Depression often contributes to sexual problems and can intensify a dysfunction caused by medical issues. Depression has long been shown to negatively affect sexual performance. It can reduce Sexual Drive and Blunt Sexual Interest. Depression can reduce energy levels and make it more difficult to achieve optimal physical and sexual functioning. Becoming sexually aroused is difficult if the individual is feeling depressed. Fully enjoying sex may be impossible under these conditions.
Depression may be associated with feeling of sadness, lack of energy and lack of initiative. For this reason many men with complaints of ED are not quick to seek help. When they do, these men with depression associated erectile problem are a particularly difficult group of patients to treat. Many men with depression are treated with anti-depressives, which may be a problem, as the medication used to treat their psychological problem is highly associated with an Iatrogenic (physician caused) form of erectile problem.
During history taking, it is common to note that the Erectile Dysfunction associated with depression more commonly starts after treatment for depression has been initiated than after the depression itself. Physical examination should attempt to identify other potential causes of Erectile Dysfunction, such as Peyronie's disease, vascular insufficiency or androgen insufficiency, which has symptoms similar to depression. Men with depression on anti-depressant agents should undergo a full hormonal profile, as there is a high association to androgen insufficiency syndrome in such men. Psychological assessment is obviously a critical component; the psychological assessment should consider the relationship of the treatment strategies to alterations in erectile function.