Erectile Dysfunction and OCD: Is There a Connection?

Men of all ages can experience sexual dysfunction, although researchers suggest that young men are beginning to experience a lot more. Sexual issues like erectile dysfunction can wreak havoc on your self-confidence, and cause performance anxiety in the bed, leading to problems in your romantic relationship.

Ultimately, sexual dysfunction can lead to an unsatisfactory sex life for you and your partner. There are several reasons why a man may start to have sexual issues. Most people assume that sexual dysfunction, like erectile dysfunction, stems from an injury or health condition, such as penal trauma, obesity, high blood pressure, diabetes, neurological conditions, medication side-effects, high cholesterol, neurological conditions, heart disease, penal diseases, and/or metabolic diseases.

But can it also be caused by psychological issues like stress, depression, or anxiety? Moreover, is there a connection between erectile dysfunction and OCD? In this article, we will learn more about erectile dysfunction, obsessive-compulsive disorder (OCD), and if and how these two conditions are connected.

What is OCD?

Obsessive-compulsive disorder (OCD) is a common anxiety disorder that involves unwanted, involuntary, intrusive, and repetitive thoughts, urges, fears, doubts, emotions, visions (obsessions), and/or rituals or routines (compulsions). OCD is a real condition, although it is often mocked, misdiagnosed, or misunderstood. In fact, people with OCD tend to be made the “butts of jokes” in sitcoms and movies, but the truth is, this condition is no laughing matter.

It is a serious, life-altering mental health condition that can take over your life and cause a variety of health problems if left untreated. OCD is linked to stress and anxiety – as a trigger and symptoms of the condition. There are a variety of different types of OCD with each one causing stress and anxiety. The types of OCD range from relationship OCD and contamination OCD to meta OCD and reading OCD. 

All forms of OCD involve cyclic behaviors, such as stress=anxiety=obsessions=compulsions. The good news is there are a variety of psychological and pharmaceutical treatments, self-help tools, and natural remedies, such as cognitive-behavioral therapy (CBT) and exposure-response and prevention (ERP) therapy, SSRI antidepressants, CBD, homeotherapy, hypnosis, art therapy, probiotics, crystal therapy, and mindfulness meditation, and Impulse Therapy, an online OCD recovery treatment program designed to treat OCD.

What is Erectile Dysfunction?

Approximately 18 million men in the US, age 20+, struggle with erectile dysfunction (ED). However, some researchers suggest this number is closer to 30 million men. The discrepancy is likely due to under-reporting. Erectile dysfunction (ED), also referred to as impotence, occurs when a man is unable to obtain and maintain an erectile (firm enough) long enough to complete a sexual act. 

The most common symptoms of ED include an inability to obtain an erection, an inability to maintain an erection long enough to have sex, and a low libido or sex drive. Understand that occasionally experiencing a “soft or limp erection” is not usually a cause for concern. However, if this problem persists or worsens, it can lead to a cycle of stress, performance anxiety, and ED. Additionally, persistent erection issues can lead to low self-confidence, infertility, and relationship problems. 

Even more important, problems obtaining and maintaining an erection could signal an underlying mental or physical health condition that requires treatment, such as high blood pressure, anxiety, depression, etc. While researchers suggest that as a man ages, his risk of experiencing ED increases, ED is not always linked to age. In other words, even teenage boys and young men can experience ED. The good news is that your doctor or a urologist can usually pinpoint the cause of your ED, and prescribe treatment for it, so it is no longer a factor in your life. 

Talking to a doctor about your erection issue may feel embarrassing, however, it is necessary to get the treatment you need for it. Often, the remedy involves treating an underlying condition, such as stress, anxiety, obesity, high blood pressure, etc. Sometimes, that is enough to reverse erectile dysfunction and restore your self-confidence and sex life. Other times, psychotherapy and/or medications may be needed to help you get back on track in the bedroom.

What Causes Erectile Dysfunction?

