Stress is one of the primary causes of erectile dysfunction, according to a leading sexual health expert.

Dr John Tomlinson, director of the Sexual Dysfunction Association, claims that men typically suffer due to a combination of psychological and physical factors.

Physical reasons for erectile dysfunction include diabetes, vascular disease, veno-occlusive disease and Parkinson's disease, as well as damage from surgery to the pelvic area. Frequently, however, there will also be psychological barriers to sexual fulfilment, driven principally by stress.

"The older the person, the more likely there is to be a physical cause," Dr Tomlinson said. "But in the younger man – I'm talking about under 50 – it seems to be on the whole a stress-related thing."

Anxiety and stress is particularly common among men in their 20s and 30s, he added, when nerves can play a part.

Erectile dysfunction is also something of a vicious circle, because knowledge of a physical problem almost inevitably leads to stress.

"Once you know there's a physical problem you get very anxious, start worrying about it and make it worse," he said.

Dr Tomlinson has insisted that erectile dysfunction among younger men is "extraordinarily common".

"If you've got a young guy with a young wife and small children and they're working hard and not getting much sleep, things tend to go wrong," he said. "For younger men, there are two common problems: one is relationship problems, they've fallen out of love with one woman and are interested in another, but then they can't perform with the new one - the problem of first-time nerves.

"The other one is someone who fails on one occasion and starts to worry whether they'll succeed the second time around – and then inevitably he'll fail because he's anxious."

The secret, he added, is to reassure the individual. "Very often, one tablet of one of these PDE5 inhibitors [such as Viagra] will give them the confidence to go on," he said.

On the other hand, Dr Tomlinson has observed that erectile dysfunction can be a sign that there are other underlying physical problems that need to be addressed. "Erectile dysfunction can be a warning sign," he said.

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