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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!

Dribblin’ Instead of Shootin’?

Name: Alvaro
Gender: Male
Age: 21
Location: Mexico
Hi, I’m concerned because I never shoot when I cum. I dribble. I don’t like the way I cum, can you advice me how to cum shooting?? Is there anything I can do? Is it my fault or I was born with a less powered gun than others?? Sorry to bother. And thx for your help.

The problem you describe is a common one. And the solution is relatively simple. It lies in, of all things, muscle mechanics. An ejaculation is primarily a muscle contraction — built up energy being released — thus the spurt. No spurt, or a dribble most likely indicates poor muscle tone. But there’s an easy and fun solution, or more properly an exercise. Kegel exercises to be precise.

turkey-basterLet’s start at the beginning, which is always a good place to begin, don’t ‘cha know. Your prostate is the source of your ejaculate. You have a handle on that concept, right? Good! Now picture a turkey baster. Imagine your prostate as the bulb on the one end and your dick as stalk with a hole in it at the other end. Picture the baster pointed upward, like your cock with an erection. Imagine the bulb is full of fluid and you need to get that fluid out the bulb, up the stalk and out the hole…just like your spooge when you cum. How ya gonna do that? A firm grasp on the bulb and a hefty squeeze, that’s how!

So Alvaro, if you’re dribblin’ instead of shootin’, your muscles need to be strengthened and toned. And like I said, I have just the right exercises for you.

Anyone who is paying the least bit of attention to the ranting and raving of Dr Dick will fruit_genitalsimmediately be familiar with Kegel exercises. I talk about them a lot. And those who haven’t been paying attention — listen up, you monkeys! Kegel exercises serve to tone and strengthen the pubococcygeus muscle or as we in the know like to call it, the “PC” muscle, which is part of the muscle group at the floor of the pelvis. The health of this muscle group plays a vital role in getting you up and getting you off, as well as in other aspects of healthy genital functioning.

Kegel exercises help increase blood flow to the genital area (getting you up). And Kegel exercises strengthen and tone the muscles that are involved in ejaculation (getting you off). If you exercise this muscle regularly, you’ll gain greater control over the timing and strength of your ejaculations. Kegel exercises can also prevent incontinence and other problems associated with aging, but we’ll save that for another time.

male_anatomy.jpgSo you’re probably saying to yourself, “sure, Dr Dick, I’d like to strengthen my PC muscle, but I never even heard of that muscle, let along know where to fine it.”

Alrighty then, Alvaro, here’s what ya do. Work up a full bladder, the more full your bladder the better. Go to the john and sit on the toilet. (Yeah, just like a girl!) Now let the pee flow. As you’re doin’ that, I want you to interrupt the stream of piss several times before you empty your bladder. The muscle you are using to do this is your PC muscle. Look to distinguish between your PC muscles and your anal sphincter muscles. With a little practice you’ll become adept at separating out these two muscle groups. Actually strengthening all your pelvic muscles is a swell idea, especially for power bottoms, but again we’ll save that topic for another time too.

Now that you have located your PC muscle, you can exercise it at will, even when your bladder is completely empty. First, try squeezing your PC muscles as hard as you can for a count of three seconds. Then relax. Repeat this till you feel the muscles tiring. How fun is this?

I want you to work for both muscle strength and tone. For example, start with five strong prolonged squeezes (5 seconds apiece). Relax. Then do a series of 10 rapid contractions in a row. Doing three sets of each twice a day for a week is your goal. When you are ready to proceed try increasing this to three sets of eight to ten prolonged squeezes and 20 rapid contractions in a set. The advanced Kegeler will be able to vary the type and timing of his PC squeezing; slow clenches to quick flutters.PG-TrainingKitOnly-Promo

If you keep this up, you’ll be shootin’ jizz across the room in no time. And the beauty part of Kegel exercises is you can do them whenever and wherever you like. You can be sitting in a meeting with your boss and be doing your Kegel exercises. You can argue with your boyfriend/girlfriend and be doing your Kegel exercises. You can be watching reruns of Leave It To Beaver with your maiden aunt and be doing your Kegel exercises. Who would have guessed improving your sexual health would be such a pleasure?

If you’re serious about all of this, I have else to share with you. This is The Private Gym. It’s the first interactive, follow-along exercise program that helps men strengthen the muscles that support and control our cock. As men approach age 30, the muscles that support erectile function begin to weaken. By age 40, more than 50% of men experience some form of erectile dysfunction and this number increases to more then 66% as men approach 60 years of age. And for all you bottoms out there, you know how important it is to keep anal muscles in tip-top, pardon the pun, shape. And, just in case you didn’t know, The Private Gym won the coveted Best Health Related Product or Toy of 2014 as compiled by the Dr Dick Review Crew. So how about them apples?

