Academics from the Leverhulme Centre for Demographic Science have called for deeper research into the link between male mental health, sexual function, and infertility. As fertility rates decline and conditions such as erectile dysfunction (ED) become more common, there has been a lot of focus on the physical causes of sexual dysfunction and infertility.

However, the University of Oxford reports that a new comment piece published in the journal Nature has called for a closer examination of the role of mental health. In particular, they call for a better understanding of how lifestyle behaviours may lead to mental health problems such as depression and anxiety, which in turn can cause ED.

The introduction to the piece states: “Declining birth rates are drawing attention to male reproductive health, with infertility receiving overdue interest. Alongside genetic and environmental factors, lifestyle behaviours are a key risk factor.”

“Exploring how lifestyle behaviour links to mental health and its interplay with sexual function and fertility can improve understanding of trends in live births and improve men’s health overall.”

The link between mental health and ED

The piece goes on to explain that ED can trigger mental health problems, because it may cause relationship difficulties, or become a source of shame and create a sense of failure. Men who are already depressed or anxious can go on to develop ED, because their sex drives take a hit, or they become too anxious about their performance in bed.

Conditions such as depression can be very complex in themselves, and the relationship between cause and effect when it comes to sexual performance adds another layer of complexity. This can make it a particularly challenging problem to treat. However, it’s also often overlooked or underestimated by the medical profession.

ED can be successfully treated through oral medication such as Viagra, which is cheaper to buy under its trade name sildenafil. It can be ordered online after a short consultation with a pharmacist. However, if mental health problems are suspected to be the cause, it’s obviously best to tackle these as well or before embarking on a course of treatment.

Professor Melinda Mills, Director of the Leverhulme Centre for Demographic Science and Demographic Science Unit said, ‘This piece stresses the need to consider the often-

forgotten topic of reproductive health and infertility for men, so that we can fully comprehend global trends in live births and improve reproductive health for all.’

Vincent Straub, DPhil student at the Leverhulme Centre for Demographic Science and Demographic Science Unit added:

‘This piece calls for a unified approach to research and policy surrounding male health and reproductive outcomes, and advocates the integration of epidemiological studies on mental health, genetics, and lifestyle risk factors with research on their urological effects on reproductive health.’

How can you manage the psychological impact of ED?

The first step is to understand the nature of the mental health problem. For middle-aged men, common causes include life stressors and worries regarding their careers, finances, or relationships.

Younger men may be prone to performance anxiety, which is the fear of not being able to get or maintain an erection, and can become a self-perpetuating cycle that is difficult to break out from. Further issues may arise from body dysmorphia or low self-esteem, where a man feels ashamed or inadequate about the way he looks.

However, depression and anxiety can be complicated and everybody’s experience of them is different. Sometimes, lifestyle changes such as taking more regular exercise, quitting smoking, drinking less, socialising more and eating a healthier diet can be beneficial. More serious cases of depression may need professional help such as medication or therapy.

Men who suffer from performance anxiety may be reluctant to open up about their problem with sexual partners, but this can be the key to overcoming the issue. Open and honest communication eases the pressure and creates an atmosphere of greater intimacy and understanding.

If the relationship has become strained and distant, couples therapy may help to get it back on track by providing a non-judgemental safe space where the issues can be brought to light. Self-help techniques such as challenging negative self-talk, mindfulness meditation, deep breathing and progressive muscle relaxation may also be beneficial for some men.