Stress, Erectile Dysfunction¬†and Libido
Many people’s daily life is filled with stress. Can stress cause¬†erectile dysfunction¬†and a weak¬†libido? If so, why and how does stress do this? What’s the point of experiencing stress in the first place? Read on and I will answer these questions. I will also tell you about my experiences with stress and how it impacted my sexual functions and¬†libido? ¬†
Stress Can Cause¬†Erectile Dysfunction¬†And¬†Libido¬†Problems
When a man stresses, his body and mind are put on high alert ‚Äď fully focused for a situation requiring special attention. Often this will be a situation that is potentially dangerous or having a potentially negative outcome ‚Äď a situation triggering what is often referred to as a ‚Äėfight or flight‚Äô response.
One such situation could be being chased by a big and hungry animal. Another could be being told by the boss that the report is not good enough and that you need to re-do it and have it on his desk in perfect condition by tomorrow morning.
Both of these situations would normally be highly stressful, would make a person highly focused on this particular situation, would give the person a burst of energy and alertness, and would temporarily make this person shut out other thoughts. In these situations, the emotions we normally experience are fear or anxiety.
When a stressful situation happens, the body reacts by releasing hormones (often referred to as stress hormones) into the bloodstream. Stress hormones act by mobilizing energy from storage, increasing heart rate, blood pressure and breathing rate and shutting down metabolic processes such as digestion, reproduction, growth and immunity.
In other words, stress hormones shut down areas of the body that are not necessary for dealing with the current threat, and mobilize stored energy to produce a boost of energy to vital functions such as large muscle groups important for escaping, vision, hearing, etc., to handle the current threat. This is relevant for libido and erectile dysfunction, because during stress, the body directs bloodflow and attention away from the penis and reproductive function as these are not useful for ‘survival’.
There are three principal stress hormones. These are largely responsible for the reactions and responses to stress:
Adrenaline¬†and¬†norepinephrine¬†are together largely responsible for the instant boosts in alertness, focus and energy a person experiences when stress kicks in. If, for instance, someone close by shouts out very loudly, your brain (the¬†hypothalamus) causes the immediate rush of¬†adrenaline¬†and¬†norepinephrine¬†into your bloodstream that puts your systems on high alert.
These two chemicals, which are both¬†hormones¬†and¬†neurotransmitters, work together to fully focus the body for the current threat. A person is then suddenly more aware, focused, alert, responsive, gets a boost in strength, endurance and energy levels. The release of these¬†hormones¬†will normally signal the heart to pump faster to increase bloodflow, open airways in the lungs, expand arteries of essential muscles and constrict arteries of non-essential muscles, release¬†glucose¬†from storage, dilate the pupils, increase sweating, reduce digestive activity, shut off the immune system and¬†shut off¬†the reproductive system, etc.
The effects of¬†adrenaline¬†and¬†norepinephrine¬†are immediate and only lasts for a few seconds. During stress, it is not uncommon to have 50 times more of these chemicals in the blood than during rest.
After¬†adrenaline¬†and¬†norepinephrine¬†have given the body an immediate boost and hopefully have enabled the body to cope with the current threat or danger, the¬†hormone¬†cortisol¬†kicks in.¬†Cortisol¬†is slower to impact the body than¬†adrenaline¬†and¬†norepinephrine, but it is also longer lasting.¬†Cortisol¬†helps the body sustain a high level of alertness and energy for a long period ‚Äď it is designed to produce this energy boost until the threat has been avoided or overcome.
What¬†cortisol¬†does is to mobilize energy, primarily in the form of¬†glucose.¬†Cortisol¬†stimulates something called¬†gluconeogenesis, or the production of¬†glucose.¬†Cortisol¬†also breaks down proteins and¬†fatty acids¬†to create this¬†glucose.
As¬†cortisol¬†works hard to produce energy, it also continues the process of diverting resources from non-essential areas to essential areas. This means that heart rate and blood pressure will normally continue to be elevated, the¬†immune system¬†will be typically be neglected, as will normally also anything related to sexual functions.
Although the body needs some levels of¬†adrenaline,¬†norepinephrine¬†and¬†cortisol¬†for normal body functions, elevated levels of these¬†hormones¬†over time will normally have a particularly negative effect on sexual function. Two of these are¬†erectile dysfunction¬†and reduced¬†libido. In fact, persistent stress can be one of the¬†worst¬†enemies of both a man‚Äôs desire for sex and also his ability to function sexually.
Stress is not a bad thing. It is in fact very useful, and as most other sensations we experience, it serves a very important purpose. Stress helps us survive and it enables us to avoid danger and harm. It is therefore very important for staying alive. Throughout evolution, individuals that did not experience stress, or experienced low degrees of stress, probably had a lower rate of survival. This is because they would probably be less likely to escape dangerous situations. Therefore, there has probably been a selection for people who experience this stress.