Good luck

Sounds…difficult

Name: Pete
Gender: Male
Age: 60
Location: New England
What is sounding the penis and why is it called that?

Sounding is a kind of urethra play. It’s called that because the it involves sounds, a kind of dilator. Why not mozie on over to Dr Dick’s Stockroom and check out the Sounds & Dilators section, you’ll get an eyeful!

Rosebud Urethral SoundsUrethra play freaks out lots of folks, myself included. Most of us would equate having something inserted into our urethra…for any reason…with a root canal by a sadistic dentist. Not something purposely done for the sheer enjoyment of it.

I’m always curious about how folks come to odd fetishes like urethra play. One of my correspondents way back in July 2007, Georgia,  wrote that her urethra play began when she was a child. When she asked her mother where babies came from. Her mother said it’s where peepee comes out. Georgia looked down there and saw this teeny-tiny hole. She knew having a baby was difficult and painful and thought, no wonder! So she decided she’d better try and make the opening bigger. And so it began.

Once a guy told me that he was playing doctor with his older cousin, when his cousin inserted a twig into his urethra, mimicking how he thought a doctor would take a patient’s temperature. This guy said that the moment was so sexually charged, even as boy of no more than 5, that his piss hole became an object of fascination and pleasure from that day onward. When I knew him, he was able to insert the bristle end of a toothbrush into his urethra. That bit of unsolicited information just about made me swoon into a faint back then. Even now, retelling that story gives me the willies.

So ok, this isn’t for me, but I am told by those in the know that because the urethra is such a sensitive organ, stretching it can provide exquisite sexual pleasure.Dittle Sounds

Practitioners of this unique kink often start out young, like Georgia and the other guy. Maybe it’s just a function of some people’s natural curiosity about their body, when one day they discover their urethra. They toy with it, stretch it, and find pleasure. Once that happens, of course, it becomes like most pursuits of pleasure; it becomes a fascination, then a full-blown kink.

If a little accidental stretching is pleasurable, what about intentional stretching with one kind of gadget or another — Q- tips, thermometers or a ballpoint pen? Once these kids are old enough to do some research, they discover there are an array of medical implements available to them like latex or plastic tubing, catheters and urethral sounds and dilators. Well, you can see how this could just grow and grow…pretty much like any fetish. Pleasure is curious that way, spurring us on to higher and higher heights.

Silicone SoundBut like all pleasure related things, practitioners ought to have his/her wits about them when they play with their pee hole. I think it’s ill advised to be stretching your urethra with just any old thing lying around. One’s bladder and urethra are sterile areas and one ought only use sterile equipment and procedures while inserting anything in there. And one ought to take one’s time with this sort of play. Incremental stretching is advised. Please, don’t forget the surgical lube.  The use of mind altering, or body desensitizing drugs is not recommended, for obvious reasons. Like I always say, safe and sane play is happy play.

And here’s something you should know — the male urethra is approx. 10 to 13 inches long and has a “J-shaped” curve to it. The female urethra is much shorter, only approx. 2 1/2 to 3 inches long, and there is no curve. Therefore, a woman can stretch her urethra much easier and to a greater extent than can a man. You will find that gender differences also makes for gender specific toys.

Good luck

Slut Shaming

Name: Martin
Gender: Male
Age: 50
Location:
Thanks in advance for your assistance, Dr. Dick.
Here’s my dilemma; I’m so in love with my partner, he’s actually the man of my dreams. We met much later in life, he being 45 and I’m 50.
I was married before w/children, out now as a gay man and all is well with my children’s relationship.
My partner has always known he was gay, has had numerable relationships, and was a sexual addict. He has wanted me to understand his past in relationship to his level of happiness now, stating that he was a bottom slut only because he was never truly in love or satisfied.
He wants me to believe that “I’m the one” that has changed his life-long addiction to strange dick up his ass.
I can’t seem to get past his past slut behavior, and oftentimes get so pissed off because he wants me to meet and develop friendships with many of these past fucks (primarily because they were military buddies also).
Why can’t I accept his slutty past and stop the suspicions?
Why do I get so upset just knowing that he was a total bottom slut??
How can I get him to understand that I have no desire to know any more about his sexual past and just focus on creating our lives???
Thanks,

Martin, Martin, Martin! How you do go on, darling.bullshit

Take a look at your language, why don’t ‘cha? Could you possibly be any more pejorative when speaking of the sexual experiences of someone who has lived a different lifestyle than you? I doubt it. Look at how many times you use the word “slut” to describe the man you say you love. I’m gonna call you out on that. You simply can’t tell me you love someone that you have so little regard for.

