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The Psychological Impact of Erectile Dysfunction On Relationships and Self-Esteem

  1. Introduction

    1. Definition of Erectile Dysfunction

      Erectile dysfunction, or in short known as ED is the inability to get or keep an erection firm while having sexual intercourse. This condition is sometimes also referred to as “impotence”.

      Erectile dysfunction can be occasional or frequent. The occasional ED is not rare and many individuals experience this when they have stress or due to a change in their lifestyle or nutritional change. However, frequent ED can be due to certain health issues that need treatments. Sometimes, it might also be a symptom of relationship difficulties.

    2. Prevalence of Erectile Dysfunction

      About 30 million men in the United States have Erectile dysfunction, and this has been mentioned by the National Institute of Diabetes and Digestive and Kidney Diseases.(1)

      The prevalence of Erectile dysfunction increases with age. It is estimated by researchers from The University of Wisconsin that mild to moderate Erectile dysfunction affects 10% more men in each decade of their lives.(3) For instance, 60% of men in their 60s could experience some of the conditions.

      However, younger people can also be affected by ED. Many men experience occasional failure to achieve an erection, and this could be due to various reasons like stress, relationship issues, smoking or drinking so much, or being extremely tired. In general, it can be said that the healthier you are, the better will be your sexual function.

    3. Purpose of the Article

      With this article, we would like to give you a deep insight into the psychological impacts of erectile dysfunction and also would suggest you some of the ways to address the issue in men being affected by the condition.

  2. The Psychological Impact of Erectile Dysfunction on Relationships

    1. Strained Relationships With Partners

      Based on the severity of a man’s symptoms, they might not be able to have satisfying sexual intercourse for long or as frequently as they once could. Some persons with ED might not be able to have sexual intercourse at all. This could psychologically impact their relationships.

      Sexual intimacy could be an important part of a long-term relationship or marriage. So, when a man suffers from erectile dysfunction it can cause anxiety, stress, or a feeling of loss for both partners in love.

      According to a study conducted in Iran, it has been shown that erectile dysfunction can make the affected males feel angry, depressed, less masculine, lacking in self-confidence, socially isolated, and desire to avoid their spouse or partners.(3)

      Erectile dysfunction not only affects the mental health of an affected man but also their partner’s mental health. As per a review in 2016, it has been mentioned that ED can make the affected person’s partner feel anxious, confused, suspicious, or undesirable.(4) These feelings together can put a lot of strain on a relationship.

      So, studies confirm that ED has a considerable psychological and social effect.(5, 6)

    2. Decreased Intimacy and Sexual Satisfaction

      One more psychological impact of ED on relationships is that due to the problem, there is reduced intimacy and sexual satisfaction between the partners and this creates many disturbances between them.

      A study has examined that there is an association of four important sexual problems in men (and they are erectile dysfunction, loss of sexual desire, absent orgasm, and premature ejaculation)and other multiple problems. There is also an association between physical intimacy, sexual satisfaction, and relationship happiness between male and female partners and the psychosocial and health problems in men. It was predicted that men with one or more sexual issues reported decreased relationship happiness and sexual satisfaction.(7)

    3. Increased Conflicts And Arguments

      When in a long-term relationship, men are affected by erectile dysfunction, there can be a serious effect on their sex life, and there are also chances of many unwanted conflicts and arguments between the male and the female partners. This, in turn, affects their relationships.

    4. Feelings of Shame And Embarrassment

      Common feelings among partners of men with erectile dysfunction (ED) are a complex mixture of shame, guilt, feeling unloved, rejection, and frustration. This feeling is also experienced by the affected male partners. Men feel rejected and shameful when they are unable to hold an erection for long and provide appropriate sexual satisfaction to their female partners.

      Someone has stated that many people have a certain sense of insecurity about their bodies, and when their partners have a sexual problem, they felt a sense of shame.(8)

  3. The Impact on Self-Esteem

    1. Decreased Confidence and Self-Worth

      In every man’s life, sexual activity is essential. However, when there is a reduced level of sexual function due to ED or any other sexual problem, it impacts their quality of life negatively. Men start feeling low, experience decreased confidence and self-worth.

