Yes. Research has shown that men with ED are at higher risk for depression, and, in turn, men with depression are at higher risk for ED.
In 2018, the Journal of Sexual Medicine published a review of 42 studies ED and depression. Together, the studies included over 192,000 men. The authors reported that men with depression had a 39% increased risk for ED. And men with ED were almost three times more likely to have depression than men who had no trouble with erections. (Read more about the study here.)
These results do not necessarily mean that depression and ED cause each other directly. However, the authors recommended that men with ED be screened for depression and men with depression be screened for ED.
Scientists are not sure exactly why the two conditions are so closely linked, but theories suggest both physical and psychological connections.
Physical connections may include the following:
- Low testosterone. Some men with low testosterone have weak erections or are unable to have erections at all. Similarly, low testosterone has been linked to depression.
- Poor muscle relaxation. In order get a firm erection, the muscles in a man’s penis need to relax and allow blood to flow in. It’s possible that depression affects areas of the brain that release compounds involved with this process.
- Medications. Many medications used to treat depression have sexual side effects, which may include ED. Some examples are serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic and tetracyclic antidepressants, and some forms of monoamine oxidase inhibitors (MAOIs). Bupropion, mirtazapine, vilazodone, and vortioxetine tend to have fewer sexual side effects. If men suspect that medication is causing their ED, they should see their doctor. Sometimes, changing the dosage or switching to a different medication helps, but these steps should always be taken under a doctor’s care.
Psychological factors can also be involved:
- Performance anxiety. People with depression tend to think more negatively and may feel less confident. A depressed man might think, “I don’t have what it takes to please my partner” and then have erection difficulties.
- Relationship conflict. ED can be stressful for men and their partners, and depression can develop from relationship conflict. The man with ED might worry that he is not meeting his partner’s needs and feel that he is inadequate or less masculine. His partner might worry about being attractive enough or suspect that the man is having an affair. If these feelings aren’t brought out into the open, the situation can worsen, with both partners withdrawing, avoiding each other, or missing the intimacy that they once shared.
Both ED and depression can be treated, and it’s important to seek help for both conditions. Men should have a full physical checkup to make sure that physical causes of ED, such as diabetes, low testosterone, or heart disease, are addressed if necessary. Psychotherapy and counseling can benefit both men and their partners.
The Journal of Sexual Medicine
Qian Liu, MPH, et al.
“Erectile Dysfunction and Depression: A Systematic Review and Meta-Analysis”
(Full-text. Published online: June 27, 2018)
International Society for Sexual Medicine
“What is low testosterone? What are the symptoms and how is it diagnosed?”
“Low Testosterone May Raise Depression Risk”
(July 6, 2015)
Hall-Flavin, Daniel K., M.D.
“Antidepressants: Which cause the fewest sexual side effects?”
(November 15, 2017)
“Discussing Erectile Dysfunction With Your Partner”
(November 23, 2010)
“Depression and Erectile Dysfunction (ED)”
(Reviewed: September 8, 2017)