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The Heartbreak of Male Performance Anxiety

I get a dozen or so messages a month on this topic. I’ve written about it in numerous postings and spoken about it in several podcasts, but still the email comes.

One of the real bugaboos for anyone, regardless of gender, is living up to our own expectations of sexual performance. So many things can get in the way, literally and figuratively, of fully enjoying ourselves and/or pleasuring our partners.

The arousal stage of our sexual response cycle is particularly vulnerable to a disruption. And when there’s trouble there, there’s no hiding it. A limp dick or a dry pussy can put the kibosh on all festivities that we may have hoped would follow.

However, performance anxiety can strike any of us, regardless of age, and at just about any point in our sexual response cycle. This is a particularly galling when it seems to come out of the blue. And regaining our composure can be more far more difficult than we imagine.

Today we will be focusing on male performance anxiety.  I’ll address female performance anxiety at a later date.

Here’s Bob, he’s 26:
Doc, this has never happened before. But I couldn’t get it up tonight, and this chick was H.O.T. Now I’m not gay at all, but I haven’t had sex in about 3 years because I was locked up…so I masturbated pretty regularly, about 3 or 4 times a week. But I can’t figure out why I was soft… the only thing I can think of is I ate clams tonight and I’ve never had them before. Could it be that or should I get checked out?

It weren’t the clams, darlin’! And I don’t think you need to get “checked out” either…at least not right away. If you could back away from the situation a bit and stop freaking out, I think you’d discover the source of your problem all on your own.

Here’s the thing—while you were out of commission there in the slammer, you relied, as you say, on jerking off. Okay, cool. We all do what we gotta do. Now the first time you try to score after your release…you go soft. This tells me you have a mild case of performance anxiety. We all get that from time to time.

There’s probably nothing wrong with you or your johnson. You just got the jitters first time you tried to get you some after being away, that’s all.

The anticipation of boning this H.O.T. chick—fueled by some predictable self-consciousness; what with just getting out of the big house and all—pulled the plug on your wood. No surprise there, right?

What I don’t want to see happen is for you to replay the incident over and over in your mind’s eye til that’s all you can think about. If you do, this proverbial molehill will become a mountain. You’ll then bring all this anxiety to your next encounter, setting yourself up for even more disappointment. You can see how this shit can snowball? If you interpret every less than satisfying encounter as a failure, your fears will become self-fulfilling. You’ll begin to avoid partnered sex and you’ll develop a full-blown sexual dysfunction. And your self-esteem will take a nosedive, too.

If you’re preoccupied with your performance, it’s less likely that you’ll be fully present during sex with a partner. This pretty much fucks up your sexual responsiveness and any hope for spontaneity. Why not just relax into the whole sex thing and not try to prove your manhood with your pecker?

Then there’s Steve with a slightly different take on this meddlesome problem:

My partner and I have been together for just over 3 years now in a monogamous relationship. I am the top and he the bottom. Our problem is not premature ejaculation on his part, but his inability to have an orgasm at all. No matter what I try and even if he masturbates, sometimes it is impossible to get him to cum. Is this a medical issue? Have you ever heard of this?

Delayed ejaculation is the difficulty one has ejaculating even with a firm erection and sufficient sexual arousal and stimulation. This problem is not uncommon. For most men, delayed ejaculation occurs during partnered sex more frequently than while masturbating. In fact, 85% of men with delayed ejaculation can usually cum by jacking off. However, in partnered sex, the guy may be unable to ejaculate at all, or only after prolonged partnered stimulation. This problem can be very frustrating and cause distress for both partners involved, as you already know.

What causes delayed ejaculation? Well, it could be a number of things. It could be something as simple as performance anxiety, or inadequate stimulation, or there could be neurological damage.

I don’t want to be too reductionist here, but most of us experts believe that the majority of instances of delayed ejaculation aren’t physical in nature, but rather are the product of psychological concerns. Simply put, there’s a difference between the psychosexual response we have when we are alone and the one we experience with a partner. There’s probably nothing wrong with your partner’s unit. It’s all in his head…or his mind, to be more exact. If I had to guess, I’d say he’s got a real bad case of performance anxiety.

When I see this sort of thing in my private practice, I always begin the therapeutic intervention by calling a moratorium on fucking of any kind. This immediately takes the pressure off the couple. From there we begin to rebuild the partnered psychosexual response one step at a time. We begin with sensate focus training (Sensate Focus is a series of specific exercises for couples that encourage each partner to take turns paying increased attention to their own sensations. More about these helpful exercises in the weeks to come.), stress reduction and relaxation exercises. These applications are designed to reduce performance pressure and instead focus on pleasure. The idea is to get them to stay in the moment; absorb the pleasure present without worrying about what is “supposed” to happen.