During periods when I have experienced frequent or constant stress over time, my libido has been significantly reduced and sometimes almost non-existent. In addition, my ability to function sexually has been rock bottom. In these periods, I have typically had a mind pre-occupied with negative thoughts, I have not been happy and most of my mental energy has gone towards thinking about how to solve the stressful situation.
I once worked for a small and entrepreneurial company. We were about 10 employees and shared a tiny office. We almost sat on top of each other and therefore had no privacy. Everyone overheard everyone else’s conversations. Some of the people working there were not my cup of tea and I found it difficult to deal with them. And I worked from about 08:30 in the morning until about 20:00 in the evening, so I pretty much spent all my awake time in the office.
After a few months of being there, I started to really dislike the situation. I woke up in the morning grumpy because I didn’t want to go to work and spend my whole day there. My days would be filled with negative emotions. I didn’t smile, I just ensured I got my work done so I could collect my paycheck. I felt I was wasting my time working with the wrong people and in the wrong environment. And at the same time I also sensed fear and guilt over potentially getting fired since I was not putting in as much effort as I could have.
This was not the sudden spurs of high levels of stress, but rather constant and persistent stress. It was also of a milder form, but it was there all the time. It would put me in a constant depressed mood, not only at work but outside of work as well as I would carry this stress with me almost wherever I went.
During this time, my desire for sex was almost non-existent. It wasn‚Äôt on my mind, I didn’t think about it, and even if tried to watch pornography, there would be no or only a small reaction. My penis was barely alive. When I was with a woman, even if it was a new partner, I would simply not be able to get and stay hard. I was just not in shape to perform sexually. For me, this was a period of severe erectile dysfunction
I have also gone through other periods of my life where I have had relationship issues, lost money, had work issues, health issues, or other personal problems that were very stressful and mentally exhausting. During these periods, I have had similar experiences regarding low libido and little success with performing sexually. For me, stress has been a big enemy to my sex life.
Today‚Äôs society is very different from what it used to be when these ‚Äėfight or flight‚Äô systems were developed. Today, many people are stuck in traffic for hours, travel on congested subways, have jobs that require them to spend the majority of their life at work, have work environments that are hostile, have difficulties making ends meet, have inadequate social relations, etc.
As a result, many people experience stress on a daily or even continuous basis, and therefore experience a constant production and release of adrenaline, norepinephrine and cortisol. These chemicals were¬†probably not designed for these situations of constant stress.
In fact, there are several reasons why elevated levels of these chemical are harmful. First of all, there is an inverse relationship between the levels of cortisol and the levels of testosterone in men, as cortisol is more or less an enemy to testosterone, and the two hormones compete to occupy the same space. This means that more of one is normally highly correlated with less of the other. Healthy levels of testosterone¬†are necessary for a man to have a healthy sex-drive and to function sexually.¬†To learn more about¬†testosterone¬†on Truelibido, please go¬†here.
Stress can also often cause a person to get inadequate amounts of sleep as well as having poor quality sleep. Reduced or inferior sleep is likely to result in inadequate testosterone production, because essentially all¬†testosterone¬†is manufactured at night when a person sleeps. That means that if a person gets less sleep than what is optimal, he will normally have lower than normal¬†testosterone¬†levels.
Chronically elevated levels of cortisol may also inhibit the effectiveness of insulin, and may cause what is called insulin resistance. The cells in the body need insulin in order to utilize glucose. Insulin¬†basically acts as a key that enables glucose¬†to enter the cells.¬†When the cells in the body are not able to use insulin as effectively as normal, too much glucose will be floating in the blood stream, a condition called hyperglycemia.
Hyperglycemia impairs optimal bloodflow and has also been shown to potentially cause endothelial dysfunction and reduced production of nitric oxide. Nitric oxide is an essential element needed for a man to get an erection.¬†Hyperglycemia also increases the risk of developing atherosclerosis, which in turn may cause erectile dysfunction via decreased bloodflow. To learn more about nitric oxide on Truelibido, please go here.
Separately, elevated levels of stress over a long period of time may also put additional strain on the heart and vital organs, and may eventually lead to high blood pressure, heart disease and may cause damage to the internal lining of the blood vessels called the endothelium. All of this is likely to impair bloodflow, and anything that restricts bloodflow may cause erectile dysfunction.
Norepinephrine, along with free calcium, is contributing to keeping the penis flaccid. Or put differently, an erection is associated with a decrease of free calcium and norepinephrine, which is in turn caused by an increase in nitric oxide. Therefore, elevated levels of norepinephrine is also likely to cause the penis to remain flaccid, or make it more difficult for a man to get and keep an erection.
Andersson K, Stief C. Penile erection and cardiac risk: pathophysiologic and pharmacologic mechanisms. Am J Cardiol. 2000 Jul 20; 86(2A):23F-26F.