According to researchers, male sexual arousal is a complicated process that involves a wide range of bodily functions, such as emotions, the brain, hormones, blood vessels, nerves, and muscles. A disruption in or problem with any of these bodily functions can lead to ED. Similarly, stress and mental health conditions, like anxiety or depression, can worsen ED. In fact, researchers suggest that many times ED stems from a combination of psychological and physical issues, such as high blood pressure and anxiety. 

For example, a physical condition, such as heart disease, that can delay your sexual response could trigger performance anxiety (fear that you will be unable to complete a sexual act and satisfy your partner due to a physical or psychological issue), which in turn, could lead to or worsen ED. 

The causes of ED can be physical, psychological, or both. Treatment depends on the cause of the ED. Psychological (stress, anxiety, depression, etc.), emotional, and environmental factors are usually treatable and “curable,” while physical factors may involve medication, surgeries, or procedures to treat or “cure” the condition.

Physical Causes 

For most men, erectile dysfunction is caused by physical factors, such as:

• Heart Disease
• Atherosclerosis (Clogged or Blocked Blood Vessels) 
• High Cholesterol
• Hypertension (High Blood Pressure)
• Diabetes
• Obesity
• Metabolic Syndrome (High Blood Pressure, High Insulin Levels, High Cholesterol, and Waist-Centered Body Fat) 
• Parkinson’s Disease
• Multiple Sclerosis
• Prescription Medication Side-Effects (i.e., SSRI Antidepressants)
• Tobacco Use
• Peyronie’s Disease (Scar Tissue Inside of Your Penis)
• Alcoholism and Substance Abuse
• Sleep Disorders (i.e., Insomnia)
• Prostate Cancer Treatments 
• Enlarged Prostate Treatments
• Pelvic or Spinal Cord Injuries or Surgeries
• Low Testosterone

Psychological and Emotional Causes 

Understand that your brain plays a pivotal role in the “triggering” of the psychological and emotional processes involved in obtaining and maintaining an erection. This process typically begins with sexual arousal (sexual excitement). A disruption in any of these psychological or physical processes can delay or prevent sexual arousal and trigger or worsen ED. 

These processes include:

• Depression or Mood Disorders (i.e., Bipolar Disorder)
• Anxiety or Anxiety Disorders (i.e., Performance Anxiety)
• Other Mental Health Conditions
• Stress
• Sadness
• Feelings of Hopelessness and Helplessness
• Relationship Problems (i.e., Stress, Poor Communication, Betrayal, etc.)

What Are Some Risk Factors Associated with Erectile Dysfunction?

It is true that as you age, erections can take longer to obtain and may not be as firm as when you were younger. You may also need more stimulation (direct touch) to your penis to get those “juices flowing” to become and stay firm during sexual activity.

Certain factors can contribute to ED, such as:

• Medical Conditions

  Medical conditions, like diabetes, high blood pressure, and heart conditions, can elevate your risk of experiencing ED. 

• Nicotine and Tobacco Use

  Nicotine and tobacco can restrict blood flow to the veins and arteries in your penis, which, over time, can lead to chronic health conditions. These chronic health conditions could, in turn, trigger ED.

• Obesity

  Obesity or being overweight can predispose you to ED (due to the extra pressure placed on your genitals and lower limbs).

• Medical Procedures

  Medical procedures, like prostate surgery or cancer radiation treatments, can increase your risk of ED. 

• Penile Nerve Injuries

  Damage to the penile nerves and arteries (that control erections) can cause or worsen ED.

• Medications

  Certain medications, such as SSRI antidepressants, antihistamines, high blood pressure, pain, and prostate medications can trigger or aggravate ED in some men.

• Mental Health Conditions

  Psychological, emotional, and mental health conditions, like, stress, anxiety, and depression, can trigger or worsen ED in some men.

• Substance Abuse 

  Chronic alcoholics and drug abusers are at risk of experiencing ED.

Can Stress and Anxiety Cause Erectile Dysfunction?

Yes, it can. 

