Sex can be very complicated. It involves your emotions, your hormones, your past experiences, your expectations and, yes, your psychology. So, of course, it’s possible that a man struggling with erectile dysfunction may be dealing with other emotional and mental issues that are compounding the problem.

Here’s a depressing statistic for you: In 2014, the U.S. Travel Association found that 41 percent of Americans did not plan to use all the paid time off they received from work.

On the face of it, this is incredible information. It means that millions of Americans, knowing full well that they have days available to them in which they could literally be paid for doing nothing do not take advantage of them.

But let’s be real. We know why so many Americans don’t use all their vacation time. It’s because we’re a nation of workaholics, in which our office productivity frequently comes before our families, our communities and our own sense of wellbeing.

Here’s another depressing statistic: One in four American men is suffering from low testosterone levels (known as Low T) and the problem is only getting worse.

Now, there’s no way of knowing for sure how much—if any—of America’s decline in testosterone and increase in work is linked, but here’s what we do know: High stress releases a hormone called cortisol, which is associated with low testosterone. Researchers don’t completely understand the links between stress and Low T yet, but a few studies do suggest that they are linked. A study from the Journal of Physiology found that male guinea pigs with high levels of cortisol relaxed significantly after they were given hormone therapy.

Now, guinea pigs don’t have jobs, but high stress environments to activate your brain’s “fight or flight” mode, which releases cortisol. Simply put, if you’re working too much, you’re stressing yourself out. And if you’re stressing yourself out, your testosterone may take a hit.

Low T can be tied to any number of unwanted symptoms in a man’s life, including low sex drive, low attention span and even depression. Low T can also be tied to a decrease in muscle mass and bone density, and an increase in weight gain. And, of course, Low T has a lot of correlations with the dreaded erectile dysfunction.

However, even if your ED is all in your head, that doesn’t mean the cure is all in your head. Men get this idea that erectile dysfunction is being mental, and so they spend years trying to get over something psychologically that could be very easily fixed medically.

Even if your erectile dysfunction does have its roots in a psychological issue, the longer you attempt to deal with it, the more your body will deteriorate from disuse. Your body is going to need treatment for ED no matter what the root cause is, and the sooner you take charge and seek real, professional treatment, the faster you’ll be back in the game.

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