How do stress and anxiety affect sexual performance and erectile dysfunction?

6 min

Related conditions

Stress is the body’s reaction to any change that requires an adjustment or response to maintain normal function. The body may react to changes with physical, emotional, or mental responses. Anxiety can be described as feelings of worry, nervousness, or unease about something with an uncertain outcome.

Anxiety is the most common mental health condition in Australia, and 20% of men will experience anxiety at some stage in their life.

Feeling stressed is usually connected to your circumstances and is usually temporary (like an upcoming project deadline, exams, a new baby on the way, relationship struggles, or retirement).

Anxiety, on the other hand, is more than feeling stressed, nervous, or worried. Anxiety is continuing to feel stressed or worried after the source of this stress and/or worry has passed (like ongoing health anxiety, financial anxiety, and social anxiety).

So, how does stress and anxiety affect sex drive?

Stress and anxiety may cause your sex drive to spike, or it may cause your sex drive to dip.

On the other hand, stress and anxiety may cause a dip in your sex drive, and there are two reasons for this.

From a biological (physical) perspective, your sex drive may dip because:

When we get a sudden fright our ‘fight or flight’ response kicks in so that we can cope with the immediate threat. This response is due to the activation of our sympathetic nervous system and is an unconscious way that our brain helps to protect us.

The response includes a quicker heart rate and deeper breathing, which can help us to meet the threat head-on or outrun the danger. It also includes inhibition of bodily functions that aren’t needed to fight or flee, like digestion or having an erection. Once the threat has gone, and you’ve beaten it or out-run it, things go back to normal.

If threats continue, or a whole lot of problems keep coming up, our hypothalamic-pituitary-adrenal axis (HPA axis) gets activated to try and help us cope with the ongoing stress. Activation of the HPA axis results in an increase in cortisol (our main stress hormone), which raises our blood sugar levels and blood pressure, and inhibits our immune system.

High cortisol levels are linked with anxiety. Cortisol also inhibits testosterone, the primary male sex hormone, which is responsible for sex drive (libido) and might contribute to the blood flow changes that cause an erection.

How do stress and anxiety affect erectile dysfunction?

You might be wondering how something that you experience in your mind may affect your erectile dysfunction.

Stress and anxiety are a natural part of life, and most of us will experience one or both throughout our lifetimes. 

What is performance anxiety?

Sexual performance anxiety is a term used to describe feelings of worry or fear related to sexual activity, but it’s not recognised as a diagnosis. Anxiety about sexual performance can become a hard-to-break cycle in which your worries contribute to sexual difficulties like erectile dysfunction or premature ejaculation, which then causes you to worry more about future performance. 

What should you do if you are having issues?

Whether you are in a relationship or you are single, changes in sex drive and your ability to achieve an erection can both be confronting issues.

If you are in a relationship, try to speak with your partner about how you are feeling. Encouraging understanding between you and your partner will be helpful for working through the sexual issues you are having.

If you are single, consider talking to a person you trust, like your doctor or a friend, about changes in your sex drive or your erectile function. Talking through your source of stress and anxiety may help you to better understand the next best steps you can take.

Remember that it is completely normal to feel stressed or anxious during this time. It is normal to not feel like having sex all of the time.

If your sex drive remains low and you are having issues with erectile function for a couple of weeks, you should visit your doctor. Your doctor can carry out a physical examination to help understand the causes of your erectile dysfunction and set up a treatment plan for the next steps.

For more information about erectile dysfunction, watch our short video:

You can also find more information and resources regarding erectile dysfunction on our Erectile Dysfunction information page. 


Erectile dysfunction
Mental health
Sexual health
Sexual performance

Did you find this page helpful?

Information provided on this website is not a substitute for medical advice

Call 000 for emergency services

If you or someone you know needs urgent medical attention.

Call MensLine Australia on 1300 78 99 78 for 24/7 support

MensLine Australia is a telephone and online counselling service for men with emotional health and relationship concerns.

Sign up to our newsletter

We release two monthly newsletters – one written for men, family and friends, and another for health practitioners.

Your preferred mailing list

Your name

Your email

Stay up to date


Healthy Male acknowledges the traditional owners of the land. We pay our respects to elders past, present and future. We are committed to providing respectful, inclusive services and work environments where all individuals feel accepted, safe, affirmed and celebrated.


Healthy Male is funded by the Australian Government Department of Health and Aged Care. This website does not host any form of advertisement. Information provided on this website is not a substitute for medical advice.

Trusted information partner of