Stress and anxiety can alter or disrupt your body’s ability to trigger your body’s physical response (i.e., sweating, shaking, breathing faster, etc.). When it comes to erections, stress, and anxiety can disrupt how your brain’s ability to trigger the physical response of extra blood flow to your penis so an erection can be obtained. Researchers suggest that chronic stress and anxiety can create an ED cycle consisting of stress, anxiety, and ED. Researchers also found that chronic or repeated episodes of ED can cause behavioral changes, such as avoidance of sexual activities, social withdrawal, secrecy, porn use, etc.

Is Erectile Dysfunction Connected to OCD?

Yes, erectile dysfunction can be connected to OCD.

Studies suggest that anxiety can play a major role in the development of sexual dysfunctions like erectile dysfunction (ED). Psychological, emotional, and behavioral responses to ED can lead to a never-ending cycle of avoidance, conflicts, low self-esteem and self-confidence, doubt, and uneasiness.

The result? Less sex, less time spent with a romantic partner, feelings of confusion and betrayal, less communication between partners, and a higher risk of porn use or porn addiction, cheating or infidelity, and sexual dissatisfaction.

Because OCD is a type of anxiety disorder, the anxiety linked to it can interfere with erotic stimuli (i.e., foreplay), leading to impaired or delayed sexual arousal. In other words, when you experience anxiety, your body’s stress response is triggered leading to an elevated heart rate, blood pressure, and breathing.

When this occurs, you are less focused on the sensations (i.e. touches, kisses, etc.) you are feeling in your body during sex and more focused on the fear and anxiety you are feeling from the anticipation of having sex. Your anxiety overpowers sexual arousal or the sensations you are receiving from sexual activity.

The result? Erection issues or ED. Along with impairing or delaying sexual arousal and desire, OCD can also cause orgasmic problems, which also contribute to ED issues. One of the most common causes of ED is negative emotions, such as performance anxiety, or the fear of failing to satisfy a partner and live up to their expectations.

Approximately 37% of men with ED also struggle with anxiety disorders. OCD is an anxiety disorder, so it is reasonable to say that some of these men struggle with OCD. While there are not many studies on OCD and ED, it is safe to assume that ED and OCD are connected – at least through anxiety.

According to researchers, anxiety changes how the sympathetic nervous system functions. The sympathetic nervous system is responsible for obtaining and maintaining erections, thereby, chronic stress and anxiety can not only lead to ED, but also performance anxiety, a loss of sexual self-confidence, and even depression. In fact, studies suggest that 25% of men with OCD also struggle with depression.

According to a 2020 study, 6% of men with OCD experience erectile dysfunction (ED) with men between the ages of 45 and 54 being the most affected. Researchers also found that selective serotonin reuptake inhibitors (SSRIs) antidepressants may not only delay ejaculation but also trigger a decline in sexual arousal and excitement, leading to sexual dysfunction and erection issues like erectile dysfunction (ED).

Common OCD medications (i.e., antidepressants) can cause sexual side effects. A reduced sex drive, ED, and an inability to reach orgasm are common side effects of OCD medications (i.e., antidepressants). The problem with common OCD medications is that the same medication you take to ease your anxiety-related OCD symptoms is the same medication that may be causing your ED symptoms.

Because you are now experiencing ED, your anxiety returns in the form of sexual performance anxiety, so while you may be helping one condition (OCD), you are, at the same time, triggering another one (ED). Researchers found that SSRI-induced, sexual side-effects (i.e., ED) appear to be dose-dependent and fairly reversible. When OCD is treated with medications, the first-line treatment tends to be high-dose SSRIs. In the case of OCD, sexual side effects, like ED, can sometimes continue after this OCD treatment has been discontinued.

How is ED And OCD Treated?

Well, if your ED symptoms are connected to OCD, you may want to treat your OCD symptoms first with psychotherapy (i.e., CBT or ERP therapy), medications, self-help tools, and natural remedies. Note: There are a variety of OCD medications that will not cause you to experience erection issues or sexual dysfunction. If your ED symptoms are truly linked to OCD, then treating your OCD symptoms will reduce or alleviate your ED symptoms. If your ED symptoms are not linked to OCD, then you will likely need to see a urologist to identify the root cause of your symptoms. A urologist will be able to develop a treatment plan with you that will address your erection issues and get you on the path to recovery.

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