      In a study that evaluated the relationship between ED and self-esteem, and symptoms of severity in 80 patients, it was found that the patients having mild cases of erectile dysfunction are not satisfied completely even with normal sexual frequency, which causes significantly low self-esteem among the affected men. Preventing erectile dysfunction will result in increased self-esteem and happy lives among men and their partners.(9)

    2. Negative Effects On Body Image And Masculinity

      Erectile dysfunction or feeling of impotence can impact men greatly, and this impact is more negative concerning their body image, masculinity, and self-esteem. Their sense of masculinity is harmed, with profound effects on their feeling of worth to their female partner.

    3. Fear of Judgment And Rejection From Partners

      One more impact of ED on a male’s life is they start fearing being judged and rejected by their female partners. In any intimate relationship, it is hard to feel rejected.

      Mostly the perceived inability of some males to pleasure their female partners are one of the major concerns, with some feeling that they were ‘letting their female partners down’, and this would lead their partners to reject or leave them.(10) This, unfortunately, become the reality for many.(11)

  4. Coping Strategies for Erectile Dysfunction

    1. Seeking Professional Help From A Doctor

      One of the most important and effective coping strategies to deal with erectile dysfunction is seeking professional or medical help from a doctor. Several treatments are available for the treatment of ED. However, the best option for treating the condition would depend on the factor that might be causing erectile dysfunction. It is always good for both partners to know about the various treatment options available to them.

      1. Noninvasive Treatments For Erectile Dysfunction (ED)

        Some noninvasive treatments available for ED include different oral medicines, such as Viagra, injectable medications like Alprostadil (Caverject), testosterone therapy for low levels of testosterone, suppositories that a person inserts into their urethra, pump devices that would draw blood into the penis and make it possible to temporarily maintain an erection.

      2. Invasive Treatments For Erectile Dysfunction (ED)

        Invasive treatment like penile implant surgery could be beneficial for patients with erectile dysfunction (ED). This type of surgery involves a surgeon placing implants into the affected person’s penis that would make it possible for their penis to be rigid while having sex. These devices include semirigid implants and inflatable implants.

        Inflatable implants allow the person to create an erection by pumping fluid into their penis. The patient undergoing surgery with inflatable implants can inflate or deflate the implants in their penis with the use of a pump, which would be inserted b the surgeon into the scrotum of the affected person. However, semirigid implants are quite firm all the time.

    2. Open and Honest Communication With Partners

      Communication is one of the most important things in everyone’s life. It is more important in the case of persons with erectile dysfunction (ED). Though it could be hard, having open communication with your female partners can help reduce the stress associated with erectile dysfunction.

      Having an honest conversation about the stress or other low feelings due to ED can clear up misunderstandings between both partners and help get rid of various unwater relationship problems.

      The University of California, Los Angeles (UCLA) has also suggested that partners should let people with erectile dysfunction (ED) know that their condition does not make them any less desirable or less masculine, sex is not as important as the health and well-being of the person, they can together work on the issue.(12)

    3. Incorporating Lifestyle Changes For Improved Sexual Health

      Some lifestyle changes that can help a person with ED for improved sexual health are mentioned below.(13)

      • Quit smoking, in case you are a smoker.
      • Limit or eliminate consuming alcohol
      • Maintain a moderate body weight
      • Increase physical exercise.

      Apart from all these, it is also important for the partners to support their male partners with ED and provide them with the best moral and emotional support.

    4. Addressing Psychological And Emotional Factors

      Another important coping strategy for people with ED and their partners is that they should address the emotional and psychological factors that could be affecting their lives and relationships. Erectile dysfunction causes emotional distress. Addressing this condition is highly essential.

      Individual counseling can be helpful where men can talk about their problems with ED. A psychologist or counselor can help them manage feelings of anxiety, stress, or low self-esteem. However, couples counseling could also be effective. Some studies have suggested that 50% to 70% of males who have stress-related erectile dysfunction, experienced improvement in their symptoms when their partners attended counseling sessions or therapy with them.(14) Couples counseling can also help partners learn more about ways to communicate with and support each other, and this could ultimately solve their problems.

