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Enjoy sex like you used to
The stress caused by erectile dysfunction (ED) often leaves men contemplating a chicken-or-the-egg question: Can erectile dysfunction cause stress, or can stress cause erectile dysfunction?
The connection between poor erectile function and poor stress management is a lot deeper than most guys suspect. Stress is among the leading causes of erectile dysfunction, along with high blood pressure and other cardiovascular health problems.
But stress can have more than one effect on your ability to get or maintain an erection.
Does stress cause erectile dysfunction? Below, we’ll explain the relationship between ED and stress, how it can affect bedroom performance, and what treatment options you should consider for stress and ED management.
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Stress can trigger sexual dysfunction or exacerbate erectile dysfunction risk factors. Over time, chronic stress might cause a lack of sleep, high blood pressure, emotional fatigue or overall poor physical health, all of which can make maintaining an erection difficult.
There’s plenty of information out there showing how stress can ruin your health. On top of contributing to things like blood pressure issues or cardiovascular diseases, stress can affect you in the bedroom.
Research has shown that common life stressors can cause anxiety and lead to ED. Unfortunately, this can create a vicious sex-stress cycle. You’re stressed, which leads to ED, then your ED makes you self-conscious, and it leads to more stress.
Hence, the “chicken-or-the-egg” analogy.
A study from 2015 looked at 64 men struggling with ED or premature ejaculation (PE). It found a significant connection between ED and anxiety or depression.
For a majority of participants, the anxiety or depressive disorders started before the sexual dysfunction. In other words, mental health issues — including stress-related conditions — can lead to erectile dysfunction.
Stress can affect sexual function in three ways:
Erectile dysfunction
Performance anxiety
Reduced libido or sex drive
How it does this speaks to exactly how serious a health risk chronic stress can be.
So, how does stress cause erectile dysfunction? Let’s start from the bottom.
Erectile dysfunction is a condition in which a man can’t get or maintain an erection during sexual stimulation. The causes can be physical, mental or both.
Many physical conditions can cause ED: cardiovascular issues, heart disease, blood pressure issues, diabetes, and obesity. Psychological causes — anxiety, depression and chronic stress among them — can also lead to ED symptoms.
Stress can interfere with your mental state as well as with the signals that your brain sends to increase blood flow to your penis.
See our blog to learn how to increase blood flow to your penis.
Even if the blood flows fine throughout your body, life can get in the way of erections, making it really hard to get excited — sexually or otherwise.
Some types of stress that have specifically been linked to ED include work or financial stress, relationship stress, anxiety and performance nerves. Here’s what to know.
Money and career woes are two very common stressors in life.
In fact, according to a study by the American Psychological Association from 2020, 63 percent of people say they’re stressed about the economy. In the same survey, 64 percent reported work as a big source of stress.
Research published in 2020 also found that a job loss or concerns over losing a job can affect sexual desire, potentially resulting in ED.
Frustrations in intimate relationships can lead to erectile dysfunction.
If stress in your relationship is affecting your sexual function (and thus, your level of intimacy with your partner), that lack of intimacy can eventually lead to more stress.
Another “chicken-or-the-egg” conundrum. See the pattern?
Up to 37 percent of men with ED also have an anxiety disorder.
Some experts think anxiety can affect the sympathetic nervous system, which plays a crucial role in getting an erection. Because of this, those with anxiety disorders may find themselves navigating ED as well.
Another study found that men with post-traumatic stress disorder (PTSD) are more likely to experience ED too.
Another type of stress that can lead to ED? Worrying you won’t be good enough in bed. This stress is often called sexual performance anxiety.
Research has found that performance anxiety is closely connected to sexual dysfunction in men.
Performance anxiety can result in different types of sexual dysfunctions — including ED. For instance, you may worry about getting hard, finishing early or your skills in bed. All of this can make it tough to get an erection.
Watching porn can also lead to performance anxiety, which could then result in ED. If you’re comparing yourself to a porn star, you may feel insecure and could have a tough time getting hard.
Our blog goes into more detail about porn-induced ED.
A whole host of things can cause stress. Common culprits include:
Work pressure, such as deadlines or a demanding boss
Losing a job
Financial problems
The demands of parenting
Legal issues
Divorce or a breakup
Loss of a loved one
Social confrontation
Busyness and burnout
Even good change can lead to stress. So don’t discount positive life transitions, like getting married, moving into a new home you like better than your last one or starting a job you’re really excited about.
Some stress is normal and to be expected. But when is it too much?
Severe, chronic stress could result in a loss of focus, mood swings, sleep issues, fatigue, overeating or undereating, weight loss or gain or elevated blood pressure.
In some cases, the effects of stress could contribute to erectile dysfunction.
Stress causing ED likely means the sources of stress in your life are getting to be too much. You’re wise to find healthy methods to reduce stress and manage its sources.
Luckily, there are a number of ways to approach a less stressful lifestyle.
There’s some proof that a good workout can help you battle stress.
A 2014 study looked at the effects of physical activity on 111 healthy men and women who did and didn’t report regular physical exercise.
The researchers found that those who exercised as infrequently as once a week had a lower heart rate at rest than non-exercisers. More importantly, people who didn’t exercise reported a steeper decline in mood than those who did.
How much exercise do you need? Your goal should be about 150 minutes of moderate-intensity aerobic activity a week (which comes out to about a half-hour five days a week). Or, you could opt for 75 minutes of high-intensity aerobic exercise (that would be just 15 minutes five days a week). You should also build strength training into your exercise routine.
