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An (extremely long) Tale Of Woe


First Name: Sam
Age: 22
Gender: Male
Location: North Carolina, USA
Wow, where do I even begin….

I am a 22-year-old gay male and believe that I may have SOME form of erectile dysfunction. I emphasize “some” because it is possible for me to get hard, firm erections, but I’m ALWAYS by myself when I do.

I have been able to give myself orgasms since I was in preschool. I did not masturbate the “traditional” way that men do (or ejaculate) until I was in 6th grade. Before that, I would lay down with my hands cupped around my crotch area and would “hump” into them until I felt an orgasm sensation and would then stop. In 6th grade I began to look at gay internet porn, and, seeing how most of those men masturbated, began to emulate the process. I even practiced “edging” often, beginning in 6th grade, as I had read on the internet at that time that it built up sexual stamina and led to powerful orgasms.PERFORMANCE_ANXIETY_pic_02_3

I would say that since I’ve been able to have orgasms (beginning in preschool), I would have one usually at least once a day. There were days here and there where I wouldn’t, but I guess an average would be 6 out of 7 days per week, with an average of twice per day. Of course, it’s hard to average them out since I’ve been having them for so long.

I did not start having sexual intercourse until my freshman year of college when I was 18, with my roommate at that time. Even that first time, I had problems maintaining my erection. I also had to use my hand and masturbate in order to have the orgasm, which took much longer than when I’m by myself. My roommate and I engaged in sexual intercourse regularly for the latter 2 and a half months of my freshman year, and every time, I had to have an orgasm by masturbating. Oral sex would not work, his hand would not work, and we did not engage in anal sex.

From ages 19-20, I had very little intercourse, but regularly masturbated (almost always to porn), and had no problems maintaining an erection and achieving orgasms. I hooked up with older men occasionally during this time, and again, could not have an orgasm unless I masturbated. It was also slightly more difficult to get an erection than by myself watching porn, and always took me longer to achieve orgasm than by myself. I had my first experience with anal sex (as a “top”) during this time as well, and could not ever reach orgasm, same with oral sex and hand-jobs.

When I was 20 I met and began dating my first boyfriend. We were together for 10 months, and while I enjoyed my time with him, our sex life was poor. We did not engage in anal sex except once, because we both considered ourselves tops. The one time we engaged in anal sex I tried to be the bottom, but did not enjoy it at all and had to stop. We did engage in oral sex, but I could never achieve orgasm that way. Again, I had to masturbate in order to have an orgasm. Not only that, but I began to have significant trouble sometimes to get an erection. Also, it took a lot longer for me to reach orgasm when I masturbated with him. By myself with porn, I could reach orgasm as quickly as 5-7 minutes. With him, it often took me at least 20 minutes, and it was usually 25-35 minutes.

loving legsAfter we broke up, I began to hookup a little more frequently then I had in the past, but it was not that often. Whenever I did, again, I always had to masturbate to achieve orgasm, and it took me a long time to do so. AND, during some of these hookups, I simply could not even achieve orgasm myself, as I started to have difficulty maintaining or even getting an erection. I highly doubt it was because of my sexual partners, because I would not hookup with someone I was not sexually attracted to. Also, I usually could have erections during foreplay, but when it came to the “big finish” my erection would start to wane or just become completely soft, and nothing I did or thought about changed that. Once, I achieved orgasm from barebacking (which I have not done since and luckily did not contract HIV or an STD), and there was also only one time where I hooked up with a guy and achieved orgasm from him giving me oral sex, although I believe this was because I refrained from masturbating for the past few days beforehand.

I am 22 now, and am starting to worry that I will not be able to ever have any good sex with someone else other than myself. In almost all of my most recent hookups, I have had to use a cockring to get an erection, and even then sometimes it doesn’t even help. Also, in almost all of my most recent hookups, it either takes me around 30 minutes to masturbate to orgasm, or I simply can’t have an orgasm because of lack of an erection. However, if I am by myself watching porn, I do not have any trouble getting and maintaining “rock-hard” erections and reaching orgasm.

