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The Heartbreak of Male Performance Anxiety

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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!

The Yin and Yang of Desire

Today I’d like to talk about: The Yin and Yang of Desire — Dopamine, Prolactin and Testosterone.

Let’s talk about love, lust and desire. But instead of looking at these things as social phenomena, let’s look at the chemical reactions going on inside our bodies that make us feel and behave the way we do.

sex-on-the-brainThere are clear links between certain chemicals and our most basic drives, which explains, for example, why we feel horny one moment and utterly disinterested the next. Or why our sex drive peaks after exercise. At the core of our sexual and affectional interests and behaviors lie the two chemicals — dopamine and prolactin. In many ways they are complimentary to one another; dopamine turns on desire and prolactin turns it off.

Dopamine is a neurotransmitter. This is basically your body’s pleasure and reward system. Our brains releases dopamine, to one degree or another, when we see, read or think about something sexy, taste something sweet, puff a cigarette, or come into skin-to-skin contact with another person. When dopamine levels are high, our libido goes into overdrive. Sometimes levels can be so dramatic that a person will neglect other essential bodily functions like eating and sleeping. Some “street” drugs —meth and coke among them — can mimic the body into thinking it’s dealing with dopamine.

Dopamine is critical to the way the brain controls our movements. If there’s not enough dopamine, we can’t move, or control our movements. If there’s too much dopamine, we are plagued with repetitive moments like jerking, tapping and twitching.

Get this; novel situations can increase dopamine releases. For example, hooking up with someone for the first time triggers especially high levels of dopamine. Curiously enough, these same high levels will not occur again during subsequent hookups with that same person. This is called the one-night-stand phenomenon; it’s why you can be attracted to someone at first encounter but not afterward.hormones and the brain

However, falling in love with someone can sustain high dopamine levels for a longer period of time. This explains why physical infatuation is at its peak in the beginning months of a relationship. Also dopamine floods the brain when we get drunk or take certain drugs, which is why drinking alcohol can make a potential partner look more attractive.

Prolactin is dopamine’s foil. It causes dopamine levels to plummet. Prolactin is a hormone, as opposed to a neurotransmitter, like dopamine. It floods the body during orgasm, virtually shutting down the sex drive, which is nature’s way of allowing us to attend to other essential bodily functions like eating and sleeping. Prolactin release in men will temporarily disable our ability to have an erection. This is called the refractory or recovery phase of our sexual response cycle. And prolactin is at least partially responsible for that happy, relaxed state after we cum. This is precisely the release women get while breastfeeding; in fact, the word “pro-lactin” directly indicates its role in milk production.

growing larger and largerProlactin primes the mind for long-term attachment — a role that helps the mother bond with her suckling child as well as lovers to each other. This means that if you stick around cuddling with your partner right after sex, you may actually start to like him/her more and more. This is called the pair-bonding effect. But prolactin’s dopamine-reducing action has a darker side. It cancels the tolerance you may have for your partner’s flaws.

While dopamine and prolactin are good indicators of the immediate workings of sexual pursuit, it is testosterone that best explains long-term changes in courtship. Testosterone is responsible for the masculinization of the adolescent male body during puberty. And it increases the dopamine levels that regulate our sex drive. But testosterone leaves its fingerprint on the body as much as the brain. It’s the catalyst for changes in skin tone, fat distribution, musculature and demeanor, which are signals to others that this individual male is sexually mature and in good health.

However, if you get a fever or become depressed, your testosterone levels can drop significantly. Malnutrition or high levels of anxiety or stress will also interfere with testosterone levels. The most immediate effect of this is a decrease in libido, and a noticeable drop-off in energy levels as well as confidence. There’s no doubt about it; testosterone levels will signal to potential mates that you are in the throws of depression, stress, anxiety or malnutrition. You will appear a little less attractive to people subconsciously. That’s why a confident, dominant male with high-testosterone levels generally enjoy more mating success.tits

Testosterone levels are highest in the morning, then wanes throughout the day. It’s also much higher in men in autumn and lowest in the spring.

However, sexual desire is still more complicated than is known to science, and there may be multiple archetypes of partners we’re drawn to — there is evidence that aggressive high-testosterone men appear sexier to women and gay men for a one-night stand. But softer, more sensitive balanced men are more likely to tug at our heartstrings in a relationship. Scientists reason that the bulkier mate is more likely to be physically powerful and carry good genes to create strong children. While the slimmer guy is a more loving, reliable partner likely to help raise the kids so they survive to adulthood. The effect of this strange contradiction seems to be a biological predisposition against monogamy and sexual exclusivity.