Finally we address as frankly and openly as possible any fears or anxieties that they may have—as individuals or as a couple. I have the greatest confidence in this method; it succeeds over 90% of the time.

Ok, let’s recap shall we?

Overcoming sexual performance anxiety is dependent on five simple things.

  • First, a guy needs to be attuned to his sexual response cycle — arousal, plateau, orgasmic and resolution phases. He should know what kind of stimulation he needs at each phase to fully enjoy himself and satisfy his partner.
  • Second, the more worried a guy is about a performance issue, the more likely that problem will present itself. A bad experience in the past can often set the stage for its recurrence.
  • Third, don’t be afraid to talk this over with your partner. Withdrawing from your partner or shying away from sex altogether will only increase the likelihood that the problem will persist.
  • Forth, be proactive! Fearing the loss of your sexual prowess or feeling sorry for yourself is counterproductive. Confront the challenge head on. Employ sensate focus training stress reduction techniques and relaxation exercises to help you push past this temporarily impasse and regain your self-confidence.
  • Fifth, free yourself from the mindset that your dick is the center of the universe. Your manhood or your capacity to be a great lover does not reside in your genitals. Expand your sexual repertoire. Remember, pleasure centers abound in your body as well as your partner’s.

Good luck!

Parts is Parts!

Name: Charles
Gender: male
Age: 47
Location: Northridge CA
I’ve heard a lot about checking your balls for possible problems — but none ever say what lumps you have naturally. At the low point of my testacles I feel a lump (I would explain it as an area that would feel more or less like a cracked egg, you have that part that is globules and is string-tethered to the yoke. Is that exactly what’s happening? Should you feel any pain if you squeeze it — especially trying to figure out if it is a lump or not?

My friend, I’m clever as all-get out about lots of things, but the lump on your balls ain’t one of those things. I’m not a medical doctor; I don’t even play one here on the internets. And I can assure you, no reputable doctor anywhere would hazard a guess about what you present without first seeing you in person. That’s just good medicine.

That being said, I applaud you taking note of your balls in an inquisitive sort of way. Good for you! But you should also have at least a rudimentary understanding of your testicular anatomy. So that when you do your self-exam, you can have some sense about what it is you are examining. To this purpose, I offer the diagram to the right. Is there anything in the diagram that looks even remotely like what you are feeling in your ballsack?

Finally, if you have a concern about what you think may be an abnormality, isn’t it high time for you to high tail it to a doctor for a look-see?

Good luck

Name: Tom
Gender:
Age: 18
Location: New York
Okay so I’m not sexually active yet so I’m not in a rush to solve this but I just had a question for you. Is it possible to have too much foreskin? I mean even when fully erect the skin still overhangs by like 1 quarter inch or so (never measured so not exact). So a few times I’ve tried to do it by hand and yet still it doesn’t fully go back and gets to a point that it starts to hurt and I can’t continue. So do I probably have to get cut some day or something? Also what if I decided not to get cut would this cause problems, just asking because if I didn’t have to go in and get cut I’d prefer that but you gotta do what you gotta do. Well thanks for the help.

Too much foreskin? Never heard of such a thing!

That being said, it does sound like you have been blessed with an abundance of lace curtains. What’s also obvious is that you’ve yet to learn how to manage a foreskin…particularly a wild and unruly foreskin, like yours.

Phimosis, or tight foreskin, can be a real pain. But stretching, not circumcision, is the cure for all but the most severe cases. I’d be willing to guess that you’ve never been taught to stretch your foreskin to make it more elastic, right? Alrighty then, let’s start with a few stretching exercises.

Exercise 1 — While you’re dick is soft; retract your foreskin as far back as you can. Work two fingers in under your hood till you can touch the head of your dick. Now attempt to roll your hood forward and over your fingers. It’s like docking another dick, only you’re using your fingers. This exercise depends on you having your fingers inside your foreskin for it to be effective. In time you’ll be able to add three fingers, instead of just two. This will stretch your skin to the point you’ll be able to easily retract it over your erect dick head.

Exercise 2 — Grab each side of the foreskin opening and gently pull each side apart. Stretch the opening till it’s stretched with a tension you can tolerate, but not actually painful. Hold for a count of 10 and release. Repeat for 5 sets of 10 pulls per day, more if you can handle it. Here’s a tip, these stretches are best done after soaking in a warm bath or a long hot shower.