  5. Conclusion

  1. Recap Of The Psychological Impact Of Erectile Dysfunction

    Erectile dysfunction can impact personal relationships and also an individual’s life in various ways. Affected men start feeling low, lose their self-esteem, and suffer from stress and anxiety, and this, in turn, can lead to various relationship problems. They start feeling rejected and shameful too for not being able to provide optimum sexual satisfaction to their partners. This also makes them lose their self-confidence, and doubt their masculinity, and body image.

  2. Importance Of Addressing The Issue

    It is essential to address the condition and help the patients and their female partners to communicate with each other, take help from counselors and medical professionals, and get rid of the problem and their relationship issues too.

  3. Call To Action For Individuals Affected By The Condition

    So, males suffering from erectile dysfunction (ED) and having difficulties dealing with the condition should communicate with their partners properly and their female partners should support them morally and also help them to undergo the appropriate treatment for ED. This would prevent their marriage or long-term relationships from breaking off and help the individuals lead a stress-free, generous, and respectable healthy life.


  1. https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/all-content
  2. https://www.uwhealth.org/conditions/erectile-dysfunction
  3. Ozgoli G, Ziaei S, Ahmadi F, Azar M (2014 Mar)’ Transition stages in adjustment of wives with their husbands’ erectile dysfunction’ Iranian Red Crescent Medical Journal. v. 16(3). e16594. doi: 10.5812/ircmj.16594 LINK: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4005452/
  4. Hongjun L, Gao T, Wang R. (2016 Feb) ’The role of sexual partner in managing erectile dysfunction.’ Nature reviews urology. v. 13(3). DOI:10.1038/nrurol.2015.315 LINK: https://www.researchgate.net/publication/292944012
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  7. Rosen R C, Heiman J R, Fisher W A, Sand M. (2016 Jan) ‘Men with sexual problems and their partners: Findings from the International survey of relationships.’ Archives of sexual behavior. V. 45(1). Pp. 159 to 73. DOI: 10.1007/s10508-015-0568-3 LINK: Men with Sexual Problems and Their Partners: Findings from the International Survey of Relationships – PubMed (nih.gov)
  8. Kale S. Erectile dysfunction or performance anxiety? The truth behind a modern malaise. The Guardian 18 October 2018 (www.theguardian.com/lifeandstyle/2018/oct/18/erectile-dysfunction-performance-anxiety-truth-modern-malaise; accessed 27 October 2021).
  9. Ozkent M S, Hamrat M B, Taskapu H H, Kilinc M. T, Goger Y E, Sonmez M G. (2012, Feb)’ Is erectile dysfunction related to self-esteem and depression? A prospective case-control study’ Andrologia. V. 53(1), e139190. DOI: 10.1111/and.13910 Is erectile dysfunction related to self-esteem and depression? A prospective case-control study – PubMed (nih.gov)
    Tomlinson J, Wright D. Impact of erectile dysfunction and its subsequent treatment with sildenafil: qualitative study. BMJ 2004; 328(7447): 1037. CASPubMedWeb of Science®Google Scholar
  10. Kale S. Erectile dysfunction or performance anxiety? The truth behind a modern malaise. The Guardian 18 October 2018 (www.theguardian.com/lifeandstyle/2018/oct/18/erectile-dysfunction-performance-anxiety-truth-modern-malaise; accessed 27 October 2021). Google Scholar
  11. Cancer & Erectile Dysfunction | UCLA Health
  12. National Institute of Diabetes and Digestive and Kidney Diseases. ‘Treatment for erectile dysfunction.’ Last reviewed. July 2017. https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/treatment
  13. Mobley D F, Khera M, Baum N. ‘Recent advances in the treatment of erectile dysfunction.’ Post Graduate Medical Journal, BMJ Journals. V 93. Issue 1105. https://pmj.bmj.com/content/93/1105/679

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Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:March 4, 2023

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