As the UK marks Mental Health Awareness Week, a new survey by LloydsPharmacy Online Doctor has revealed a significant gap in men’s understanding of erectile dysfunction (ED). Among 500 British men surveyed, 49% were unaware that mental health issues such as stress, anxiety, or depression can contribute to ED, with many attributing the condition solely to physical causes like low testosterone.

Emotional and psychological burden of erectile dysfunction

• Prevalence of ED. Half of respondents (50%) reported experiencing ED at least once in their lives.
• Performance anxiety. 55% said they sometimes feel stressed or anxious about sexual performance, while 15% said they often feel this way.
• Avoidance of sex. 60% said they avoid sexual activity due to performance anxiety.

Dr Bhavini Shah, a GP at LloydsPharmacy Online Doctor, highlighted the connection between mental health and ED. “Many young men may find it embarrassing or uncomfortable to discuss mental health issues. If ED is being caused by stress, anxiety or depression, they may be unknowingly avoiding the root cause,” she said.

ED, or impotence, is the difficulty in achieving or maintaining an erection. Though more common in men over 40, it can affect men of all ages. Its effects can be profound, leading to low self-esteem, embarrassment, and relationship strain. Notably, 49% of respondents incorrectly believed low testosterone to be the main cause, overlooking psychological contributors.

Dr Shah explained that ED can arise from both physical and psychological causes. “In most cases it is due to reduced blood flow to the penis. However, external factors including some lifestyle choices can also cause erectile problems,” she said. These include anxiety, depression, relationship issues, medication, poor diet, and lack of exercise. Among younger men, psychological factors tend to be more prominent, yet physical causes are often the focus.

Mental health and ED are closely linked in a cycle where stress, anxiety, or depression reduce sexual desire and make it harder to relax, thereby worsening ED. This can in turn intensify feelings of frustration and low self-esteem. “Chronic stress, anxiety, depression and other mental health conditions can make it harder to get and keep an erection,” said Dr Shah. “When we’re stressed or anxious, our body releases hormones that can affect the blood vessels responsible for erections.”

The findings highlight a need for better awareness. The 15% of men who often feel anxious about sexual performance and the 55% who occasionally do reflect how widespread the issue is. Dr Shah noted that stress and anxiety can also lead to unhealthy behaviours such as smoking or drinking, which further aggravate ED. She recommends managing stress through relaxation techniques or speaking to a trusted person, alongside seeking professional help when needed.

For those with ongoing ED, Dr Shah advises seeing a GP. “If you keep experiencing erectile dysfunction or it is affecting other aspects of your life such as your mental wellbeing or sex life, you should book an appointment to discuss it with your GP,” she said. A GP can provide guidance, run tests, and explain treatment options.

Prescription medications such as Viagra (sildenafil), Tadalafil, Vardenafil, and Levitra are commonly used to treat ED by temporarily improving blood flow to the penis. However, Dr Shah cautioned that focusing solely on physical treatments without addressing mental health factors may only delay proper recovery.