But none of this is carved in stone. A man’s hormone’s levels increase when he is in a competitive environment or carries out acts of aggression, which can explain how guys seem to bulk up quickly when they go to prison or join sports teams. These levels decrease when he feels intimidated or humiliated, which might explain why those who get picked on at school stay skinny and mild-mannered compared to their peers. This in turn made them easier targets and only increased the likelihood of them being bullied.

butt shakeThis is not uncommon behavior among primate colonies that have huge alpha males looming over a population of smaller, submissive males and females. While this is not a perfect parallel to human social groups, it does go a long way in explaining how a social environment can be a precursor to physical body changes. And just so you know, our testosterone levels also drop during long-term relationships, giving the male brain a sense of stability and mellowness, easing off the drive to forage for new sexual partners.

Science alone lacks a moral element, and fails to explain, in a modern context, why we should desire to be masculine, aggressive, potent or dominant in the first place. In nature, the alpha-male is the most likely to enjoy reproductive success, but that isn’t what gives our lives value today. We might have more success being an average male that falls in love and becomes a good provider. And in the modern world it’s probably the more stable and sensitive man who is most likely to sire children.

Still, science gives important clues to what’s going on in our minds and bodies and that of our potential partners. A lot of our basic inclinations are out of our control, but when we know what causes them or what to expect, we can work with them for the best outcome.

Mean Girl

Name: Fay
Gender: Female
Age: 23
Location: LA
I met this guy on the Internet and he seemed nice and all, but I wasn’t that turned on to him. All I remember is he was pretty nerdy and had really sweaty palms. We went out a couple of time, nothing serious. He just wasn’t my type. So I stopped responding to his calls. Last week I was out at this club with some friends and I saw Mr. Nerdy with this other chic. And I was like, wait a minute, that skank’s hornin’ in on my stuff! I know I wasn’t returning his calls, but still, I saw him first. It was like totally freaky, how they were all kissy-kissy right there in everyone’s face. What should I do?

mean girl

Seriously? What should you do? How about getting a life your vacuous twit? And I mean that in the nicest sort of way.

If you could just pull your head out of your ass for a minute and listen to yourself, your misguided notions about dating and your fundamental lack of respect for the feelings of others would surly grate on you as much as it does me. Your chatter is like fingernails on a blackboard. I mean REALLY!

Think about what you are suggesting here. You’re gettin’ all territorial about some guy you could barely bring yourself to give the time of day to and then blew off like he was excess baggage. You didn’t bother to take the time to look beyond his nerdy-ness and his sweaty palms, like this other woman have done. Had you, you might have discovered what this other “skank”, as you so lovingly refer to her, has found.

Like most nerds, this guy probably has developed other means of making himself attractive and interesting to compensate for his nerdy-ness. Maybe he’s got a big dick, or he’s great in the sack. Maybe he got a big bank account or maybe he simply has a handle on the basic social graces, something that you, my dear Fay, have yet to grasp.

Your jealousy is neither cute nor charming. It does, however, mark you as self-centered and childish. For the most part, jealousy is a byproduct of a person’s lack of self-confidence and self-esteem. Here’s a tip. Try and develop a healthier sense of self, so that you can mature into someone who can interact with others in a respectful manner that is befitting other human beings.

Oh, and have a nice day! Sheesh.

New Mommy Woes

Name: Megan
Gender: Female
Age: 29
Location: Toronto
I’m a new mother and this is my first child. He was born 3 weeks ago, but I am still enthralled with the miracle of it all. So far motherhood has been pretty wonderful. Sure I’m tired, but just holding my son in my arms makes me so happy I sometime cry with the joy. There is a problem, however, my husband wants to resume our sex life, but I have absolutely no interest. I love him dearly and I know I owe him this, but I have no libido. What can I do?

Yep, this is common enough complaint. This is precisely the place where new parents experience the most strain on their relationship. And when you think about it, it’s not all that surprising. Most new mothers are exhausted by the expectations of motherhood. And first babies are the most challenging. Added to these burdens her partner eagerly awaits the resumption of the sort of sex life that was in place before the pregnancy. New mothers often feel like their husband is just one more person to service, one more person with needs and demands that are keeping her from much-needed sleep.

New Mother LoveNew mothers can find sex unappealing for reasons both physical and emotional. If you’re breastfeeding, your breasts are sore, heavy, and leaky. Your body just doesn’t feel sexy, with its stretch marks, cellulite, dark nipples and dark line down the abdomen, not to mention the weight gain and varicose veins. Then there is lochia, the discharge after the birth, which lasts for 3 to 4 weeks and does not smell very good. If you had an episiotomy, the stitches are very uncomfortable and you may worry about infection. Your hormones may still be in a state of flux, so you feel moody or depressed. And you may not have a good method of birth control, so sex is the last thing on your mind!

Some doctors recommend that new mothers refrain from sex until their first post partum examination, usually about 6 weeks after the birth.NewMother

So if you and your husband weren’t warned about all this, you’re probably both totally unprepared. And if you can’t talk about it, there will be trouble ahead. Many new fathers labor under the misconception that once the baby is born, their sex life will return to normal. Besides this being completely unrealistic; it mostly puts pressure on the wife to do, as you suggest, her ”duty”. This is no way to pursue a sex life together.