I have become particularly concerned about this problem now, because I have begun to date someone and engage in sex with him for the past few weeks. When we first had sex I topped him anally and had a good erection. But we still masturbated together to completion. Ever since the first time though, I have had a LOT of difficulty just getting an erection period. Cockrings do not help, and oral sex and foreplay don’t really help either. Sometimes when we make out for a while I’ll start to get kind of hard, but then when I try to get ready to penetrate him or simply masturbate with him, I’ll go soft again. I’ve been able to reach orgasms sometimes when I masturbate with him, but my penis is usually semi-soft when I reach orgasm, and again, it takes more effort and certainly more time to do so then when I’m alone watching porn. He is incredibly good FleshJacklooking, good at sex, and very passionate, so I know it is not him. Luckily, he does not mind when I cannot perform, he says he likes me for me and that everything is fine, and he thinks that I shouldn’t worry about it. But at this point, I really can’t help but worry about it…

The last time this problem happened I had willingly decided to not have an orgasm for three days beforehand, hoping that it would help the issue. But unfortunately, it did not help or change anything. I’ve decided to completely stop viewing or watching any pornography whatsoever, and have also decided that when I masturbate I will avoid as much contact with my hand and, instead, use my FleshJack (the gay version of FleshLight) with the “Squeeze” texture (their most “realistic” anal texture). I have not had sex with him since I decided this (which is the day I’ve written this question, May 27, 2015).

I apologize for this EXTREMELY long inquiry, but I didn’t want to leave out any details of my sexual history in case they were important. I’m wondering if masturbating regularly since preschool has anything to do with my poor performance. And I’ve considered that I’m “overthinking everything” when I engage in sex and maybe that’s preventing me from getting erections with other men, but I’m such a sexual person that I can’t think of anything but dirty, sexual thoughts when I’m with another man, yet it just doesn’t seem to work. I do start to focus on not being able to get an erection if I’m not getting one for 5-10 minutes, but during that time beforehand, I’m not thinking about anything other than the pleasure, so I don’t see what I’m doing wrong. The problem is beginning to be REALLY embarrassing and I’m concerned that if I’m already having these problems at only 22 years of age, I’ll likely have the worst of erectile dysfunction problems in the future.

I suppose my main questions are:
1) What could be causing this to happen?
2) Is my proposed method of completely avoiding porn and masturbation via my hand an appropriate solution?
3) Do you have any specific suggestions or general advice that can help me with this problem and/or my sex life?

Again, I apologize if this is way too long; I’ve just never been so concerned about it before. I’m 22, I should be able to get rock hard erections easily, but I feel like a 70 year old man who just “can’t get it up.” ANY advice you can give me will be sincerely appreciated.

Whew, Sam, that was like the War And Peace of sex advice questions.

It’s perfectly clear that you are worried about your sexual response. But I’m gonna guess that your worry is actually making things worse. Before I respond to your three questions, I want to say; get thee to a therapist! You need to sit down with a sex-positive therapist and work through this stuff with him/her. This is super important, don’t just blow it off. If you need a referral, see the Directory of the American College of Sexologists to find someone in your neck of the woods. I also offer remote therapy via Skype or phone. See my Therapy Available page.

whewNow to your questions in the order you asked them…
1) What could be causing this to happen?
Everything you tell me points to performance anxiety. I’ve written and spoken a great deal about this issue over the years. Use the CATEGORIES pull down menu in the sidebar to your right. Scroll down till you find the main category, Sex Therapy. Under it you will find the sub category, Performance Anxiety.  You’ll find tons of information.

2) Is my proposed method of completely avoiding porn and masturbation via my hand an appropriate solution?
It might be, but not for the reason you suspect. Again, you need to discuss this with a therapist. It’s important and more involved than I have time and space to lay it out for you.

3) Do you have any specific suggestions or general advice that can help me with this problem and/or my sex life?
Yeah, chill the fuck out! Honesty, that’s the best thing you can do right now. Then, with the help of a therapist, work through your problems, put in place a program to rebuild your partnered psychosexual response one step at a time. You’ll probably begin with sensate focus training, stress reduction, and relaxation exercises.

Hey, Where’s My Big “O”?

Name: BJ
Gender: Female
Age: 23
Location: PA
I’ve been sexually active for several years now and have yet to reach an orgasm. Oral sex, intercourse nor masturbation have been effective. Is there something wrong with me, what might help?

