Precarious Manhood Beliefs are Positively Associated With Erectile Dysfunction in Cisgender Men

Background: The notion that manhood status is hard to earn, easy to lose and needs to be proven via public action is termed Precarious Manhood Beliefs (PMB). Since PMB is a new concept, it is entirely unclear whether and how PMB relate to erectile dysfunction (ED) in cisgender men. The ability to achieve an erection is often still considered a cornerstone of masculinity, which is why sexual performance can be a proof of one’s masculinity. ED, on the other hand, can be understood as sexual failure and a threat to a man’s masculinity and sense of adequacy.Methods: In an anonymous online survey focusing on men’s mental health conducted in German-speaking countries of Europe, 507 cisgender men (Mage = 44.2, SDage = 15.2) completed measures on PMB, sexual function, self-stigma, social desirability, and conformity to traditional masculinity ideology (TMI). Applying multilinear regression analysis, stepwise introduction of relevant covariates was used to elucidate potential associations between PMB and ED.Results: Of the 507 men, 63.1% reported an increased risk for ED based on previously established cutoff points. Strong PMB predicted reduced sexual and erectile function in all models, even when relevant control variables such as age, education, self-stigma, social desirability, or conformity to TMI were introduced. Group comparisons revealed that men suffering from ED show stronger PMB but not elevated levels of self-stigma nor TMI than men without ED.Conclusion: PMB are significantly associated with ED, suggesting that stronger PMB may lead to increased tension to perform sexually resulting in increased psychological pressure and a higher risk to develop ED. However, whether PMB are more cause than effect of ED needs further investigation.