Episode 423: The Hidden Causes Of Erectile Dysfunction

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Aug 15, 2025

In this engaging discussion, Dr. Nazanin Moali, a clinical psychologist and sex therapist, dives into the hidden causes of erectile dysfunction. She explains the psychological roots, such as the impact of early attachment trauma and performance pressure often tied to childhood messages. The conversation also addresses whether porn really causes ED and the rising rates among young men. Dr. Moali highlights the benefits of sex therapy, emphasizing that true healing involves understanding emotional and relational dynamics beyond just medication.

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INSIGHT

ED Is More Than A Medical Problem

Erectile dysfunction is highly treatable but requires understanding root causes, not just band-aid fixes.
Early attachment wounds, relationship dynamics, and performance anxiety often underlie ED.

INSIGHT

Unpredictability Versus Chronic ED

Many men experience erectile unpredictability rather than chronic ED and mislabel occasional problems as dysfunction.
Cultural pressure to perform on demand magnifies normal variability into perceived failure.

INSIGHT

Porn Is An Easy Scapegoat

Research does not consistently support porn as a direct cause of ED and heavy users may report fewer erection problems.
Blaming porn is often a scapegoat that ignores deeper psychological and relational factors.

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Erectile dysfunction is one of the most common sexual difficulties that men encounter, and it can be very distressing. But while ED is highly treatable, we really need to understand what causes it in the first place in order to treat it most effectively. In today’s show, we’re going to explore some of the psychological reasons why it occurs, including how early attachment wounds can manifest as erectile difficulties later in life.

I am joined once again by Dr. Nazanin Moali, a licensed clinical psychologist, AASECT-certified sex therapist, and the host of the internationally acclaimed Sexology Podcast. Based in Los Angeles, she leads a successful private practice where she helps individuals and couples deepen emotional intimacy, overcome sexual challenges, and create more fulfilling relationships.

Some of the specific topics we explore include:

Does porn cause erectile difficulties?
How can insecure relationship dynamics play a role in erectile difficulties?
How does early attachment trauma affect sexual function during adulthood?
Where does performance pressure come from and how does it affect erectile function?
What are some of the benefits of sex therapy for ED?

You can check out Nazanin’s website to learn more about her work.

Got a sex question? Send me a podcast voicemail to have it answered on a future episode at speakpipe.com/sexandpsychology.

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The Kinsey Institute at Indiana University has been a trusted source for scientific knowledge and research on critical issues in sexuality, gender, and reproduction for over 75 years. Be sure to register for the Sex and Aging Symposium , which will take place on October 4, 2025.

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Credits: Precision Podcasting (Podcast editing) and Shutterstock/Florian (Music). Image created with Canva; photos used with permission of guest.