Anxiety and depression are among the most common psychological triggers for erectile dysfunction (ED), and their impact is particularly significant in urban settings such as Riyadh. While ED is often associated with physical health problems, psychological factors can play an equally important role, either independently or in combination with underlying medical conditions. Understanding the ways in which anxiety and depression influence sexual function is essential for men seeking to manage erectile dysfunction effectively. The Role of Anxiety in Erectile Dysfunction Anxiety can manifest in many forms, including generalized anxiety, social anxiety, and performance anxiety, all of which can contribute to erectile dysfunction. Performance anxiety is particularly relevant in sexual contexts. Men who fear they may fail to achieve or maintain an erection often experience a cycle of worry that inhibits arousal. In Riyadh, where societal and cultural expectations regarding masculinity and sexual performance may place additional pressure on men, performance anxiety can be amplified. The fear of embarrassment or disappointing a partner can make sexual activity stressful rather than enjoyable, further reducing the ability to achieve an erection.