I’d be very much surprised if there was actually something physically wrong with you. But you clearly have some difficulty letting go. And simply put, an orgasm is letting go of built up sexual tension.the big O

Lot of preorgasmic women don’t feel entitled to an orgasm, for one reason or another. Other women are simply unversed on how to make the big “O” happen in their own fine self. Sometimes it’s a combination of both resistance and a lack of know how.

I once had a client, a woman in her late 30’s, the mother of three and a devote Catholic. She was preorgasmic too. Her big stumbling block was fear. You got it; fear of having an orgasm. She had heard from other women over the years how powerful orgasms were and how much fun they were. My client somehow got it in her head that if she were to ever let go and give up that long-awaited screamin’ meme, her entire world would collapse. She’d become a sex addict, neglect her children, divorce her husband and turn her back on God…the whole enchilada.

With that kind of mindset, this little lady wasn’t gonna let herself cum no how.

the big O 2I had to reassure her that, as delightful as orgasms are, they are not like crack cocaine. I told her there was no chance that she’d fly to pieces as a mother, wife and friend of Jesus if she were to diddle herself once in a while. I had to keep repeating this over and over till it finally sank in. You talk about hardheaded! In the end, she had her precious orgasm, joined the ranks for the sexually satisfied and lived happily ever after. …Well, I can’t honestly say about the happily ever after part, but she sure did smile a whole lot more afterwards.

Back to you BJ, I don’t suppose there’s any way you could have one of your gal-pals show you how it’s done, is there? The reason I ask is most guys learn how to choke the chicken by watching, or being instructed by another guy. Us men folk are really good about doin that for one another. Women, on the other hand, don’t seem to do this for one another as much. Which is a freakin’ pity, if ya ask me.

If you can’t (or won’t) get a pal to show you around proper pussy pleasuring, I have another suggestion for you. Mozie on over to DR DICK’S HOW TO VIDEO LIBRARY  and check out a swell instructional video. (There’s a link to this marvelous resource in the header.) Do a quick search for “female masturbation” and let the experts show you a thing or two. You’ll be so glad you did.

Another great resource: The Ultimate Guide to Orgasm for Women: How to Become Orgasmic for a Lifetime by the brilliant Mikaya Heart. By the way, you can find a dynamite two-part interview with Mikaya HERE and HERE!ultimate-guide-to-orgasm-for-women-lg

Here are a few tips:

Get in the mood

Relax as much as you can. Whatever that means for you. Take a warm bath or have a glass of wine. Ensure your privacy: turn off the phone, lock the door for privacy from roommates, kids, whoever. Find a comfy position. Most women start out lying on their backs, legs bent and spread apart, with feet on the ground. Remove most or all of your clothing (or as much as your comfortable with).

Explore your body

Run your hands along your body, lingering along areas that are more responsive to touch than others. If you’re able to do it, and you’ve never done it before, you might want to try to look at your genitals in a mirror. Because so many women are raised with negative messages about their bodies, and particularly their genitals, being able to see while you touch can be powerful and surprising. Find and touch your inner and outer labia, your clitoris, your vagina and your perineum.

Touch yourself

Using one or two fingers, rhythmically stroke the different parts of your vulva, paying particular attention to your clitoris and labia. Experiment with different types of pressure, speed and motion. Try placing a finger on either side of the clitoris and stroking up and down, or placing two fingers on the clitoral hood and rubbing in a circular motion.


Try different types of touch: stroke, tickle, knead, pinch, or lightly pull your genitals. Try using one or several fingers, the palm of your hand, even your knuckles.

Build up excitement

Learn to hold onto sexual excitement by building up and then reducing or temporarily stopping the stimulation. (Men do this all the time when they jack-off.  It’s called edging.) Pay attention to how your body is responding. It will tell you the particular stroke that feels best and when to pick up or slow down the tempo.

Don’t forget to breathe

Many women hold their breath as they get excited. Be mindful of your breath and learn to play with breathing during arousal. Try to breathe deeply rather than hold your breath. This can help release the sexual energy, rather than fight it.

