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Erectile Dysfunction Is Not Always Physical

If you're young and healthy, you're more likely to have sexual performance anxiety.

13/01/2017 4:09 PM AEDT | Updated 13/01/2017 4:12 PM AEDT
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The good news is that it can easily be treated.

In my practice, I see many young men who believe they have physical erectile dysfunction. They experience great fear every time they engage in sexual intercourse, especially with a new partner.

Most of these clients are healthy individuals who are not taking any medication or drugs. When I take their sexual history, I ask if they lose their erections when they masturbate and most say it usually only happens when they attempt intercourse.

Sexual performance anxiety occurs when a man anticipates a problem during the sexual act and, as a result, becomes anxious or panics while attempting to have sex.

After seeing so many men with these problems, I've come to the conclusion that most of them have acquired sexual performance anxiety. When I explain that they don't have any physical problems but have a psychological condition that can be fixed, they are very relieved.

Sexual performance anxiety occurs when a man anticipates a problem during the sexual act and, as a result, becomes anxious or panics while attempting to have sex. There are many other insecurities and questions that can occupy their minds: "Will I get hard enough?" "Will I keep it up?" "How will I compare to other guys she's been with?" "Will I last long enough?" "Will she tell her friends if I fail?"

All these thoughts can sabotage their performance and they end up losing their erections. This, in turn, exacerbates their anxiety and leads to feelings of sadness, disappointment, guilt and shame. A man's sexual performance is often perceived as synonymous with his identity and ability to be a man. Sex should be a pleasurable experience but it's very difficult when men have performance anxiety, especially when they are unaware of the reason and worry and suffer in silence.

The more this happens, the more these men lose their confidence. They may start avoiding sex or become so traumatised they stop having sex altogether. This cycle often continues until it is addressed. To break the cycle, they first need to admit there is a problem.

Once people understand the issues that cause the anxiety and how to reduce or eliminate it through psychosexual education, tips and techniques, the symptoms usually go away after one or two sessions.

It's important for men to be vulnerable and share the problem with their partner.

Loss of erection can also happen to men who have never had a previous problem. Even in a stable relationship, a single event can be a frightening experience and anticipating the possibility it may happen again can become a self-fulfilling fear. Men need to know that occasional sexual difficulties are normal and can happen to any guy, young or old, and that most healthy men occasionally experience erectile dysfunction or failure.

A major part of performance anxiety is the fear of what others are going to think of you. It's important for men to be vulnerable and share the problem with their partner. At the same time, the partner needs to be understanding, guiding and supporting the man by letting him know he can relax, take his time and let things happen naturally.

Unfortunately, some women and men can be tactless, often without realising how hurtful it is, by telling their partners this has never happened to them before or how well their former lovers performed. This only compounds the problem.

Young men also need to be aware that how they treat their health now can affect their sexual performance in the future. For instance, there is a strong link between smoking and erectile dysfunction due to limited blood flow. Smoking can cause hardening of the arteries and delicate penile arteries can be affected and damaged.

There are other important health issues contributing to erectile dysfunction:

  • Mental illness: stress, depression and anxiety can affect sexual performance.
  • Obesity: being very overweight can make men impotent, although with a change in eating and drinking habits this can be reversed.
  • Heavy drinking: too many drinks affects the ability to get an erection, even with the most desirous of intentions.
  • Drugs: party drugs and many prescription drugs can create huge problems.

As mentioned before, in most cases erectile dysfunction can be fixed with the help of an accredited sex therapist, which will lead to an overall happier sex life for men and their partners.

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