You probably aren’t surprised to hear that meditation can lower stress. After all, that’s kind of the whole point of it.
A 2014 study found that just 20 minutes of mindful meditation can decrease stress and anxiety.
Not sure how to meditate? No problem. There are plenty of apps that contain easy-to-follow guided meditations.
Our guide to meditation for anxiety has tips for getting started.
Cognitive behavioral therapy (CBT) is a great option for treating both stress and ED. You can talk about things that stress you out, along with how erectile dysfunction impacts your life.
In CBT, you’ll focus on patterns (or triggers) that may cause you stress. Then, you and a mental health professional will come up with ways to change these stress-inducing behaviors and adopt healthy coping strategies.
If you think stress specific to sex is behind your ED, you could also try sex therapy.
In sex therapy, you might talk about your sexual history, past sexual health issues and mental obstacles you face during sexual activity.
Stress and erectile dysfunction are two issues that create combined problems — and sometimes make each other worse. Though managing stress may take time, treatment for erectile dysfunction can provide relatively quick results.
Does stress cause ED in your life? Consider the following:
Whether you’re dealing with stress from work, sexual performance anxiety or stress caused by mental health conditions like anxiety disorders, it can really hurt your sex life and erectile function.
If you’re experiencing physical symptoms of erectile dysfunction, you might try incorporating exercise and meditation into your daily routine.
Other healthy lifestyle habits that may help minimize stress and improve sexual function include eating a nutritious diet, maintaining a healthy weight, getting outside daily, limiting alcohol and quitting smoking.
Think about talking to a healthcare professional about trying erectile dysfunction medication. Options include PDE5 inhibitor drugs, like sildenafil (generic Viagra®), tadalafil (generic Cialis®) and avanafil (sold as Stendra®). Another option is our chewable ED hard mints.
If you’re interested in speaking to someone about sexual performance issues or ED and exploring medical treatments, schedule an online appointment with a healthcare provider.
You can also learn more about psychological ED and the different types of therapy in our blog.
Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!
This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.
Bachelor of Arts, Egyptian and Ancient Western Asian Archaeology - Brown University | College, 2011
Doctor of Medicine - Brown University | Warren Alpert Medical School, 2017
Master of Public Health - Columbia University | Mailman School of Public Health, 2018
Master of Liberal Arts, Journalism - Harvard University | Harvard Extension School, 2022
Master of Science, Healthcare Leadership - Cornell University | Weill Cornell Graduate School of Medical Sciences, 2024
Master of Business Administration - Cornell University | Samuel Curtis Johnson Graduate School of Management, 2024
Internship - NYU Grossman School of Medicine | Internal Medicine Residency—Community Health Track, 2019
New York, 2019
Certified in Public Health - National Board of Public Health Examiners, 2018
Medical Writer Certified - American Medical Writers Association, 2020
Editor in the Life Sciences - Board of Editors in the Life Sciences, 2020
Certified Personal Trainer - National Academy of Sports Medicine, 2022
Certified Nutrition Coach - National Academy of Sports Medicine, 2023
Board Certified Medical Affairs Specialist - Accreditation Council for Medical Affairs, 2023
Certificate of Advanced Education in Obesity Medicine - Obesity Medicine Association, 2025
Regulatory Affairs Certification - Regulatory Affairs Professionals Society, 2025
General Practice
Medical Expert Board Member - Eat This, Not That!, 2021–
Director Scientific & Medical Content - Stealth Biotech PBC, 2023–2024
Director, Medical Content & Education - Ro, 2021–2023
Associate Director, Medical Content & Education - Ro, 2020–2021
Senior Medical Writer - Ro, 2019–2020
Medical Editor/Writer - Sharecare, 2017–2020
Medical Student Producer - The Dr. Oz Show, 2015–2016
Research Affiliate - University Hospitals of Cleveland, 2013–2014
Title: Biomechanical evaluation of a novel suturing scheme for grafting load-bearing collagen scaffolds for rotator cuff repair
Published in: Clinical Biomechanics
Date: 2015
URL: https://www.clinbiomech.com/article/S0268-0033(15)00143-6/abstract
Title: Pelvic incidence and acetabular version in slipped capital femoral epiphysis
Published in: Journal of Pediatric Orthopaedics
Date: 2015
Title: Relationship between pelvic incidence and osteoarthritis of the hip
Published in: Bone & Joint Research
Date: 2016
URL: https://boneandjoint.org.uk/Article/10.1302/2046-3758.52.2000552
Title: Effects of PDGF-BB delivery from heparinized collagen sutures on the healing of lacerated chicken flexor tendon in vivo
Published in: Acta Biomaterialia
Date: 2017
URL: https://www.sciencedirect.com/science/article/pii/S1742706117305652
Dr. Bohl’s medical expertise is regularly featured in consumer health media:
Eat This, Not That!: Contributor and Medical Expert Board Member on nutrition and wellness topics
The Dr. Oz Show: Behind-the-scenes contributor to Emmy Award-winning health segments
Sharecare: Public-facing health writer, simplifying complex medical issues for millions of readers
Dr. Bohl developed a passion for medical content while working at The Dr. Oz Show. He realized that, through the media, he could bring important health information to the lives of many more people than he would be able to working in a doctor’s office.
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