Moving a little

In addition to often holding our breath, many women tense up and don’t move much at all when wtheye masturbate. This might work for you just fine, but if you haven’t explored movement, it’s worth a try. Moving while you are getting turned on, and moving during orgasm can change the way you experience pleasure in your body. For some women this means rocking their pelvis. For others it means moving their legs or torso side to side. Find what movement works for you and then intentionally start doing it while you masturbate.

Letting go

If your hand gets tired, give yourself a rest, switch hands, or try a vibrator. If you’re on the brink of orgasm, but can’t quite get over the hump, try to become more conscious of your breathing, give yourself extra stimulation: caress your nipples, or try thrusting your other fingers or a dildo in and out of your vagina.

Ride the Wave

As you begin to orgasm, continue the stimulation through the orgasm. Lighten up on the stimulation during the first extremely sensitive moments but keep it going to enjoy those little pleasurable aftershocks. Your first orgasm may feel like a blip or a blast, but the more you practice, the more variety you will experience.


Sexual fantasy can be a double edged sword when it comes to masturbation. If you have trouble getting yourself in the mood or getting over the top, a hot fantasy may be just the ticket. I often suggest reading erotica to get in the mood. However, when we fantasize some of our attention is taken away from what’s happening in our bodies in the moment. Sometimes what is getting in the way of us enjoying masturbation is that distance from our bodies. It’s good to try everything, but be mindful of whether or not your fantasies are acting as an enhancer or a distraction.

hitachi-magic-wand-2Some final thoughts…
Vibrators take some of the manual labor out of masturbation by providing direct, intense physical stimulation to the clitoris.  check out all the marvelous vibrators we’ve reviewed for you at Dr Dick’s Sex Toy Reviews.

Many women learn to jill-off in the bath or shower. A direct the stream of water on your vulva and clitoris can be a game changer. Vary the pressure, the pulsation, and the temperature. Alternate methods: slide your butt over the drain so your legs are up in the air and your genitals are up under the tub faucet (rather awkward but do-able for some), or use Jacuzzi jets.

Rub against something–a pillow, the corner of some furniture, a washing machine in operation.

Dildos can be a pleasurable accompaniment to clitoral masturbation, as they offer the fullness of penetration and can also stimulate the g-spot.

Write back again, BJ, and let me know how things go. If you’re not successful, I still have a few other tricks up my sleeve.

Good luck

Review: An Intimate Life: Sex, Love and My Journey as a Surrogate Partner

Hey sex fans!

I have another swell sex-positive book to tell you about today. Anyone who frequents this site will already be familiar with my dear friend and esteemed colleague, Cheryl Cohen Greene. If ya don’t believe me type her name into the search function in the sidebar to your right and PRESTO!

Not only will you find the fabulous two-part SEX WISDOM podcast we did together, (Part 1 is HERE! And Part 1 is HERE!) you will find a posting about the movie The Sessions. You’ve seen it right? It’s the award-winning film staring John Hawkes, Helen Hunt, and William H. Macy. It’s the story of a man in an iron lung who wishes to lose his virginity.  He contacts a professional surrogate partner with the help of his therapist and priest. Ms. Hunt plays Cheryl, the surrogate partner in the movie

Cheryl also contributed a chapter on sex and intimacy concerns for sick, elder and dying people for my book, The Amateur’s Guide To Death And Dying.

With all that as a preface, I now offer you Cheryl’s own story: An Intimate Life: Sex, Love, and My Journey as a Surrogate Partner. The first thing I want to say is this book is it’s not a clinical or technical tome. It is an easily accessible memoir. And that, to my mind, is what makes it so fascinating.

She writes in the Introduction:An Intimate Life

I started this work in 1973, and my journey to it spans our society’s sexual revolution and my own. I grew up in the ‘40s and ‘50s, a time when sex education was—to put it mildly— lacking. As I educated myself, I found that most of what I had been taught about sex was distorted or wrong. The lessons came from the playground, the church, and the media. My parents could barely talk about sex, much less inform me about it.

What follows is a candid and often funny look into the personal and professional life of a woman on the cutting edge of our culture’s movement toward sexual wellbeing.

