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Psychological ED: is your brain shutting down your hard on?

Written by Mojo, reviewed by
Silva Neves, Psychosexual and Relationship Therapist

Two guys share a beer and talk about their experiences of ED.

What is psychological ED?

The most important sexual organ is the brain. It’s where all sex begins.

To get an erection, your mind and body need to work together. When both systems are ready and raring to go, sex comes naturally. 

However, loads of men have experiences where their brains can’t quite get there, even though their bodies are more than capable of getting an erection. 

This is known as psychological erectile dysfunction. It includes all the mental reasons you might not be able to get it up.

The signs: how to know if your erectile dysfunction is psychological

ED can be physical or psychological, and could happen because of a mix of causes related to both the body and mind.

However, it’s more likely you’re struggling with psychological erectile dysfunction if:

  • you have only had ED for a short time or can remember a time when you didn’t have ED
  • you can get erections during masturbation or in some situations but not others
  • You’ve seen your doctor about ED and confirmed your physical health is all in check

If these symptoms sound familiar, the good news is you’re not the only one.

Psychological ED can become a vicious cycle

Sometimes the experience of ED is enough to spark fears that it’ll keep on happening.

Worrying that an erection won’t arrive or that your performance won’t be good enough can stop your penis in its tracks. 

It all begins to feel like way too much pressure.

“No matter what triggered your erection issues, once you doubt your ability to get one you will be battling against psychological factors too.”

Amanda Barge, Psychosexual and Relationship Therapist

These feelings can be devastating, but these mental blocks are very common. And remember, you’re not alone.

More than a quarter of men under 40 have struggled with erection issues, with many dealing with psychological issues such as stress, according to an ED study.

What are the most common causes of psychological erectile dysfunction?

  • Stress and anxiety
  • It can come from anywhere; your job, money worries, relationship issues, or just having too much on. You might think your penis doesn’t have a stake in that big house move. Think again.

  • Depression
  • Our mental and physical health are tightly interlinked. Periods of depression can have a huge impact on sexual desire and confidence in the bedroom. 

    Depression can be both a physical and psychological cause of ED. Antidepressants can also play a role, but there are ways to help. 

    If you’re worried about how depression might be impacting you, your doctor is a great place to start.

  • Tiredness
  • The truth is, sometimes we’re just too tired for sex.

    Sleep is your body’s time to repair itself. It takes sleep pretty seriously and will often prioritise it above reproduction. 

    That’s why it might be difficult for the body to respond to your request to get hard right away. 

    If your erections are out of office late at night or early morning, maybe try having sex at a time when you’re feeling more refreshed.

  • Insecurities or low self-esteem
  • We all have hang ups. Sometimes that voice in our heads telling us we can’t, shouldn’t or aren’t experienced enough to have sex can get really loud.

  • Boredom or indifference
  • Sometimes you may just not be in the mood, and that’s okay.

    Lots of people go through periods where they find it hard to get turned on and come out the other side. 

    The best thing you can do is give yourself space. Don’t force it if you aren’t feeling it, because you probably won’t be present and could make it worse. 

    The trick is to give yourself the best chance of success so you don’t feed a negative cycle where false starts lead to uncertainty and lower confidence every time.   

    “You don’t need to be perfect to have sex, but you definitely want to be present. For me, it helps to treat it as a game. Sometimes it’s fun, sometimes it’s messy, sometimes I’m not going to stay hard right the way through, and that’s OK.”

    Ben Bidwell, Mindset and Performance Coach

  • An unhealthy relationship with porn
  • Porn is neither a good nor a bad thing. It’s just adult entertainment.

    However, porn isn’t a great sex education tool or example of what real sex is like. It can create unrealistic expectations for both you and your partner.    

    If you’re worried about porn, you’re not on your own.

    Signing up with Mojo will give you access to a porn course, which can help if you feel like your relationship with porn is taking a toll on your bedroom activities.

  • Lack of sex education
  • If you haven’t been given the right knowledge and tools to understand and navigate sex, how can you feel confident in the bedroom? 

    Sadly, quality sex ed has been neglected for too many of us for too long. But learning about our sexuality is a journey that should stretch way beyond school. 

    When you take your learning into your own hands, you empower yourself to create a richer sex life (one that’s tailored to you).

  • Relationship problems
  • Conflict, lack of trust and poor communication can all put the brakes on your erection.

  • Libido or loss of sex drive
  • Loss or lack of libido happens to loads of men and women at some point in their lives. 

