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Anxiety, depression and mood disorders are major causes of ED, especially among young men. Psychogenic ED is, however, a big mystery. This is an area where our ignorance still exceeds our knowledge.

Anxiety is a normal biological reaction but it may get in the way of sex. When you get too anxious, the release of adrenaline constricts peripheral circulation so that blood can get to your vital organs (heart, lungs) more rapidly (fight or flight response). The penis is not a vital organ. In fact, the last thing you need when you're facing a dangerous/stressful situation is an erection!

Depression is another important cause of ED. Erections start in the brain and if the brain isn't working properly (i.e. sending the right signals) sexual problems may occur. There are several ED drugs that act directly on the brain, e.g. dopamine agonists.

Speaking of dopamine, Rexahn Pharmaceuticals is developping a new ED drug that shows great promise. It's called Zoraxel and it modulates dopamine and serotonin levels in the brain. Unlike Viagra or Cialis, this one doesn't just improve erections, it also improves mood and sexual desire. I contacted Rexahn recently and they told me that Zoraxel should be available in 2013.

For more on the subject of psychogenic ED, I suggest this study:


FROM PREMATURE EJACULATION TO ERECTILE DYSFUNCTION VIA DEPRESSION

MOHAMMAD HARIS BURKI (M.B.B.S., Ph.D.)
MAHRUKH MASOOD (M.Sc., M.Phil)
SALEEM-U-ZAMAN ADHMI (MRCP)

ABSTRACT

BACKGROUND
Master and Johnson have argued that premature ejaculation and erectile dysfunction are inter-related sexual dysfunctions. Premature ejaculation leads to erectile dysfunction due to the self imposed numbness to the erotic stimulation from the partner, in order to delay the ejaculation.

AIMS
To explain the relationship between premature ejaculation and erectile dysfunction in terms of psychiatric illness; mediated by the functional imbalance of different neurotransmitters.

METHOD
Several websites were searched for the words like depression, anxiety, premature ejaculation, erectile dysfunction, serotonin, noradrenaline and dopamine. It was followed by manual search for research papers, books and articles from sexology, psychiatry, and urology.

RESULTS
Studies quoted prove that anxiety is closely related to premature ejaculation. Later on anxiety gets converted into depression, which in itself is an etiological factor of erectile dysfunction.

CONCLUSIONS
It is concluded that premature ejaculation causes erectile dysfunction in the same way as anxiety leads to depression. Neurochemical changes in both the phenomenon are similar.

Read more: http://www.wpanet.org/uploads/Education ... lation.pdf

Flavio,
Thanks for the great info! This ties in directly with what Bonefish posted on the Mental/emotional thread.

Depression, Anxiety are what hurts us most - physically, mentally and emotionally.
I often remind guys to not be too hard on themselves since performance anxiety at any time will only kill what treatments are trying to cure.

As most sex therapists will say, taking actual intercourse out of the equation will probably do more than anything to return confidence.

It's a complex issue, isn't it?
thanks for the post
Paul

It's definitely a complex issue. And even though tremendous progress has been made in the field of ED, there's still a lot we don't know about the relationships between the brain and sexual function.

Depression is unquestionably a major cause (and consequence) of ED but I believe that even simple mood variations may have an impact on sexual performance. In fact, Zoraxel is said to improve mood, as well. This is why I have so much faith in Rexahn's new ED drug: whereas Viagra and Cialis only act locally, Zoraxel goes to the root of the problem and improves all phases of sexual function.