Exercise 3 — This is a variation on exercise 1. Insert a smooth cylindrical object into your foreskin opening, like the cork from a wine bottle. This object needs to be just large enough to stretch the skin without pain. Once inserted, leave it there for as long as you can during the day, or for over night. As your foreskin stretches you want to swap one object for another with a larger diameter. If a wine cork is too big to start with, consider a smaller smooth wooden or plastic dowel. You can find these sorts of things at the Home-O Depot. You might need to use a bit of surgical tape to keep these stretchers in place.

These exercises may sound a bit invasive or uncomfortable, and perhaps they will be at first. But they’re nothing compared to getting cut as an adult. In a short period of time you will achieve the success you are looking for. Remember, properly caring for your foreskin will insure that you’ll be able to keep this amazing piece of your anatomy. So that when it’s time for you to become sexually active it will work flawlessly and exponentially increase your pleasure.

Good luck

LORDY, LORDY, LORDY!

Hey Dick!
As you know, I am an escort. My business is doing very well. In fact, so well I need to ask if you know of any meds, besides Viagra, that I can take that will help me maintain an erection over a longer period of time?
Can I be frank? Here’s the deal, let’s say I have I have two one-hour clients during the day. Then a regular of mine calls and wants an all-nighter. That’s not a problem other than the fact that this particular client wants to get fucked hard. I mean real hard, for hours at a time. He’s an insatiable power bottom.
I want to be able to ride his ass, like the bitch he is. Hell, I’m even attracted to him. I just can’t stay hard enough to fuck him like he likes (especially after having had the two clients before him that same day). Sometimes I have difficulty getting it up for him, and wind up finger-fucking him till my hand is sore. I do not want to lose this client. And shifting days is not the solution. Because when he wants it he wants it and I have to produce. That’s what I do, I sell “muscle.” I have a reputation for giving the best hard driving, dominating and controlling sex around.
Again, is there a medication I can take to maintain the erection?
— Works Hard

Dear WH,

Your life reads like a cheap porn movie script. Lordy, the good doctor nearly got the vapors simply reading through your very explicit missive. (As you can see, I had to edit out some of the more gory details so I could protect your identity in this public forum.) Of course, as you suggest, it never hurts to advertise. You’re so bad!

I thoroughly understand the pressures you and other sex workers face. It’s not as glamorous a life as it is often portrayed, huh? Ok, so you’re beautiful, men idolize you and crave your attention. You’re getting loads of sex, putting all those “bitches” in their place, and crying all the way to the bank to boot. It’s a tough job, but someone’s got to do it. But then again, there are all those sniggling performance issues that even a he-man like you must contend with.

The trouble lies in the fact that you are a workaholic. And that’s never good, regardless of the work one does. Sex work, like any other work, will burn you out if you’re not careful. If you don’t learn to pace yourself, darlin’, you’ll fizzle. (How’s that for an appropriate euphemism?) And from what you tell me, this is already beginning to happen. Keep it up (no pun intended), and you won’t be the first causality in this line of work, nor will you be the last. But If you ask me, and I happen to know a little something about sex work myself, the object here is to grow old (or older in your case) in your chosen profession.

I’m tellin’ ya, WH, if the erectile burnout don’t get ya the psychological torment will. I’ll bet you’re terrified the word will get out that Mr. Big-Beautiful-29-year-old-Stud-Power-Fucker can’t get it up. That would be real bad for business. And you know how those johns can gossip. Bitches! They don’t know that you’re servicing men at a rate that would make a superhero blush. All they see is limp willie and that spells trouble right there in River City.

It’s not surprising that you are having erection concerns given the number of clients you are seeing in one day. I mean, girlfriend, when do you find time to eat? You don’t need a new med, you need a vacation. If Viagra and a good cock ring don’t do the trick, then, in my humble opinion, your body is telling you to slow the fuck down.

And here’s another tip; research is beginning to show that prolonged and persistent use of Viagra can have some very unpleasant side effects. Those who overuse this potent cardiovascular drug, particularly young men who use it recreationally, may be in for some very unpleasant surprises down the road. So, I have one simple suggestion, WH, have a care about your sexual wellbeing and treat your dick gently. Despite the pounding you can inflict with it, it is a very delicate mechanism.

Good Luck

What’s up with me, Doc?

Can we talk about sexual orientation for a bit? I sure hope so, because I’m gonna go ahead and launch into it here, if you’re ready or not.

Among the load of email I get from the sexually worrisome in any given week, I will predictably get a handful of questions, mostly from guys, who are concerned that they might get gay.