Cheryl comes out of her conservative Catholic upbringing and her often tortured family dynamics with what one would expect—her own sexual awakenings as well as the conspiracy of ignorance and repression that wanted to stifle it. This is a common story, the story of so many of us.

Starting when I was around ten, I masturbated and brought myself to orgasm nearly every night. … If my nights began with anxiety, my days began with guilt. I became convinced that every earache, every toothache, every injury was God punishing me. … I couldn’t escape his gaze or his wrath. Sometimes I imagined my guardian angel looked away in disgust as I touched myself and rocked back and forth in my bed.

The miracle here is that this troubled tween would blossom into the remarkable sexologist she is today.

rsz_1greenecherylSome of the chapters in her book describe one or another of her hands on therapeutic encounters as a surrogate partner, but equally important and compelling are the chapters that describe Cheryl’s own sexual struggles as she moved to adulthood and beyond. Cheryl’s acceptance of her own sexuality enables her to build a career out of helping others do the very same thing.

Everyone has a right to satisfying, loving sex, and, in my experience, that most often flows from strong communication, self-respect, and a willingness to explore.

Despite the frank discussion of sexual topics within the book, there is no prurience or sensationalism. For the most part, Cheryl’s clients are regular people, mostly men, who have pretty ordinary problems—erection and/or ejaculation concerns, dating difficulties, as well as self-esteem, guilt and shame issues. Cheryl helps each of her clients with the efficiency and confidence of the world-class sex educator she is. Most of her interaction involves her supplying her clients with some much-needed information, dispelling myths, and giving them permission to experiment. As she says;

I continue to be amazed at how solid education delivered without judgment can eradicate much of the guilt and shame that turns life in the bedroom into a struggle instead of a pleasure.

Her most famous client, Mark O’Brien, the 36-six-year-old man who had spent most of his life in an iron lung after contracting polio at age 6, was the author of How I Became a Human Being: A Disabled Man’s Quest for Independence, in which he writes about his experience with Cheryl. This, of course, was adapted into a film, The Sessions, which I mentioned above. For her part, Cheryl delivers a most poignant remembrance of Mark early in her book.

I explained Sensual Touch to Mark. Although he was paralyzed, he still had sensation all over his body, so he would feel my hands moving up and down. … I encouraged him to try and recognize four common reactions: feeling neutral, feeling nurtured, feeling sensual and feeling sexual.

An Intimate Life chronicles Cheryl’s life-long interest in human sexuality. Her life and sometimes-turbulent loves are on display, but in the most considerate fashion. She teaches by example. She’s even able to speak with great compassion of her time living with and through cancer.

As I inch toward seventy, I appreciate more and more how much I have to be grateful for and how fortunate I’ve been. I was lucky to find a wonderful career and to be surrounded by so many smart, adventurous, caring people. My personal sexual revolution auspiciously paralleled our culture’s, and in many ways was made possible by it. I am eternally grateful to the pioneers, rebels, and dreamers who made our society a little safer for women who embrace their sexuality.

There is so much I loved about this book, but mostly it’s the humanity I found in abundance. Cheryl’sdr.-cheryl-cohen-greene enlightened soul shines brightly from every page. Her no nonsense approach to all things sexual is an inspiration. And her perseverance to bring surrogate partner therapy into the mainstream is laudable.

…what separates surrogates from prostitutes is significant. When people have difficulties grasping [that], I turn to my beloved and late friend Steven Brown’s cooking analogy that I’ve so often relied on to help me through that question: Seeing a prostitute is like going to a restaurant. Seeing a surrogate is like going to culinary school.

Finally, An Intimate Life is the culmination of Cheryl’s life as a sex educator, her surrogate partner therapy practice being just part of that mission. I highly recommend you read this book. You will, I assure you, come away from it as I have, a better person—enriched, informed, as well as entertained.

Cheryl, thank you for being in my life and being such an abiding inspiration. Thank you too for this marvelous book; now you can be in the lives of so many others who need you so that you can inspire them along their way.

Be sure to visit Cheryl on her site HERE!

What’s a mother to do?

What we have here is an exchange I had with a woman and while I don’t know anything about her, not even her name, I can make some inferences. If I had to guess, she’s in her 40’s. She’s married and has kids.

