.1065.

Rosen RC. Psychogenic erectile dysfunction. Classification and management. Urol Clin North Am. 2001 May; 28(2):269-78.

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