There are several reasons why a man might develop erectile dysfunction. These reasons can usually be categorised as either a physical cause or a psychological cause (although sometimes it may be a combination of both that is responsible).

It’s not always the case, but a lot of the time intermittent erectile dysfunction is associated with psychological causes, whereas chronic or persistent symptoms are more often linked to physical causes (particularly underlying medical conditions).

Men who experience symptoms for the first time may ask themselves ‘What is ED?’ or how long they have to have it before it’s officially recognised as erectile dysfunction. Generally, the term is widely used to describe the symptom (not being able to get an erection) but it becomes a condition when someone has this problem repeatedly.

On this page, we’ll explore some of the more common psychological and physical factors behind ED symptoms, and what you can do to prevent them.

When is ED psychological?

Stress and anxiety can play a considerable role in male sexual dysfunction. Sometimes this may be related to the act of sex itself; so for example, a man in a new relationship might get ‘performance anxiety’, where the pressure to prove himself sexually to his new partner becomes overwhleming and induces ED. Other men might feel self-conscious about their bodies or their partner seeing them for the first time, and develop ED symptoms for this reason.

In other scenarios, the psychological cause of erectile dysfunction might have little or nothing to do with the act of sex itself, and be related to something entirely different. For example, a man having problems in his professional life or going through financial difficulty might be experiencing stress that serves as a distraction during sex, and subsequently causes ED.

In most of these cases, symptoms of erectile dysfunction can be temporary. The problem may pass once the external situation (be it to do with money or work) resolves itself. If a couple in a new relationship who experienced difficulty at first manage to successfully have sex, this can serve as a confidence boost and help the man overcome that initial psychological hump.

But symptoms related to these factors might not end quickly all of the time. There’s been a long held belief that ED in younger men is more often caused by psychological factors. One study published in 2013 in the Journal of Sexual Medicine found that one in four men seeking ED treatment for the first time were under the age of 40. So this would suggest that in some cases, psychologically or emotionally-induced ED can be persistent enough to drive men to seek treatment (be in the form of prescription medication such as Cialis, or talking therapy sessions).

When is ED caused by physical factors?

An underlying medical problem will generally persist, no matter what the situation is surrounding sex. So whether it’s with a new partner, or a partner someone has been with and is familiar (and comfortable) with sexually, someone who has chronic ED is more likely to be experiencing it due to a physical cause.

This might be a condition restricting circulation to the penis, such as high cholesterol or high blood pressure. It could also stem from a problem affecting nerve endings or the transmission of signals from arousal centres in the brain, such as Parkinson’s. 

It’s this problem of circulation that PDE5i treatments like Viagra work to resolve, by enabling better blood flow to the penis.

Because health problems such as these become more common as men get older, ED has a higher prevalence among men over 40. 

But physically induced cases aren’t exclusive to older men. A paper published in 2015 in the Asian Journal of Andrology, evaluating the proportion of ED causes in young men, approximated that 15-20% of cases in the younger population had an ‘organic etiology’ (meaning they were the result of physical conditions that occurred naturally). An example of this might be testosterone deficiency or hyperthyroidism.

Lifestyle can also play a huge role in ED. Men who drink excessive amounts of alcohol, smoke, use recreational drugs are more likely to develop erectile dysfunction. 

It depends on the nature of consumption, but these habits might only cause temporary ED. For example, if a man experiences symptoms on one occasion because he’s consumed too much alcohol in that instance, but is generally otherwise healthy, there’s a good chance the problem won’t be present when he comes to have sex again without alcohol in his system. 

But if someone drinks excessive amounts of alcohol habitually, then this is more likely to lead to chronic ED.

What is Occasional ED, Compared to Chronic ED?

What sets ‘occasional ED’ apart from more persistent cases is, more often than not, the probable cause.

Someone with chronic ED may have an underlying condition they don’t know about, or be experiencing a prolonged psychological issue which stops them from performing. Treatment for chronic instances may be issued in the form of prescription treatments like Spedra and Levitra.

But occasional erectile dysfunction may be a little more difficult to predict, and the cause of it may not be firmly rooted in cardiovascular health. Someone with this form of ED may only notice symptoms once every couple of weeks, once a month, or even less.

While it may not sound like a serious problem, it can still be frustrating to encounter when it does occur.

What Should I Do About Occasional Impotence?

The good news is that, if you only have occasional symptoms, you can likely overcome the issue without prescription treatment, and employing ED prevention methods.

Some men who experience the condition intermittently may think about turning to ED treatment to help them get through the odd night where things aren't going their way.

But a disadvantage of using ED treatment ‘recreationally’ suggested by one study is that it may have a deleterious effect on confidence, therefore leading the user to become psychologically reliant upon it.

WebMD notes it is extremely common for men to experience erectile difficulties around 20 per cent of the time, and cases such as these often require no medical attention.

But even in those instances where problems only arise sporadically, there are several non-medicinal measures you can take to improve your erectile health, and reduce the chances of encountering problems.

Determining the Possible Cause

Think about what those times you’ve run into erectile problems have in common with each other.

You might have eaten in a particular way, or engaged in a particular activity prior to intercourse.

Sometimes, improving your erectile health is as easy as avoiding these instigating factors.

Preventable habitual causes of occasional impotence include smoking and consuming alcohol, eating a big meal prior to intercourse, and being tired.

Limiting alcohol intake, stopping smoking and eating only in sensible amounts before sex can help, as can making sure you’re getting enough sleep and rest.

What many people often don’t consider is that occasional ED can occur when they’re having too much sex.

Erectile definition can become reduced if, for instance, you have sex every day without a break. Remember that it’s important to give your body a chance to recover in between sessions.

Psychological factors can also play a role in occasional ED.

It’s perfectly normal to be daunted by a new sexual experience. For instance, if you and your partner are trying something new, a lack of experience in this particular practice may cause feelings of nervousness, and induce erectile problems.

The important thing to remember in such cases is that, if something is new to you, discussing it with your partner beforehand can help to temper your nerves.

When to See Your Doctor

It’s important to seek treatment if you think ED symptoms have escalated to a point where they are posing a problem.

Left untreated, impotence can have a damaging effect on a relationship; and the longer the issue goes unaddressed, the bigger a problem it becomes.

Your doctor will be able to help you rule out any underlying health issues which might be interrupting blood flow, and causing the condition.

It’s not uncommon for some to go through ‘rough patches’ where erections don’t come as easily.

The worst thing you can do is not talk about the problem; if you think ED is presenting an issue, discuss it with your partner.

The main thing to remember is that you are the best judge of whether erectile dysfunction is occurring often enough for you to seek treatment for.

Page last reviewed:  01/07/2020