Anxiety plays a major role in the development of the problems associated with erectile dysfunction (ED). Psychological and behavioural responses to ED can lead to a vicious cycle of increased uneasiness, distance and conflicts. This in turn leads to a lower frequency of sexual encounters, less time spent together and lack of communication between partners in a relationship. In this review, methods to decrease sexual anxiety are discussed. Primary care psychosexual counselling including a detailed explanation of ED, reassurance to the patient and proposal of a solution for ED are outlined. A multidisciplinary approach to ED therapy is recommended using psychosexual counselling in conjuction with pharmacotherapy.