Erectile dysfunction can cause stress and strain in a relationship. Here’s how to cope.

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Sex is a big part of relationships, so when something happens that prevents one partner from being able to have sex… well, it can be confusing, frustrating, or even embarrassing.

But the reality is erectile dysfunction, or ED, is a common condition that can affect anyone with a penis. Though it does become more common with age, it can affect anyone at any age for various physical and psychological reasons.

And when it does — especially more than once — it can affect someone’s mental health, leading to anger, anxiety, depression, or low self-esteem. It can also affect one’s relationship with their partner.

ED is a sexual disorder that affects someone’s ability to achieve or maintain an erection of the penis during sexual activities.

It affects about 30 million people with penises, according to the American Urological Association.

ED is the term used to describe:

  • people who sometimes can’t get an erection
  • folks who can get one but can’t maintain it for sexual intercourse
  • individuals who can never get an erection

While it becomes more common with age, age by itself does not cause ED.

Dr. Michele Waldron is a psychologist in Cambridge, Massachusetts, who has experience helping individuals and couples experiencing sex-related issues.

She says, “ED [can be] caused by medical conditions that impact blood flow to the penis and/or testosterone levels.”


Some of those medical conditions or diseases include:

  • diabetes
  • heart disease
  • high blood pressure
  • multiple sclerosis
  • blood vessel disease
  • Peyronie’s disease, which is a connective tissue disorder of the penis
  • high cholesterol
  • atherosclerosis, which is the buildup of plaque in the arteries
  • chronic kidney or liver disease
  • persistent genital arousal disorder (PGAD)


Also, some medications can lead to erectile dysfunction, including antidepressants and antihistamines.

Drinking alcohol, smoking tobacco, or using other recreational drugs can also cause erectile dysfunction.


“There are plenty of psychological reasons why someone may have it as well,” says Eileen Conroy, former therapist and mental health expert. “Being under a lot of stress, having difficulty with your body image, or [challenges] with depression or anxiety can affect ED.”

If your relationship with your partner is contentious, stressful, toxic, or traumatic, this can also contribute to ED.

“ED can be caused by a lack of arousal or attraction to the person,” says Waldron, “[because] emotions can contribute to it. If you and your partner just got into a fight and it isn’t resolved, or they remain in a bad mood, then you are unlikely to be attracted to them.”

Similarly, she says, your partner’s mood and demeanor toward you can play a role.

“I often tell clients that a ‘prickly’ mood in a partner is like a porcupine,” Waldron continues. “Would you be aroused or want to have sex with a porcupine? A partner’s attitude all decrease arousal, which impairs the ability to achieve and maintain an erection.”

This can also escalate or get worse over time, especially if you start to develop performance anxiety due to repeated loss of erection with your partner.

“Thoughts about one’s performance, what the partner thinks or says all impact arousal and thus erectile functioning,” says Waldron. “Men often have performance anxiety after even one time of their being an erectile issue.”

Physically and emotionally abusive relationships can also contribute to ED.

“Because stress is one of the psychological factors associated with erectile dysfunction, someone in an abusive relationship could definitely be experiencing this, especially if they end up with PTSD,” says Conroy.

“There is actually research that points to the correlation between trauma and PTSD and its relationship with ED.”

In short, yes. Especially if you feel guilty or stressed because you cheated on your partner. The stress, guilt, and other emotional hang-ups could all prevent you from getting or maintaining an erection.

This is also true if your partner is aware of the cheating.

“To maintain an erection, focus is needed, so any distracting thoughts or behaviors have the ability to reduce an erection,” explains Waldron. “There are many emotions from both people after infidelity that impact both people’s ability to focus,” she says.

“A partner may not be as into the sex if thinking about whether their partner is aroused to them or that they aren’t good enough,” she continues. “The cheating partner may worry about if their partner is enjoying it and react to the partner not being as into it.”

Waldron adds, “It can become a feedback loop where their emotional reactions cause the other to be less aroused.”

ED can cause strain on a relationship over time, especially since some research has shown that it affects your partner, too, sometimes causing them to feel confused, anxious, undesirable, or even suspicious of you.

Chronic erectile dysfunction can also cause you to feel shame — which makes open and honest communications about ED difficult, resulting in a negative feedback loop, as Waldron described.

But here’s the thing: ED doesn’t have to destroy your relationship.

“A relationship can definitely survive chronic ED,” says Conroy. “Intimacy and romance are more than just sex.”

Communication is key

You can work together as a team by talking with your partner, being honest about your feelings, and being willing to listen to their feelings.

“A long lasting relationship needs to have an ‘us vs. the problem’ mindset, not a ‘me vs. you,” says Conroy. And you can achieve that only by talking with one another.

If your partner has ED, try to be compassionate and empathetic

This can help make your partner feel less shame and stress, reducing performance anxiety.

Demonstrating more empathy might also support lowering the tension in your relationship.

Other forms of intimacy

Remember that sex doesn’t always have to be about penetration.

“Cuddling, kissing, touching, and oral are fabulous ways to keep the spark alive,” says Conroy. This can help you both maintain intimacy, even if you’re unable to maintain an erection.


Consider reaching out to a couples therapist or sex therapist.They might be able to help you work on issues in your relationship, overcome negative attitudes toward sex and psychological barriers, and find new ideas or ways to connect and have fun in the bedroom.

Remember, too, that if you are experiencing chronic ED suddenly, there could be a physical cause.

Consider talking with your doctor or primary care physician to see if there could be a medical reason contributing to your ED. They might also be able to prescribe medication, like Viagra, to help you achieve or maintain an erection.

ED is a common sexual condition that can affect anyone with a penis. It can become more common with age, and certain medical conditions can cause it.

Also, some of the causes can be psychological. Stress and relationship issues can contribute to ED and affect your relationship.

Still, if you work together as a couple and maybe seek the advice of a therapist, you can find ways to cope with ED.