It would surprise the regular guy if I told him that till the first half of the 20thcentury, the Etiology of Erectile Dysfunction (ED) was primarily attributed to a variety of Psychogenic reasons. Our current understanding of both organic and psychological factors was not always the popular view.
- Unconscious aggression,
- unexpressed anger,
- deep seated anxiety and
- internal conflict were considered to be the root cause for sexual problems.
Relationship problems and psychogenic stress frequently contribute to ED and should be considered in men with acquired or situational ED. Pregnancy fears and the partners wish to conceive can be a factor. Though limited sexual knowledge is proposed as a factor, it is difficult to comprehend that in the day of Google that this can actually exist. However, I still see albeit infrequently “limited knowledge” men. Interpersonal and relationship factors do play a huge role.
Anxiety plays a huge role in sexual response cycle. It can initiate as well as maintain sexual arousal difficulties. This is frequently mediated by cognition. If perception and attention vary, then strength of erection can be frequently altered which further perpetuates the anxiety.
Finally, “spectatoring” an event that I have already discussed in my previous blog which focuses attention away from arousing stimulus and directs it towards negative cognitions is always a possibility. This has a severe dampening effect on erectile capacity and response.