Psychogenic ED and the Autonomic Nervous System: What the Research Actually Shows

This article previously described things the study cited as evidence did not address. It was rewritten in August 2026.

Erectile dysfunction in which tests find no abnormality in blood vessels or nerves is called psychogenic erectile dysfunction (psychogenic ED). This article was originally written around the premise that chewing could correct the autonomic nervous system imbalance underlying psychogenic ED. The study cited as evidence does not mention chewing at all.

Below, we separate what that study actually measured from what the article had added on its own.

What the Cited Study Actually Measured

Hypothalamic-pituitary-adrenal axis activity and its relationship to the autonomic nervous system in patients with psychogenic erectile dysfunction | Frontiers in Endocrinology https://doi.org/10.3389/fendo.2023.1103621

This is a cross-sectional study comparing a group of patients with psychogenic ED to a healthy control group. The following differences were reported between the two groups.

• Heart rate variability (HRV): The LF/HF ratio, considered an indicator of sympathetic nervous system activity level, was elevated in the patient group.
• Parasympathetic indicators: The HF component and pNN50 were lower in the patient group.
• Stress: The psychological stress evaluation score (PSS-10) was significantly higher in the patient group (17.44 vs 13.97, p<0.001).
• Cortisol: None of the cortisol measures differed significantly between groups (CAR AUCi p=0.744, CAR AUCg p=0.972, diurnal AUCg p=0.970, DCS p=0.784).

The authors conclude that the stress response in these patients is characterised by autonomic imbalance rather than HPA dysregulation. Although the HPA axis appears in the title, this is not a study that found HPA overactivity.

This is as far as this study can take us.

And this study is a cross-sectional study. Because it only compared the two groups at a single point in time, this design cannot distinguish whether autonomic nervous system imbalance caused the ED, or whether the ED and the anxiety accompanying it produced the autonomic imbalance. This article previously stated that “the disturbance of autonomic balance functions not as a ‘result’ of ED but as a direct ‘mediator.’” This study does not determine that direction of causality.

What This Article Had Added

Here are the passages that were removed.

The act of continuously chewing food or gum at a constant tempo and intensity (rhythmic chewing) … applies inhibitory feedback (a brake) to the HPA axis, which has fallen into an overactive state.

It physically reduces the excessive secretion of blood cortisol and other hormones caused by continuous stress.

It sedates the abnormal excitement of the sympathetic nervous system and relatively restores parasympathetic nervous system activity.

These were presented with the opening phrase “from numerous past neuroscientific findings,” but no specific study was named. The cited study does not mention gum or chewing, so at minimum it did not come from there.

The heading phrase “the strongest non-pharmacological approach,” which the article used, has also been removed. Without a comparative trial, there is no basis for calling it the strongest compared to anything else.

We also removed the passage stating that GLP-1 secretion from chewing improves insulin resistance and “fundamentally reduces the risk of developing obesity, hypertension, and arteriosclerosis.” The GLP-1 study this site cites is an unpeer-reviewed report on mice, and it did not track a reduction in arteriosclerosis risk in humans.

So What Can Be Said About the Relationship Between Chewing and ED

Within what this article can cite, nothing can be said.

There are studies addressing whether chewing has some effect on the autonomic nervous system, but this site has not been able to confirm a study connecting that to improvement in psychogenic ED. What bridged the gap was not research, but the speculation of this article’s writer.

It is true that the relationship between stress and the autonomic nervous system, and the relationship between the autonomic nervous system and ED, have each been reported separately. But the existence of these two relationships does not mean that inserting chewing at one end will produce an effect at the other end.

If You Have Symptoms That Concern You

Erectile dysfunction involves multiple factors, including diabetes, dyslipidemia, hypertension, arteriosclerosis, medication side effects, and depression. Do not self-diagnose it as psychogenic; consult a urologist. When an organic cause is behind it, ED can be its first sign.

This site introduces research on chewing and has not been reviewed by a medical professional.

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This article is intended for informational purposes only and is not a substitute for diagnosis or treatment.