The guys writing in are concerned enough by something that is going on inside of them that they’re compelled to broach the issue with me. I hasten to add that rarely are these communications the “Gee, I’m Mildly Curious” type. Rather they’re more likely to be the “Oh My God, What Wrong With Me?” type. They fear that they picked up queer cooties somewhere and their undies are all in a twist fearing they are scared for life. Ya know, kinda like the pox.

Then there are those who write in wanting to me to make sense of their sexual ramblings. They’ve been playing on both sides of the fence, so to speak; and they want me make the call. My response to each group of correspondents is virtually the same — for most of us sexual interests and behaviors are way more fluid than we care to acknowledge. For example, here’s young (20-year-old) Mel.

My first sex was with a guy, and then I got plenty of sex with girls. Then there was the time that I got fucked, it hurts on the first time but as it continued it started to feel tickly and I started to enjoy it. But I still like to have sex with girls. What do you think I am really?

What do I think you are, REALLY? Why would you want me, a total stranger, to offer an opinion on who you REALLY are? I mean, REALLY!

I gather you want me to weigh in on your sexual orientation, right? Well from the bit of information you give me, I’d say you’re able to swing both ways. And that’s a good thing, at least in terms of getting a date. You have it way over all the other folks who acknowledge being interested in only one gender.

Listen, all human sexuality is on a continuum. Have you ever heard of the Kinsey 0-6 scale? The dean of American sex research, Alfred Kinsey, his associate, Wardell Pomeroy, and their colleagues developed this scale as a way of classifying a person’s sexuality in terms of both behavior and fantasy.

This is what they developed.

0 represents an exclusive heterosexual person, who has no homosexual behavior or fantasy.
1 represents a predominantly heterosexual person, who may have incidental same sex feelings — most likely in fantasy only.
2 represents a predominantly heterosexual person, who has more than incidental same sex feelings and experience — fantasy for sure and probably behavior too.
3 represents an equally heterosexual and homosexual person, one who enjoys both other and same sex behavior and fantasy.
4 represents a predominantly homosexual person, who has more than incidental other sex feelings and experience — fantasy for sure and probably behavior too.
5 represents a predominantly homosexual person, who may have incidental same other sex feelings — most likely in fantasy only.
6 represents an exclusively homosexual person, who has no heterosexual behavior or fantasy.

These pioneering sexologists also discovered that an individual can, and often does move around on this scale at different periods in his/her life. So if you really want to know what you really are, look to both your fantasy life and your actual behaviors and make your call with that information. Just don’t be overly surprised if you find that you shift from one position to another as you grow into you sexuality.

Good luck!

To elaborate on what I just said to our young friend, Mel, I’m going to go all egghead on you. Because there is a body of sexual research that underscores just how complex this whole issue is.

For example, did you know that a recent study discovered that gay men and straight women have similar brain organization? It’s true!

Researchers in Sweden found that gay men and straight women share some characteristics in the area of the brain responsible for emotion, mood and anxiety. Brain scans also showed the same symmetry among lesbians and straight men. These findings were published in the prestigious journal — The Proceedings of the National Academy of Sciences.

The researchers quickly added that their study couldn’t determine whether the differences in brain organization were inherited or due to exposure to hormones, such as testosterone, in the womb. They were also unable to conclude if brain organization is responsible for sexual orientation.

Numerous other studies have examined the roles genetics, biology and environment play in sexual orientation. But little evidence exists that any one factor in particular plays the all-important primary role. This leads most scientists to assert that both nature and nurture play a part.

To make matters worse, some research contradicts other research, and some promising findings never pan out. (Did you know that there was once a belief that male homosexuality and finger length might be linked? Another, later discredited claim, suggested that gays have distinctive fingerprint ridge patterns.) And researchers never agree on how to interpret results even when they find a likely correlation.

Here are some fun facts you might find interesting.

• A study of 87,000 British men published in 2007 found that gay men have more older brothers than straight men do. Only big brothers count. And lesbians don’t show such patterns.

Ray Blanchard of the University of Toronto, an expert on the “big-brother effect” says that each older brother will increase a man’s chances of being gay by 33%. That’s not as dramatic as it might sound. A man’s chance of being gay is pretty low to begin with — perhaps as low as 2%. So having one older brother only ups the chance of being gay to only about 2.6%.

