Depression and Erectile Dysfunction

Estimated reading time: 25 minute(s)

Depression remains a prevalent psychiatric condition worldwide with widespread adverse effects. While the condition is known to affect different parts of life, one of the most underrated and under-discussed areas it can affect is the sexual abilities of a person. Experts agree that a depressive disorder can affect a person to the extent that it may induce erectile dysfunction.

When combined, erectile dysfunction and depression can have significant consequences on life. Understanding how one of these conditions may lead to another is imperative, whereas seeking timely treatment for both is crucial to maintaining a good quality of life.

What is Erectile Dysfunction? An Overview

Erectile dysfunction, or ED, is when a male cannot achieve or maintain an erection firm enough to participate in sexual intercourse. Also known as impotence, ED is a widespread condition and affects more than 30 million people in the United States. The issue can be highly debilitating and can negatively affect life in many ways. The following are some factors that typically increase the risk of ED in a person:

• Advancing age
• Mental health disorders, such as depression
• Certain medications
• Specific medical conditions
• Substance use
• Increased body weight
• Injury
• Smoking

While many people experience erectile dysfunction only occasionally, others may report it occurring more regularly. For them, seeing a doctor can greatly help. Remember that ED can be of two types: primary and secondary. For most people, erectile dysfunction is secondary, meaning they lose their previously typical function. Primary ED means that a person can never achieve or maintain an erection. Such a problem can have different causes, including neurological, psychological, or related to blood vessels.

Depression remains one of the most common causes of erectile dysfunction. Unfortunately, both conditions are considered taboo, meaning most people never get treatment. Consequently, their quality of life goes downhill until they finally decide to do something about it.

Does Depression Cause ED?

Research has been investigating the possible link between depression and ED for a long time. So far, studies indicate that a person struggling with erectile dysfunction has approximately a 65% chance of developing depression. [1] While experts do not fully understand how these two conditions can lead to one another, the following theories are currently proposed to understand the link:

• Behavioral: Depression is a psychiatric disorder that involves low mood and negative thoughts. Both of these symptoms lead to performance anxiety, contributing to erectile dysfunction.
• Antidepressant Use: Many people fighting depression use regular antidepressants to ward off their symptoms. Unfortunately, many of these medications can trigger side effects, one of which includes lowering of libido and difficulty maintaining an erection.
• Poor Testosterone Levels: Testosterone, the male hormone in the human body, plays an imperative role in determining sexual performance. People with this issue may experience erectile dysfunction.

Lastly, factors like low self-consciousness about sexual performance, poor self-esteem, and other negative emotions and thoughts can also cause ED in people with depression. It is important to remember that the link goes both ways, i.e., people with depression are more likely to develop erectile dysfunction and vice versa. Seeking professional help can make finding the source or trigger for these conditions easier and help people manage both more effectively.

Depression and ED: What are the Treatment Options?

Treatment for depression causing erectile dysfunction includes different modalities, such as medications, psychotherapy, and lifestyle changes. The treatment choice depends on the symptoms’ underlying cause in most cases.

Medications for Erectile Dysfunction

When depression and ED co-exist, treating one condition can automatically improve the other. [2] Hence, many experts prescribe Viagra to men to alleviate their erectile dysfunction, which automatically causes a notable reduction in their depressive symptoms. Viagra is one of the most common medications used for ED management, which acts by relaxing the penile muscles and improving their blood flow for better sexual arousal. Other medications used in place of Viagra may include the following:

• Tadalafil
• Avanafil
• Vardenafil

A doctor may prescribe supplemental hormones if a person experiencing ED also has low testosterone levels. Newer research is now promoting alprostadil, a medication available as a suppository or injection for managing ED symptoms.

Medications for Depression

Sexual dysfunction has been a noticeable symptom of many antidepressant medications. Hence, if a person is already on medication for depression and complains of erectile dysfunction, a doctor may consider changing it. Difficulty maintaining an erection and low libido are the common side effects of many antidepressant medications, but not all cause these issues. Following are some examples of drugs to use in people with co-occurring depression and erectile dysfunction:

• Vilazodone
• Vortioxetine
• Trazodone
• Desvenlafaxine

Lifestyle Changes

Many lifestyle choices contribute to the development of ED and depression together. Reversing these habits or replacing them with healthier ones can make a huge difference. Some lifestyle changes to adopt in these circumstances include the following:

• Stop smoking if you have been a smoker
• Consider exercising regularly
• Stick to eating a nutritious diet
• Limit or completely cut off the use of recreational drugs, if applicable
• Maintain a moderate body weight

Psychotherapy

The following psychotherapeutic interventions have been known to help an individual manage the psychological and emotional effects of depression and erectile dysfunction:

• Cognitive behavioral therapy: Also known as CBT, this therapy helps individuals identify unhelpful behaviors and thoughts while developing healthier ways to respond to challenges.
• Mindfulness therapy: This mental exercise focuses on present moments instead of thinking about the past or the future.
• Sex therapy involves counseling both partners about their sex-related concerns and overall relationship.

Depression and ED Treatment: The Significance of Partner Support

To stop erectile dysfunction from negatively affecting a relationship, the best advice is to open the lines of communication and encourage talking honestly about the current situation. It is possible to approach and solve the problem as a team through mutual understanding and support. The other partner in a relationship can play an essential role in managing the relationship well.

If you have a partner struggling with depression and erectile dysfunction simultaneously and you wish to help them out, the following are some points to remember:

• It can be a good idea to accompany your partner for doctor visits
• Spend time learning as much as possible about erectile dysfunction, depression, and their connection
• Consider visiting a mental health expert together
• Avoid adopting a judgmental attitude and approach the situation with a positive mindset
• Watch out for any negative habits in your partner, such as heavy alcohol consumption, smoking, and recreational drug use, and encourage them to give up.

Erectile dysfunction carries the power to disrupt one’s self-esteem and relationship significantly. Regardless of which condition happens first, both can often co-exist. However, the good news is it is possible to treat both issues successfully through professional help and support from loved ones.

FAQs

When should I contact a doctor for my depression and erectile dysfunction?

If you suspect to be suffering from erectile dysfunction, it is generally a good idea to get an appointment with a doctor. You must also seek medical help if you have started experiencing depressive episodes. Remember that these episodes usually last for weeks or months. The co-occurrence of both conditions makes the matter more urgent as it may severely affect the quality of life.

How can depression cause erectile dysfunction?

Depression and erectile dysfunction share a close connection. Men with depression are up to twice as likely to suffer from erectile dysfunction than those with sound mental health. Sexual arousal happens when certain chemicals are produced by the brain that leads to an erection. When a person has depression, it messes with the production of these chemicals, which may interrupt an erection.

Are there any other causes of erectile dysfunction in addition to depression?

While depression can lead to erectile dysfunction, it is only one of the many causes. Some other things that may potentially trigger this condition include the following:

• Heart disease
• Low testosterone
• High blood pressure
• High cholesterol
• Diabetes
• Blocked blood vessels
• Parkinson’s disease
• Peyronie disease
• Multiple sclerosis

References

[1] Xiao Y, Xie T, Peng J, Zhou X, Long J, Yang M, Zhu H, Yang J. Factors associated with anxiety and depression in patients with erectile dysfunction: a cross-sectional study. BMC psychology. 2023 Dec;11(1):1-8.

[2] Seidman SN, Roose SP, Menza MA, Shabsigh R, Rosen RC. Treatment of erectile dysfunction in men with depressive symptoms: results of a placebo-controlled trial with sildenafil citrate. American Journal of Psychiatry. 2001 Oct 1;158(10):1623-30.