Can severe stress and anxiety really lead to erectile dysfunction? How long does it last and what can I do to improve it?
December 7, 2011 10:36 AM   Subscribe

Can severe stress and anxiety really lead to erectile dysfunction? How long does it last and what can I do to improve it? Is it physical, or all mental?

I'm a male in my mid-30s. A year ago, I realized I would need to break things off with my wife. We'd only been married a couple years, but we almost never had sex and had grown apart emotionally, professionally, etc. In addition, she is bipolar. For years I had been realizing I was increasingly attracted to other women, but never acted on it. Yet thoughts of sex with other women consumed me. I couldn't think of anything else. I was masturbating 2-3 times daily. My wife was very sweet, but very fragile and sad, and I felt tremendously guilty over a period of years that I wasn't more attracted to her because of the emotional complications.

Just around the time I broke things off, I was hardly sleeping, my heart was constantly racing, it felt like my body was breaking down. Suddenly, I woke up in the morning with no erection. And then every morning. This hadn't been true in 20 years. I began to obsess over it because I was also taking Propecia, but I'd been taking that for 10 years and, as many doctors since then have corroborated, it would be extremely unlikely to suddenly have sexual side effects after that long.

A year later now, I barely have the desire to masturbate. Mostly I've missed my wife and felt horrendously guilty how things shook out. The only times I've felt "normal", sexually, was when it seemed like I had a chance of working things out with her, but I'm 90% sure those chances are gone. Of course, the irony is painful -- now that I finally have the freedom to pursue other women, I can't even get aroused.

I have seen multiple urologists and family doctors and they've all said it wasn't the Propecia, it's just mental. But no real gameplan to getting better. A lot of days, my urethra and pelvic muscles feel "tight" and vaguely sore, kind of like the fatigued sensation men have after having sex. It's like there's a lack of circulation. I'm vaguely tempted to masturbate a few times a week, and even then it feels forced and my erections are weak.

Has anyone ever experienced this? Did anything help? I've tried sleeping more, meditating, prostate massage, antibiotics just in case there is prostatitis. I don't know what else to do and I feel virtually suicidal, as I've lost my wife, my ability to reconcile with my wife, and my ability to have other women, all at the same time. I am not working and am having a hard time getting out of bed each morning.

I will be seeking counseling soon as I do realize I'm depressed, but I haven't met anyone for whom the depression has manifested in quite this way, for this long. Any help would be appreciated.
posted by anonymous to Human Relations (12 answers total)

I think one of the first things you're going to have to tackle in therapy is the direction of causality in your problems. Your anxiety would probably not magically get better if only you had your wife and libido back. If you manage the anxiety and depression, then your sex drive will likely return in time. Stop thinking of it as a sexual problem only. Having trouble getting out of bed is a mental problem, and a bigger immediate problem than not having erections. Treat that first.
posted by slow graffiti at 10:45 AM on December 7, 2011

Depression alone can do this, stress can do this, guilt can do this, and anxiety can do this. The combination can be hugely powerfuly, and stress of worrying about it can make it worse, which is like some horrible unfunny joke of the human brain.

Counseling really is your best bet, the sooner the better. Seeing as you've already seen your family doctor about this, talk to them about your best counseling options.
posted by ldthomps at 10:48 AM on December 7, 2011 [3 favorites]

Agreed, stress can sure do this. But despite what the docs say, I would not rule out the Propecia. Google it and read more about the side effects afflicting something like five percent of users--effects that sometimes persist even when you stop taking the drug. (Sorry I don't have time to seek and provide links.) Of course I'm not a doctor.
posted by fivesavagepalms at 11:36 AM on December 7, 2011

Dude, yes. "Severe stress" will f...screw your body up at least until the stressor(s) is/are removed. For instance, certain kinds of stress will cause me to swell up as if I was allergic to peanuts and took a tour of the M&M factory. I am not allergic to peanuts.

Forget about prostate massage for now and deal with the real issues. For instance, if you think the ideal relationship is one where you NEVER find others of the opposite sex attractive, you are going to be an unhappy camper for quite some time.

they've all said it wasn't the Propecia, it's just mental. But no real gameplan to getting better.

I get the feeling you're avoiding the obvious. See a therapist or psychiatrist.
posted by rhizome at 11:44 AM on December 7, 2011

Can severe stress and anxiety really lead to erectile dysfunction?

God, yes. It's one of the most common causes of it.

How long does it last?

How long is a piece of string?

You need to work on reducing the stress. That's what it takes.

and what can I do to improve it?

See previous answer.

Is it physical, or all mental?

If it's caused by stress, it's mental. Attack the source of your stress. Do note also that fretting about your inability to get it up is a source of stress. It's a hell of a catch, that Catch-22.
posted by Decani at 12:47 PM on December 7, 2011

You sound like many a person poisoned by guilt.

