Erectile dysfunction (ED) is one of the most common sexual difficulties in men. Because the prevalence of it increases so much with age, ED is a sexual problem that most people tend to think of as having a biological basis, thus necessitating biological treatment (e.g., Viagra, or other ED medications). However, such a view of ED overlooks the important role that psychology plays in this sexual difficulty. Indeed, research has found that a wide range of psychological variables can trigger and/or exacerbate ED, from depression to poor body image to stress. In this article, we will take a look at one specific psychological risk factor for ED that, to date, has received relatively little empirical attention: early childhood attachment disruptions.

Decades of research in psychology have revealed that human beings have an attachment system that is shaped by early childhood experiences with caregivers. The availability and responsiveness of our caregivers contributes to the development of either a secure or insecure attachment style (i.e., a pattern of relating to others). Attachment styles are relatively stable across the lifespan and, as people enter adulthood, they come to be strong influences on how we develop and maintain sexual and romantic relationships. For instance, as discussed in other articles on Sex and Psychology, attachment styles are related to the types of partners we find desirable as well as the content of our sexual fantasies.

In light of the important role that attachment patterns play in shaping our sexuality more broadly, researchers have hypothesized that they might also be related to certain types of sexual difficulties. Specifically, when an early event happens in childhood that disturbs the development of a secure attachment style, that could have potential ramifications down the road for the development of sexual problems. A recent study published in the Journal of Sexual Medicine provides some support for this idea.

In this study, researchers examined the histories of 46 men aged 22-47 who visited a clinic in India for what were determined to be psychologically-induced cases of ED. Each man completed an interview in which he was asked questions about childhood events that are likely to produce difficulties in developing a secure attachment style (e.g., losing a parent before age 10, parental alcohol or substance abuse, parental divorce or separation, parental suicide, etc.).

Results revealed that close to half of the men (43.5%) reported at least one attachment-disrupting event during childhood. Most commonly, this involved parental alcoholism or severe marital discord among one’s parents, with a few reporting parental death or suicide.

Compared to men with ED who reported no attachment-disturbing childhood events, those who experienced such events reported an earlier onset of ED, more sexual performance anxiety, and a much greater likelihood of being single. Thus, having a history of attachment-disturbing events seemed to be related to the most severe cases of ED, as well as greater difficulty establishing relationships.

Of course, we should avoid drawing too many conclusions from such a small study of retrospective self-reports. We must also keep in mind that this study is limited in what it can tell us because there wasn’t a non-ED control group. As a result, we do not know whether attachment-disrupting events are more common among men with ED than they are in the rest of the population.

Nonetheless, the results of this study suggest that there may indeed be a link between disturbed attachment processes in childhood and erectile dysfunction in adulthood that is worthy of future research. In addition, it would be worth exploring the extent to which attachment disruptions might be precursors to so many of the other psychological variables that have been linked to ED (e.g., depression, anxiety), because it remains possible that there is a common cause uniting many of them.

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To learn more about this research, see: Rajkumar, R. P. (2015). The impact of disrupted childhood attachment on the presentation of psychogenic erectile dysfunction: An exploratory study. The Journal of Sexual Medicine.

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