Your man wants you to understand his past, but you won’t take it at face value. You belittle his experience, possibly because it doesn’t match your own very limited, sexually exclusive, predominately heterosexual lifestyle.

circle jerkListen, lots of gay men (and some straight men) have loads of sex for lots different reasons. Sometimes just for the fun of it…or, as your man suggests, just to be a big old bottom slut. There’s absolutely nothing wrong with that. One can be happily sexual without loving each and every one of his partners. And the sex can be really good too. Just as one can have very unsatisfying sex with somebody one loves deeply. Sex, intimacy, and love are not necessarily dependent on the one another. No need to make such a tangle of it all, Martin.

I also want to reinforce my belief that there’s no such thing as a sex addict. Compulsive behavior? Sure! Out of control behavior? You betcha! Self-denigrating behavior? Absolutely! Sexual addiction? No way!

Try for just a minute to extricate yourself from your sex-negative mindset by exchanging the notion of eating when you talk about your friend’s sexual exploits. Would you have the same revulsion if your guy said he had shared food with lots of other guys? Some of it was fast food that didn’t satisfy all that much. Sometimes he ate just because he wanted to, not because he was hungry. And now he wants you and he, as a couple, to be friends with some of the men he ate with. Sounds perfectly reasonable to me!fingering his ass

Your man is inviting you to open yourself up and see life and sex as most openly gay men do. This is fundamentally different from how some formerly closeted men see life and sex. If you let him, he just might help heal you of your sex-negativity.

Finally, jealousy is one of the worst human emotions. It’s actually a kind of hatred, you know. Sometimes it’s hatred of another, but it is always self-hatred. You say you love this man; again, I challenge you on that. It’s clear to me that you have a much greater love of your provincial notions about sex then you have for this guy.

Here’s a tip, Martin. Jettison the unhealthy attitudes about sexual expression and give your guy a chance to be himself, not the idealized man you’ve made him out be, or think he should be. You’d be well served by working with a sex-positive therapist to help you get over this. Do it now, because if you hesitate you will surely ruin the very relationship you claim to treasure.

Good luck

Trouble Down Below

Name: Marcus
Gender: Male
Age: 20
Location: New Jersey
I have a problem that is really fucking with my head, causing all sorts of performance anxiety and, long story short; I’m still a virgin at age 20. And because of it, a few failed sexual encounters. I can get a raging boner when I’m wacking off alone, but I feel humiliated by my dick whenever I get the chance to show it off. I have what’s known as a “skin bridge.” I’ve asked a doctor about plastic surgery to correct it, and he told me it originated when my circumcision didn’t heal correctly. (And the statute of limitations to sue the bastard expired long before I knew he was at fault.) Anyway, now I’m looking at a choice between this freakish tunnel of skin that goes halfway around my cock and a different, who-knows-what-kind-of-hideous scar might result from a second surgery. The situation is ruining my life. Maybe it’s the root of some psychological complex driving me toward homosexuality too, but don’t worry about that. If I still can’t get it up for a girl after I find some peace of mind on this issue, then I’ll drop the bi attitude and come out as gay no problem. What’s your two cents on the surgery? I realize this might be one of your toughest questions to date.

This isn’t a particularly tough question at all. And you want my two cents? Here it is: get over it! I mean, pup, really? Skin bridges from botched circumcisions are not particularly uncommon. In fact, I know two guys right here in Seattle who have the very same thing and one is a former porn star. Trust me, his skin bridge did not get in the way of him waving his thang all over the place, don’t cha know.keep-calm-and-don-t-be-a-dick

Here’s a tip: stay away from the surgeon. More cutting on your willie ain’t the answer.

Here’s the thing, if, when you drop trou, and your audience, male or female, gets a gander at your johnson; and they point and shriek, “OMG, that thing is hideous! Please, please, please put it away;” then I think you’ve got a legitimate problem. However, if no one does that, ever, then your shame and humiliation is all in your head. You’ve probably created a mountain out of a molehill. But, if by chance, you think I’m being unfair, or cavalier about your concern, then take a photo of your hideously deformed wiener and send it to me for my evaluation.

Now there are two ways to go in this instance. The first option is to grow up and realize that your “condition,” if you can call it that, falls within the natural variance of dick size and shape. The second option is to capitalize on the very thing that makes you different. Ya know how some guys have their dick pierced and then put a ring or rod through the piercing, just to doll things up a bit? Well, you already have a natural piercing. Why not take your cock down to your local piercing parlor and get it fitted for a nice piece of genital jewelry. Then you can say with pride that you adorned what you once though as a defect and made your cock even more beautiful than it was before.

Finally I have to ask; what’s up with the…if I don’t get this fixed; I’m gonna go all queer. You think gay guys are less self-conscious about their equipment than straight men? If ya do, you are living in a dream world, darling.

Good luck

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