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Erectile dysfunction (impotence): what it is and what is its treatment

Erectile dysfunction (impotence): what it is and what is its treatment

April 2, 2024

Erectile dysfunction is one of the sexual problems that most worries men . It usually happens for different reasons, although execution anxiety is one of the psychological origins that can cause it and that turns this problem into a vicious circle from which it is difficult to leave.

Erectile dysfunction can cause consequences in different areas of the person's life: problems of self-esteem, relational difficulties, etc.

Erectile dysfunction, why does it occur?

Any alteration of the mechanisms that intervene in the erection can cause erectile dysfunction . From the outset, it is very important to know if there is any alteration at the organic level (as is the example of neurological or vascular problems).


Once discarded any affectation of organic origin, is when we can examine the problems of psychological origin, being the execution anxiety again the protagonist of this dysfunction.

Causes: anxiety for execution

Execution anxiety is a state of alert that appears as a response to the set of thoughts that connect with previous unsatisfactory results and augur a new failure.

The battery of messages related to "Will I make it?", "What if it goes wrong again?" Or "What could change this time?" , it leads the individual to a state of mind governed by over analysis; the demand and fear join forces to find a channel of expression.


Questioning one's own capacity coupled with enormous ignorance (what is causing the problem) generates a feeling of frustration that, again, feeds the thoughts related to the alert.

How can Psychotherapy help us?

From Psychotherapy work different areas that can trigger stress and anxiety in the life of the patient (life experiences, current work and family situation, relationship of couple, etc.), as well as more specific aspects related to execution anxiety.

The obligation to offer results, excessive altruism and self-observation are three key issues of execution anxiety. In order to improve the self-control capacity, the therapy focuses attention on the detection of automatic thoughts that trigger the alert state. In the line of the commented, this type of thoughts respond to:


  • The need to give a very consistent and lasting erectile response.
  • The control of the satisfaction of the couple more than their own and joint eroticism.
  • The continuous observation of the penis and its functioning.

Talking about these types of concerns offers the patient a channel of expression that will increase emotional self-awareness. This, added to the creation of alternative thoughts, will diminish the voice of self-demand and facilitate the work of self-empathy . Likewise, to build a discourse with all the elements that are left in the "backstage" of the problem (taboos), will facilitate the understanding and the approach within the couple.

Guidelines and tips to follow

An important point is to provide the patient with guidelines that reduce the level of nervousness and pressure in sexual experiences.

More concretely, One of the indications that is sometimes offered in sexual therapy is to "prohibit intercourse" throughout the first sexual encounters, thus achieving that the concerns previously mentioned (the results 10, the satisfaction of the couple and the physiological response itself) cease to be a source of anxiety.

There are many myths regarding the genitalization of sexual relationships or the belief that they are only complete if penetration and orgasm are achieved. It is true that the genitals are a very important part of the human body, but reducing sexuality to genitality is limiting the experience, especially if we consider that the totality of our organism is sexed. The skin is a sexual organ, and as such, must be taken into account in our intimate relationships.

Penetration is just one more practice within the multiple possibilities we have to satisfy ourselves . There can be very pleasant sexual relations without intercourse. This connection again with pleasure is another objective within Psychotherapy.

What happens if the person does not ask for help?

First of all it is important to differentiate between an isolated manifestation or an established problem.

When it comes to a dysfunction that is repeated over time, serious problems appear, such as the affectation of self-esteem, the avoidance of sexual relationships and conflicts at the couple level. With reference to this last point, the belief that "you are becoming more distant" and "you do not want me anymore", attributes the origin of the problem to erroneous causes and ends up becoming a reason for discussion and estrangement.

From couples therapy it is essential to work on communicating the fears and needs of each member, thus achieving an atmosphere of love and mutual attention ... A problem that was previously experienced from loneliness, now happens to live hand in hand.

And premature ejaculation, why is it produced?

Premature ejaculation is the most frequent sexual problem among the male population . This lack of control can be due to very diverse causes. In fact, the origin is inaccurate. What we do know is that it depends on psychological factors and, often, beliefs related to man and sexuality (cultural aspects).

Among the factors that contribute to the existence of this dysfunction are the predisposing factors (for example, the family history, the circumstances that accompanied the first sexual relations and the bad learning), the precipitants (among which the low sexual frequency, the plaintiff couple and execution anxiety), and maintainers (where the anxiety of execution, lack of psychosexual abilities and couple conflicts stand out again), without forgetting all those biological aspects that could exist in each case.

  • Related article: "Premature ejaculation and psychology"

Causes and Treatment of Erectile Dysfunction Video – Brigham and Women’s Hospital (April 2024).


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