Most cases of erectile dysfunction (ED) are ‘secondary.’ This means that erectile function was previously normal, but later became problematic. Usually, the cause(s) of a new and persistent problem are physical.
However, there are some men who may have never achieved an erection. This is called primary ED, and the cause is almost always psychological if there is no obvious anatomical deformity or physiological problem. Such psychological factors may be due to:
Many men who suffer from erectile dysfunction feel guilty about being unable to please their partner. If the problem persists, the guilt feeling becomes more than just a side effect – it can contribute to the ongoing cycle of ED as well.
Fear of intimacy:
In many cases, the fear of poor sexual performance becomes a self-fulfilling prophecy, wherein you become nervous about being able to satisfy your partner. Eventually that nervousness may lead to sexual dysfunction.
Depression is usually characterized by feelings of sadness, hopelessness, emptiness, fatigue, agitation and so on. As you can imagine, these symptoms can make it difficult to take pleasure in much of anything, talk less of sex.
Stress & anxiety:
Stress and anxiety can interrupt how your brain sends messages to the penis to allow extra blood flow
There are some cases where psychological factors cause or contribute to ED, with factors ranging from treatable mental illnesses to everyday emotional states that most people experience occasionally.
It is important to note that there can be a combination of both medical and psychosocial causes. For instance, if a man is obese, blood flow changes can affect his ability to maintain an erection, which is a physical cause. However, he may also have low self-esteem, which can impact erectile function and is a psychosocial cause.