How do you know if it's erectile dysfunction or performance anxiety?

There is a test: http://www.issm.info/sexual-health-qa/what-is-the-nocturnal-penile-tumescence-npt-test
You can do a simple test at home with a strip of stamps around the base of your penis when you go to bed at night. You could also tape together a snug ring of tissue paper. Obviously, the electronic monitor would give much more information.

 

I think if you're with a woman you really desire physically, little will stop you from being able to get a good erection and orgasming with her other than being shitface drunk with whiskey dick.

 

It would certainly be nice for men if that were only true. ED is real, and so is performance anxiety, but you don't wake up hung over, just depressed.

 

Why don't you stop watching porn and see if it fixes the problem? If it does not then you can proceed onto other avenues and maybe seek treatment for anxiety? The only way to know if you have PIED is to stop using porn.

 

Understandable! Good luck to you.

 

As others pointed out: physiological issues can be ruled out when you are principally able to maintain an erection. To be completely sure, you can have yourself checked for testosterone levels, diabetes, or other physiological issues.

Regarding the psychological causes on the contrary, it's still difficult to nail the exact cause. Maybe others can confirm that - in case of psychologically caused ED - there is a variety of issues that can effectively result in ED without a single one discernible cause.

Just out of my head,

• performance anxiety, i.e. the fear of failing and not satisfying the expectations (as you mentioned)
• fear of intimacy (i.e. fear of rejection and being vulnerable)
• a little bit twisted: fear of joy and success (this is a thing at least according to one psychologist whose books I read)
• paralyzing inhibition, fear of "letting go" (a bit similar to the awkward feeling, when everyone's dancing to the music but I just can't and rather sit down somewhere quietly in a corner)

It doesn't have to be anxiety, however. If I may speculate, there's is a barrier to real sex for me, built up by my masturbation habits. Actually having sex (penetration) competes with my treasured fantasy of satisfaction through masturbation. Masturbation gives me satisfaction while protecting me from getting rejected or hurt, like an old wound that I never cleaned and thus it never heals.

This protective mechanism with all it's consequences (PMO) now protects itself from being replaced by the real thing.