28345 Beck Road , Suite 311, Wixom MI 48393

The Elephant in the Bedroom: Performance Anxiety & Psychological Erectile Dysfunction

Performance Anxiety Erectile Dysfunction Treatment Oakland County, MI

Erectile dysfunction (ED), frequently referred to as male impotence, is a common issue that faces as many as 18 million American men over the age of 20, according to a study conducted by Johns Hopkins Bloomberg School of Public Health and published in the American Journal of Medicine. It's also often considered a physical problem, with many factors—including heart disease, high blood pressure, high cholesterol levels, obesity and excessive alcohol consumption—tied to a constriction of blood flow to the penis which hampers your ability to achieve or maintain an erection.

Often overlooked, however, are the psychological factors which may be constraining on a man's ability to perform sexually. Stress and anxiety relating to one's performance in the bedroom can quickly turn physical, bringing about that which one fears: the inability to perform adequately. These instances, either related to anxiety regarding one's unsatisfactory sexual performance or related to other external stressors (poor job performance, relationship problems, family demands, etc.), are referred to as performance anxiety erectile dysfunction and anxiety impotence, respectively.

To schedule a consultation with a healthcare provider in Oakland County that specializes in performance anxiety ED and can address both the psychological and physical factors which may be causing your erectile dysfunction, call (248) 453-7229 or contact PSI Medical online.

How Do Psychological Factors Affect Sexual Performance?

A number of factors, both personal and interpersonal, may affect your ability to achieve an erection.


Psychological stress can quickly turn physical, as when you're stressed, various hormones change. Adequate levels of a key hormone called cortisol could be lifesaving in instances that require your body to enter into survival mode. However, when cortisol levels are too high despite the situation not calling for them, many negative consequences may follow, including a suppressed immune system, increased blood pressure and blood sugar, as well as low libido. As stress hormones constrict blood vessels, blood flow to the penis becomes constricted, while testosterone levels plummet, leading to problems achieving or maintaining an erection adequate enough for intercourse.

Performance Anxiety

Anxiety, considered a mental health disorder characterized by persistent feelings of apprehension and fear which are strong enough to interfere with one's daily activities, may trigger an increased heart rate, blood pressure issues and fatigue, all of which can affect sexual performance.

A specific kind of anxiety from which erectile dysfunction may derive is called performance anxiety—the fear and anxiety relating to one's ability to perform adequately in the bedroom. Research suggests this anxiety only worsens with external factors like pornography which presents unrealistic sexual situations to which real-life sexual encounters seldom compare. Similar to performance anxiety experienced by athletes who worry about their ability to perform in their sport and compete at a high level, sexual performance anxiety derives from a number of different fears relating to sexual ability, which may include:

  • Fear that you won’t be able to perform well in bed and satisfy your partner sexually
  • Poor body image which may relate to concern over your weight
  • Fear relating to the size of your penis
  • Fear of premature ejaculation or taking too long to reach an orgasm

Relationship Problems

A turbulent emotional relationship with your partner can affect your sexual relationship when arguments, poor communication and feelings of anger and resentment toward your partner trigger your lack of sexual desire toward that person, and constrain sexual function.


Clinical depression, caused by a chemical imbalance in the brain, triggers persistent sadness, feelings of hopelessness and a pessimistic outlook, all which can become overwhelming and interfere with both sexual desire and sexual function. Men with depression often experience low self-esteem, which may relate to their sexual ability, as well as loss of sexual desire, fatigue, changes in appetite, sleep disturbances and general apathy.

Erectile Dysfunction Treatment

The silver lining to your stress-related erectile dysfunction is, treating or effectively managing the underlying stressor causing your erectile dysfunction is often very achievable, and sexual function is often returned to men who address these stressors. It is important, however, to meet with a qualified healthcare provider who can best assess your health state and determine the best course of treatment which addresses the underlying cause of your erectile dysfunction.

Psychological erectile dysfunction treatments may include:

  • Antidepressants
  • Talk therapy, which could include:

    • Couples counseling
    • Group therapy
    • Individual counseling
  • Stress-relief techniques, such as:

    • Relaxation exercises
    • Deep breathing
    • Mindfulness

Your treatment course elected by your healthcare provider will depend upon the underlying cause of your erectile dysfunction. It is important to consult a healthcare provider's advice as certain antidepressants might actually worsen your erectile dysfunction symptoms and only your healthcare provider can recommend treatment that takes into account your unique health needs.

Extracorporeal Shock Wave Therapy for Erectile Dysfunction

When psychological factors turn physical, causing damage to your erectile function, more drastic treatment courses may be necessary. But that doesn't necessarily mean invasive surgeries with risk of complications are necessary. A new procedure for treating erectile dysfunction called extracorporeal shock wave therapy (ESWT) utilizes pulsating acoustic sound waves, targeting areas of the penis to improve blood flow and to naturally enhance your penis. Consult an erectil dysfunction specialist who can discuss the procedure with you and determine whether you are a good candidate.

Schedule a consultation with a healthcare provider in Oakland County that specializes in stress ED treatment and shock wave therapy. Call (248) 453-7229 or contact PSI Medical online.


Aline Wéry, J. Billieux. "Online Sexual Activities: An Exploratory Study of Problematic and Non-Problematic Usage Patterns in a Sample of Men." Computers in Human Behavior. Accessed March 27, 2017. http://dx.doi.org/10.1016/j.chb.2015.11.046.

E Selvin, AL Burnett, and EA Paltz. "Prevalence and Risk Factors for Erectile Dysfunction in the US." American Journal of Medicine. Accessed March 27, 2017. https://www.ncbi.nlm.nih.gov/pubmed/17275456.

Map Icon
Hours and Directions
PSI Medical


28345 Beck Road
Suite 311
Wixom, MI 48393
(248) 453-7229

Areas We Service:

Oakland County, MI, Washtenaw County, MI, Wayne County, MI, Bloomfield Township, MI, Brighton, MI, Howell, MI, Bloomfield Hills, MI, Farmington, MI, Highland, MI, Milford, MI, New Hudson, MI, Novi, MI, South Lyon, MI, Walled Lake, MI, West Bloomfield, MI, Ann Arbor, MI, Salem, MI, Canton, MI, Detroit, MI, Northville, MI, Plymouth, MI, Commerce, MI, Farmington Hills, MI, Milford Twp, MI, Northville Township, MI