Curiously enough, this “big-brother effect” holds true even for gay men who weren’t raised with their older brothers. This leads researchers to believe the key to understanding this is in the mother’s womb. After giving birth to a boy, a woman’s immune system can create antibodies to foreign, male proteins in her bloodstream. Subsequent sons in the womb could be exposed to these “anti-boy” antibodies, which might affect sexual development in the brain. How freakin’ amazing is that?

• The hand you use to sign your name might have something to do with what gender you are drawn to.

An study containing more than 23,000 men and women from North America and Europe in the year 2000 found that being non-right-handed seems to increase a man’s chances of being gay by about 34%, and a woman’s by about 90%.

Again researchers guess that different-than-normal levels of testosterone in the womb — widely theorized to play a role in determining eventual sexual orientation — could nudge a fetus toward brain organization that favors left-handedness as well as same-sex attraction.

• If exposure to testosterone in the womb influences sexual orientation, scientists reckon that straight and gay people would differ in body parts strongly affected by testosterone, such as a guy’s cock.

Here we get back to Alfred Kinsey’s groundbreaking work. Researchers at Brock University in Ontario reviewed the data on 5,000 gay and straight men collected by Kinsey and his associates from the 1930s to the 1960s. Their results, published in 1999, showed that gay men had longer, thicker penises than did straight men. On average, about 6.5 inches long and 4.95 inches around when erect, versus 6.1 inches long and 4.8 inches around for straight men.

Again, no one can actually say for certain what this means. One guess is that some male fetuses are exposed to a unique mix of hormones in the womb. Testosterone levels might spike early, causing enhanced penis growth, then drop off later in pregnancy — leading to some feminine characteristics.

As you can see, there’s a still a lot of work to be done in this field. The next frontier looks to be in the subtle differences in how gay and straight brains navigate new cities, respond to erotic movies and react to the scent of sweat and urine.

Stay tuned!

It ain’t necessarily so!

Podcasts will resume on Monday, September 6th.

Name: Tomasz
Gender:
Age: 64
Location: Budapest
Are there any vitamins or minerals that will increase the amount of ejaculate? Thanks…your site is very nice and provides a great service!

Why, aren’t you a sweetheart, Tomasz! Thank you for your kind words.

There are loads and loads of companies out there who claim to have products that will increase the volume of a man’s ejaculate. But when I search the web for products that promote male sexual enhancement, or potency, or whatever; I do so as a skeptic. That’s how everyone should go about such a search. If you keep your eyes open and look beyond the pseudo-medical babble you’ll discover two very important things, just like I did.

First, every site I visited advertises their product as a miracle medical breakthrough. Often there is a testimonial or two from some doctor (MD) or doctor (Ph.D.) who substantiates the claims being made. We never really discover who these professionals are, but we are encouraged to take their words as gospel. Why? Well because we all know that professional people would never knowingly try and hoodwink us. Exactly! And if you buy that we have some swampland in Louisiana for ya.

Each site also claimed that the product they hawk has undergone rigorous clinical studies proving its efficacy. But they never actually cite any of the studies in question or where these supposed studies were published. Here’s a tip, if there is a sited study and that study was sponsored by the company that produced the product, or is published by them, then you know you’re in trouble.

Second, inevitably the manufacturers of these products make the most outlandish claims. Take this one for instance. I’ll not disclose the product’s name, but this is actual promotional copy from one site. It says, Product X will…

  • Intensify ejaculatory contractions due to the strengthening of the vas deferens muscle (the muscle responsible for the expulsion of semen)
  • Increase volume of released ejaculate
  • Produce faster recovery for second orgasms
  • Improve semen quality
  • Produce more satisfying orgasms due to increased contractions and ejaculate
  • Improve prostate health
  • Improve Erectile Dysfunction caused by diabetes
  • Increase sexual well-being and vitality
  • Cure cancer
  • End world hunger

Ok, I made the last two up.

One has only to look closely at the claims to realize they’re hogwash. Besides, they don’t really tell us anything other than the product in question might somehow improve something that may have something to do with male virility. The same could be said about a glass of water.

Listen up…

The truth is, Tomasz, you can probably do just as well with a modest daily intake of a zinc and lecithin supplements. For some, these nutrients have a noticeable effect on the volume of ejaculate produced. And they’re a whole lot cheaper and easier to get then the trumped-up stuff you see online.

Keeping yourself hydrated will also increase the volume of your spunk. It just stands to reason, the more hydrated you are the easier and more efficiently all your glands responsible for secreting a watery substance, like your prostate and seminal vesicles, will have getting water from the bloodstream. If you’re dehydrated, your glands will not have as much water available, and subsequently you’ll spooge considerably less.

Good Luck!

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