    It can be a consequence of the other causes we’ve talked about here, or due to physical problems like a hormonal imbalance. 

    It’s important to remember there’s no such thing as a ‘normal’ sex drive. A lower libido is only considered a problem if it’s noticeably lower than what would be normal for you.

    How can you treat psychological erectile dysfunction?  

    If left unchecked, it’s easy to get into a vicious cycle with ED. 

    Fear and anxiety can often leave you wanting to avoid sex altogether, which can have a brutal impact on your mental health.  

    But this doesn’t need to be the case. 

    There’s lots of things you can try which are recommended by experts to help you move forward. 

    Psychological ED tools to try on your own:

    – Watch or listen to psychosexual therapy sessions and podcasts 

    You can feel instantly better hearing real men share their experiences, and get expert advice in our full disclosure video interviews and listen-in therapy sessions. 

    – Masturbation tutorials

     These types of tutorials can help you get back in tune with your senses.  

    – Meditations and breathing exercises

    These are designed to help get out of your head and into the moment and the sensations of sex.

    Talking therapies for psychological ED: 

    – Communication with your partner

    Talking to your other half is the foundation of a strong relationship and great sex. Vulnerability can be scary, but opening up about your fears and feelings can really help. We’ve heard lots of men share stories of partners being positive and supportive after they’ve opened up.

    Psychosexual Therapy

    This can help you learn more about how your mind works during sex and unpick how your outlook and experiences could be impacting your erections. 

    – Cognitive Behavioral Therapy (CBT)

    CBT can help you identify and ‘reframe’ unhelpful thoughts and beliefs to improve your mental health. This can be done by yourself or with a therapist. 

    Feel supported by a community:

    – The Mojo Community

    This online forum will allow you to connect anonymously online with other guys who have experienced ED.

    – Mojo Connect

    These live video calls (webcam optional!) give you a chance to chat to guys all over the world who are going through similar erection and sex struggles. You can share ED advice and support, and stay anonymous here too if you prefer. 

    “Talking about my anxieties and insecurities helped our sex go to the next level. Now, we can have sex at my pace. It feels like it’s catered to me.”

    – King, Mojo user

    Sign up to Mojo to access these types of tools today.

    It’s OK to go incognito

    One of the major blockers preventing men from getting help from a sex therapist is the shame and the discomfort in meeting a stranger to talk about such sensitive subjects. 

    With Mojo, you access expert help from the comfort of your own homes, without the daunting prospect of meeting a therapist one-on-one.

    In our performance anxiety course, Silva Neves talks about how to manage your natural stress response to prevent ED:

    “The stress response is so inconvenient in the bedroom because it draws blood to the muscles and away from the penis. 

    This happens because the old part of our brain that detects danger is preparing us to fight or run. In therapy, you can learn how to turn off the alarm and be more playful.”

    Silva Neves, Psychosexual and Relationship Therapist

    Does Viagra® help with psychological ED?

    Viagra® is the most recognisable brand name for the medicine, Sildenafil – one of several types of erection medication.  

    ED meds can be useful, but may not help all men overcome their mental issues and get an erection. 

    This is because for ED medication to work, you need to be naturally aroused, and it’s designed to overcome physical obstacles like poor blood flow.  

    Meds can also come with their drawbacks. They can have side effects, and can be expensive if that short term crutch becomes an ongoing way of managing a problem (that might not have needed pills in the first place).  

    On the upside, one of the positive things about psychological ED is that you can get your erections back up and running without relying on pills. 

    It might take more time and effort. But with help, you can bring back natural erections and become happier and healthier for the long term. 

    Before you go, here’s some 30-second advice for getting out of your head and back into the moment

    Dr Roberta Babb and Mojo co-founder Angus Barge chat by window.

    “What’s the purpose of sex? It’s really just about having fun and connecting to another person.

    There’s no exam at the end. You can’t pass or fail.

    So, when you start getting up in your head ask yourself: ‘Does this feel good enough and fun enough for me to give it a go?’

    Remember, you don’t have to be perfect when the purpose is simply to experience it and just be.”

    Dr Roberta Babb, Clinical Psychologist

    Are you feeling ready to hear more great advice from our experts, to help you improve the relationship between your mind and body during sex? If the answer is yes, you can check out our 7 day free trial here.


    Mojo aims to provide useful wellbeing resources to its users; however, you should not solely rely on opinions or advice available on the Website or given by the Community. Always seek advice from a qualified medical doctor or other healthcare professional before acting.