Features of psychogenic erectile dysfunction:
(1) potentially reversible
(2) may be able to temporally associate the onset of erectile dysfunction with a particular event (although this may be masked in a person with multiple comorbid conditions)
(3) may have a previous history of adequate sexual functioning prior to that event
(4) absence of objective findings that can explain the erectile dysfunction
A person with psychogenic ED may have:
(1) general anxiety and stress (about health, money, job, family)
(2) fear of failure (performance anxiety)
(3) fear of intimacy
(4) fear of harm from activity (after surgery or myocardial infarction)
(5) depression (may be drug-related)
(6) conflict with sexual partner
(7) psychiatric comorbidity (psychosis, neurosis, personality disorder)
(8) guilt (associated with a restrictive background)
(9) unclear gender or sexual preference
(10) history of sexual abuse
(11) a past traumatizing sexual experience
Identifying and treating the problem can significantly improve the patient's erectile function.
Differential diagnosis:
(1) erectile dysfunction related to medications taken for the psychiatric disorder
(2) endocrine or autoimmune disorder with psychiatric symptoms