Bancroft J, Janssen E, Strong D, Carnes L, Vukadinovic Z, Long JS. The relation between mood and sexuality in heterosexual men. Arch Sex Behav. 2003 Jun; 32(3):217-30.
Barlow DH. Causes of sexual dysfunction: The role of anxiety and cognitive interference. J Consult Clin Psychol. 1986; 54:140-8.
Cellek S, Cameron NE, Cotter MA, Muneer A. Pathophysiology of diabetic erectile dysfunction: potential contribution of vasa nervorum and advanced glycation endproducts. Int J Impot Res. 2013 Jan; 25(1):1-6. DOI: 10.1038/ijir.2012.30.
Chatterton RT, Vogelsong KM, Lu Y, Hudgens GA. Hormonal responses to psychological stress in men preparing for skydiving. J Clin Endocrinol Metab. 1997; 82:2503-9.
Cummings DC, Quigley ME, Yen SS. Acute suppression of circulating testosterone levels by cortisol in men. J Clin Endocrinol Metab. 1983; 57:671-3.
Daly W, Seegers C, Rubin DA, Dobridge JD, Hackney AC. Relationship between stress hormones and testosterone with prolonged endurance exercise. European Journal of Applied Physiology. 2005; 93, 375-380.
Daniel J, Mikulaj L, Vrazda L. Mental and endocrine factors in repeated stress in man. Studia Psychologica, Vol 15(3), 1973, 273-281.
Dickerson SS, Kemeny ME. Acute stressors and cortisol responses: a theoretical integration and synthesis of laboratory research. Psychol Bull. 2004 May; 130(3):355-91.
Exton NG, Truong TC, Exton MS, Wingenfeld SA, Leygraf N, Saller B, Hartmann U, Schedlowski M. Neuroendocrine response to film-induced sexual arousal in men and women. Psychoneuroendocrinology. 2000; 25:187-99.
Gruenewald TL, Kemeny ME, Aziz N. Subjective social status moderates cortisol responses to social threat. Brain Behav Immun. 2006 Jul; 20(4):410-9.
Hale VE, Strassberg DS. The role of anxiety on sexual arousal. Arch Sex Behav. 1990 Dec; 19(6):569-81.
Hedon, F. Anxiety and erectile dysfunction: a global approach to ED enhances results and quality of life. International Journal of Impotence Research (2003) 15, Suppl 2, S16‚ÄďS19. DOI:10.1038/sj.ijir.3900994.
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.
Kessler RC, Andrews G, Colpe L, Hiripi E, Mroczek DK, Normand SL, Walters EE, Zaslavsky AM. Short screening scales to monitor population prevalence and trends in nonspecific psychological distress. Psychol Med. 2002; 32:959-76.
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.
Lykins AD, Janssen E, Graham CA. The relationship between negative mood and sexuality in heterosexual college woman and men. J Sex Res. 2006 May; 43(2):136-43.
Meisler AW, Carey MP. Depressed affect and male sexual arousal. Arch Sex Behav. 1991 Dec; 20(6):541-54.
Morokoff PJ, Baum A, McKinnon WR, Gillilland R. Effects of chronic unemployment and acute psychological stress on sexual arousal in men. Health Psychol. 1987; 6(6):545-60.
Morokoff PJ, Gillilland R. Stress, sexual functioning, and marital satisfaction. Journal of Sex Research, Vol 30(1), Feb 1993, 43-53.
Opstad PK. Androgenic hormones during prolonged physical stress, sleep, and energy deficiency. Journal of Clinical Endocrinology and Metabolism. 2013; 74, 1176-1183.
Ranabir S, Reetu K. Stress and hormones. Indian J Endocrinol Metab. 2011 Jan-Mar; 15(1): 18-22.
Rizza RA, Mandarino LJ, Gerich JE. Cortisol-induced insulin resistance in man: impaired suppression of glucose production and stimulation of glucose utilization due to a postreceptor detect of insulin action. J Clin Endocrinol Metab. 1982 Jan; 54(1):131-8.
Rosner W. The function of corticosteroid-binding globulin and sex hormone -binding globulin: recent advances. Endocr Rev. 1990 Feb; 11(1):80-91.
Smith AD. Psychologic factors in the multidisciplinary evaluation and treatment of erectile dysfunction. Urol Clin North Am. 1988 Feb; 15(1):41-51.
Ter Kuile MM, Vigeveno D, Laan E. Preliminary evidence that acute and chronic daily psychological stress affect sexual arousal in sexually functional women. Behav Res Ther. 2007; 45:2078-89.
Welsh TH, Bambino TH, Hsueh AJ. Mechanism of glucocorticoid-induced suppression of testicular androgen biosynthesis in vitro. Biol Reprod. 1982 Dec; 27(5):1138-46.
Zitzmann M, Nieschlag E. Testosterone levels in healthy men in relation to behavioral and physical characteristics: facts and constructs. Eur J Endocrinol. 2001 Mar; 144(3):183-97.