You need to find a way to make peace with your ex-wife.

I knew someone with a very similar problem, and only when he healed things with his ex was he able to stop feeling that he had gotten his just desserts. That was him, though, not sure exactly how you feel about that-- YMMV.
posted by devymetal at 1:19 PM on December 7, 2011

Yeah, stress can absolutely do it to you.
That said, there are many physical issues that can cause the problem, too. Diabetes and hypertension, for instance. And, simple aging will slow the processes down.

But, you definitely sound like you're piling-on the stress. Start there.
posted by Thorzdad at 2:54 PM on December 7, 2011

Do you still get morning wood?


Good. It's in your, ahem, head and not your body and likely resolvable via therapy and when your stress, depression, &c. start to get more manageable.

Also, low ambient temperature can negatively affect developing and keeping an erection, as well as the hardness.
posted by porpoise at 5:01 PM on December 7, 2011

Do you still get morning wood?

Poster writes:

Just around the time I broke things off, I was hardly sleeping, my heart was constantly racing, it felt like my body was breaking down. Suddenly, I woke up in the morning with no erection. And then every morning. This hadn't been true in 20 years.

posted by pullayup at 9:11 PM on December 7, 2011

You spent years trying everything you could to force arousal for a woman you didn't feel it for. This connected "trying to get aroused" and "extremely high anxiety situation" in your mind. Now you're racked with guilt over same, adding to the anxiety. The "irony" of this isn't accidental. You've joined the matters at the hip. Now you're adding the meta-anxiety of being too anxious to get erect. This is a feedback loop. The only way out is to neutralize the force driving it: anxiety.

So: the autonomic sexual response only works in the absence of anxiety. Period. Brainstem has to feel safe and relaxed, or you don't get hard. See hyperarousal response -> inhibition of erection.

That's my "stranger on the internet" diagnosis anyways. YMMV, get-a-therapist, &c.

Meanwhile here's what I'd suggest doing: build a new relationship with your body. One where you don't try to force it to do things, and don't guilt it afterwards when it refuses. One where you you respond to its tingles of anxiety with the question: "what can I do to help you to relax?"

Forget about the marriage you lost. Let go of that guilt. You can't fix that anymore. It wasn't your fault. Don't blame yourself or your body. And forget about the number of orgasms you have, and the women you want to fuck. You'll get to that later. Honest. There will be more women. Just focus on being kind to your body and doing nice things for it. Respect it and give it time, pleasure, relaxation, comfort.
posted by ead at 12:17 AM on December 8, 2011

I just wanted to chime in to say that I feel for you. The guilt you feel right now is probably not a fun experience.

But I would try not to stress out about the sexual issues too much right now. Life is long, and your sexual abilities will return. Counseling or therapy will probably help; I'm not a therapist, but it sounds like the sexual problems are a symptom of the guilt you feel about your sexual desire's role in ending your marriage. Once you can work through these feelings (and it may involve delving down into deeper feelings and issues), you'll probably be fine.

You describe your wife as "very sweet, but very fragile and sad." For these reasons it sounds like it was hard for you to leave her. Maybe you feel like her life was difficult and you've made it even worse? I think you deserve some praise for the empathy you feel for her. If you were a total jerk, you wouldn't have felt bad at all about it. But you are obviously a good person. Sometimes being a good person means having very conflicted feelings about things.

The thing is, she'll be okay over time, and so will you. You don't deserve to be in a marriage that doesn't fulfill you, and if you stayed in that marriage just to make her happy, you wouldn't be doing her any favors either. She's an autonomous human being and she'll find a way to live a happier life, and so will you.

In the meantime, there is so much more to being human, and so much more to enjoying life, than being able to have sex. Cultivate your other interests and hobbies, or develop some new ones, and definitely go to therapy or counseling. You will be much happier for it.
posted by chameleon at 8:43 AM on December 8, 2011

I've posted this so that you know your/we are not alone.........I am mid 30's and I have exactly the same problem as you.........broke up with my Girlfriend with the same issues as you after 14 years, (18 months ago) paid out alot of money to buy her a house and was left with no money, I thought to myself I'll be ok, Ive kept the house etc, got a good job, not bad looking and getting interest from some girls, I'll manage.
Little was I to know I would be in exactly the same boat as you, just waiting to start some sort of counselling/Psychosex therapy as recommended by my Dr.
With regards to arousal, my concious thought wants to and is attracted to women however, I am not even able to bring myself to become aroused or even masterbate.
I think its stress and mild depression and I hate it!
It's a horibble place to be, I used to get good erections prior to the break up now I get occasional good morning wood( to my surprise) and then I get some weak morning woods, don't know what's going on!
I paid private and went to see an ED specialist he said it's all in my head!
I hope time is the healer here..........hope you improve too my friend
posted by Technoviking at 8:01 AM on February 3, 2012

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