Post-traumatic stress disorder (PTSD) can have a range of effects, including changes in sex drive or sexual functioning. In males, this may contribute to erectile dysfunction (ED).

ED refers to difficulty getting or maintaining an erection. It can have both biological and psychological causes or, sometimes, a mixture of the two.

This article discusses the links between PTSD and ED and how a person may recognize and manage their symptoms.

A man resting his hands on metal railings outdoors.Share on Pinterest
Petri Oeschger/Getty Images

There is some evidence there may be a link between PTSD and ED. A 2021 cohort study in Taiwan found that the research participants with PTSD had a significantly higher risk of ED in comparison to those without it.

However, not all the research has found strong associations.

A 2021 review of previous research on PTSD in veterans noted a link between the condition and changes in sexual desire and how a person feels about sex. However, the evidence for a relationship between PTSD was more mixed. While three of the studies the authors looked at showed a connection, four did not.

It is difficult to know how many people with PTSD develop ED, and this is due to several reasons.

Firstly, some people may feel embarrassed to report either ED or mental health difficulties. Secondly, the research to date has found widely differing statistics.

For example, a review of previous studies from 2021 found figures ranging from as low as 3% to as high as 85%.

The prevalence of ED may also vary greatly due to the effects of other coexisting conditions common in PTSD, such as mood disorders, panic disorder, and substance use disorders. These factors may also contribute to a person experiencing ED.

PTSD can cause a range of psychological and physical symptoms that may contribute to ED. For example, it may lead to the following effects.

Emotional effects

PTSD can result in many feelings that could interfere with a person’s sexual desire and confidence. For example, it may lead to:

  • anxiety
  • shame
  • anger
  • feeling chronically unsafe or “on edge”
  • low self-esteem
  • distrust of others

Any of these states could affect sexuality. For example, feeling on edge may make it difficult to relax. Stress and low self-esteem are also risk factors for ED, whether directly related to sex or not.

Flashbacks and dissociation

PTSD symptoms cause people to re-experience some aspects of the traumatic event, such as emotions or sensations a person felt at the time. Sometimes, an individual may relive the memory.

These experiences are known as flashbacks and occur when a person encounters a trigger, or reminder of a traumatic event. If aspects of a sexual situation are triggering, it could be difficult to get or maintain an erection.

Dissociation could have a similarly disruptive effect. Dissociation causes a person to feel disconnected from their thoughts, body, feelings, or physical reality, while things may feel unreal or distant. This, too, may interfere with having sex.

Physical conditions

There is some research suggesting people with PTSD may be at a higher risk for certain medical conditions during their lifetime. Some of these can affect the physical ability to get erections. Examples include:

  • diabetes
  • cardiovascular disease
  • stroke

PTSD may also lead to changes in behavior that affect physical health, and, therefore, sexual health. For example, it may have links with:

  • smoking
  • physical inactivity
  • issues with diet

These can also contribute to ED.


In some cases, ED may be a side effect of certain medications doctors can prescribe for reducing PTSD symptoms, such as:

Even if a person suspects their medication may play a role in their ED, they should not stop taking it or change the dose without speaking with a doctor first. Sudden withdrawal from some PTSD and anxiety medications may be dangerous.

There are four categories of PTSD symptoms. They are:

  • re-experiencing symptoms
  • arousal and reactivity symptoms
  • avoidance symptoms
  • cognition and mood symptoms

The re-experiencing symptoms include:

  • flashbacks
  • recurring dreams or memories relating to a traumatic event
  • distressing thoughts
  • physical symptoms of stress

The arousal and reactivity symptoms include:

  • becoming easily startled
  • having difficulty focusing
  • feeling tense or on edge
  • feeling irritable or having outbursts of anger
  • struggling to sleep or to stay asleep
  • engaging in reckless or destructive behavior

The avoidance symptoms include:

  • avoiding certain places, activities, or other reminders of a traumatic event
  • avoiding feelings or thoughts relating to a traumatic event

The cognition and mood symptoms include:

  • difficulty recalling details from a traumatic event
  • negative thoughts about themselves or the world
  • persistent negative emotions
  • loss of interest in activities
  • strong feelings of blame directed at themselves or others
  • social isolation
  • difficulty feeling positive emotions

This depends on what is causing the ED. Where PTSD is the direct and only cause, then treating this may help with ED. However, there is not yet any research on this.

If multiple factors have a role in a person’s ED, they may also need support in addressing those.

The treatments for PTSD include:

  • trauma-focused cognitive behavioral therapy
  • eye movement desensitization and reprocessing
  • cognitive processing therapy
  • medications to reduce symptoms

People with ED may benefit from speaking with a doctor about the potential effects of some PTSD medications on sexual function before taking them. There may be alternatives they can try.

If a person believes they may have PTSD, speaking with a doctor or therapist can help. This will help them get a diagnosis and recommendations on the best way to begin treating it. These approaches can help reduce symptoms and improve quality of life.

It is also important for anyone experiencing ED to consult a doctor. This is because ED can sometimes occur due to physical conditions that need medical treatment. A doctor will be able to test for these and rule them out.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

Was this helpful?

Some evidence suggests there may be a link between erectile dysfunction (ED) and post-traumatic stress disorder (PTSD), although it is not conclusive. Both conditions are complex, and there are many ways one could influence the other.

PTSD may cause symptoms that make sex difficult or even distressing, in some cases. It may also have links to physical health concerns that affect sexual health. Another possible relationship is in PTSD medications, some of which can cause ED as a side effect.

Anyone with worries about ED or PTSD needs to speak with a health professional for advice.