Of course, new fathers can help their partner move beyond those feelings of sexual disinterest by being an involved parent and helping around the house.

There are loads of sex things new mothers can do that will pleasure their partner that don’t involve full-on fucking. Hand jobs and blowjobs are always welcome. Reading erotica aloud to each other can be fun. Mutual masturbation, or even watching him and cheering him on as he squeezes one out is also an option. But probably the thing that will get your libido back is a lot of touching, massaging, hugging, kissing, and snuggling and not as a prelude to sex, but just for the joy of it. These things, without the pressure to perform will help reestablish the pair-bond between you and your old man, which will inevitably lead to the long awaited fuckfest.

Good luck

The Great Porn War

Name: Jennifer
Gender: Female
Age: 23
I am 23 years old and I like lesbian and gay porn. It’s been my favorite since I discovered it a few years ago. But my boyfriend hates the thought of people of the same gender having sex. I don’t like hetero porn, and that’s all he uses. Is there any way I can get him to enjoy my kind of erotica?

porn.jpgYour boyfriend a dreadful drag, huh? What’s he afraid of, do you suppose? Ya think he’s afraid he’ll pop wood while he’s watchin’ gay porn with his girlfriend. That’ll surly to shake his masculinity to its foundation. I mean, it’s one thing for him to get a boner when he’s checking out the queer stuff by himself — and you know he does! It’s another thing all together for him to get hard watching two dudes fuck while he’s with you. It’s clear to me that your BF has issues, darling. And I think you know that too.

Now I’m not suggesting that he has to like everything you like, or that you have to like everything he likes. A couple can have a really healthy relationship despite differences in the kind of smut each prefers. But matters of taste aside, I think a smart chick, like you, knows that porn is as much a political statement as it is a sexual statement.

Here’s what I mean. Most straight porn features male identified sex — exclusively. That’s probably why you, and 90% of your sister women, don’t like it. The producers of most of the stuff in this genre create it with a predominately straight male audience in mind. And you can pretty much count on it exploiting women in the process. Gay porn does not exploit women, for obvious reasons and lesbian porn is the most radical of all. It is unabashed female identified sex. No female exploitation there. Of course, I’m talkin’ about real lesbian porn, not the caca that simulates girl-on-girl sex that gluts the “straight” porn marketplace.

Most straight males get off on hot girl-on-girl action in straight porn, because the performance represents male identified sex. In fact, one of my good gal pals in the porn business often says that girl-on-girl sex in straight smut is about as far away from authentic female sexuality as gay porn, which has no women in it. i just can't

I’m gonna go out on a limb here, Jen and guess that you’re a little too radical for Mr. Whitebread. But if you think that he’s worth the effort involved in loosening him up, start by reassuring him that there will always be a place in your heart for his johnson even when you’re enjoying a sweet lesbo fantasy. If you really want to enjoy yourself with your guy while you enjoy your dyke porn, give him permission to do a voice over for the movie you’re watching together. Tell him you want him to pretend he’s a porn star and he’s gonna appear in the next scene with the two chicks you’re watching. Watch the lezzie scene together and then have him tell you what’s gonna happen in the next scene when he catches the two naughty vixens. Perhaps you could suggest that he roll play that with you after the movie. Ya see, Jen, you’re gonna have to trick the monkey into watching what you want, cuz he ain’t gonna open his mind all by his-own-self.

Deprogramming him of his homophobia may be a bit more challenging, but there are ways. You could start by telling him that everyone knows that no one sucks a guy’s dick like another guy. And so you want to pick up a few pointers from the pros before you go down on him again. When the big cock-sucking scene begins start grabbing at his package. We all know he’s gonna be hard as a rock. Those repressed types are so damned predictable. Now if at all possible start blowin’ him with the same vigor as the dudes in the movie. Blowjobs are the great equalizer. Mr. Whitebread will be enjoying himself so much he’ll hardly have time to reflect on how radical he’s becoming.

lesbian pronIn the end, I don’t think you should compromise and watch hetero porn unless he’s willing to compromise too. Of course you both could watch your chosen porn privately, but where’s the fun in that. Or you could just trade-off one scene of his for one scene of yours. Or compromise with some hot bisexual porn. There’s not a whole lot of really good bi porn out there, but there is some. Just be discriminating. Life is just too short for bad smut.

You could try dueling porn. Two screens, two TVs or a TV and a computer screen, each playing a different type of porn. Or you could really throw caution to the wind and have a full-blown fuck-O-rama — multiple screens with multiple images all going at once. It’s so easy to do these days with the proliferation of computers tablets, phones even, and online porn. And just about every household has at least two TVs and two computers lying around. So knock yourself out, girl!

It’s clear to me, Jen, that you’re gonna have to take the lead in this. You being the more enlightened one. I believe that your arousal will arouse him. And if your fire doesn’t ignite his, simply throw the bum out!

Good luck Ya’ll

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