You must talk to a lot of women in your practice and hear from a lot of women through your advice site. What would you say are the main sexual concerns of women over the age of 40?

Research shows that approximately 40% of women experience sexual problems. But a 2008 study out of Harvard suggests that only a few — 12% — are concerned enough with these issues to do anything about them. I find that not only surprising, but shocking! That suggests to me that sexual wellbeing is not a high priority for a good number of women.  What a bummer!sexual-Frustration

Low libido, diminished arousal, difficulties with orgasm, pain with sex or body image concerns all play a part. A lot of this is directly connected with having an ineffectual partner. I mean, I’d give up sex too if I was consistently frustrated and unfulfilled. But what about masturbation? Are sexually frustrated women seeing to their own needs through self-pleasuring? I don’t see any hard data, you should pardon the pun, on that topic.

We hear a lot about the horny dad and the tired mom, but what do you do if the “roles” are reversed – and dad is tired and mom is horny?

Curiously enough, I hear from way more men these days, who are exhausted, depressed or overweight and who have little or no libido, than I hear from women with the same problems. Sign of the times? You betcha!

But don’t sink to the lowest common denominator. Here’s one of my most popular tutorials, Sex Play — Tips and Techniques.

How can parents find common “ground” when it comes to when they might have sex (as in day of the week or time of day)? Does it always involve compromise? Can our internal clocks ever synch up?

Synching up schedules my not always be the solution. If we wait for that to happen, we could die waiting. The answer might be finding a middle ground. “I may not be up for full on fucking at the moment, but I’ll give you a fantastic hand-job.” Or “I can’t seem to get it up right now, but hand me your vibrator and I’ll send you to heaven!” I’m a huge proponent of mutual masturbation.

Another suggestion might be something like The MoodSign. We reviewed this very clever gismo awhile back. In fact, it was among our Best Products List for 2013. Check it out and see if something like this would help.

If parents are interested in kinking it up, what are some simple, not too scary ways to introduce it into the relationship?

Keep it safe and consensual. Always have a safeword. I developed a workshop called; The Gospel of Kink. I’ve also conveniently packaged this workshop into a workbook with the same title. You can find the book HERE!

GOK small cover

Both the workshop and book are designed to help people, like you, develop the skills they need to effectively communicate with one another and improve their problem solving skills. The workshop and book, as the title suggests, are specifically geared toward folks in kinky, BDSM, and alt-culture relationships, but even vanilla couples will find what I present very helpful.

Bondage games are always fun. And you don’t need anything beyond what you already have in your closets — silk scarves, belts, shoe strings, etc.

Nipple clamps, playing with sensations like ice cubes and hot wax, hair pulling, making use of blindfolds and gags

Discipline/Spanking is always fun too — a ruler, a hairbrush, a wooden spoon, a belt, rubber bands. See my tutorial: Spank Me, Daddy.

Role play is always a delight. Don’t forget about phone sex.

There are tons of instructional videos at Dr Dick’s How To Video Library.

I always suggest that couples read erotica aloud to each other. That never fails to get one’s motor purring.

I’d also love to talk with you about the taboo of sex, particularly with the parenting set, and how parents, moms, and dads, can work to break stereotypes without feeling like a sexual “deviant.”

Really? What would be so wrong about being a deviant?

Good luck

He Can’t Cum!

Name: Alice
Gender: Female
Age: 19
Location: Minnesota
My new boyfriend is really frustrated and doesn’t want to have sex anymore because he can’t come. He says he’s had this problem for a while and hasn’t come with any girl for over a year. I see how upset he is and I know he still wants to sleep with me, but says it hurts when he gets excited and nothing happens. Is there something I can do? I tell him to see a doctor but I don’t think he will. Thanks a lot!

Wow, that’s a bummer Alice. Unfortunately, you don’t supply me with enough information for me to make an educated guess about what might be up with him. Does he have erections? Does he masturbate? Is he on any medications? These are the first questions I’d ask him. Since he isn’t here and neither are you, I’m gonna make a stab in the dark.cover up

If I had to guess, I’d say your man is suffering from a real bad case of performance anxiety. He doesn’t need a medical doctor; he needs to learn to relax and be in the moment. If this is an arousal phase issue then that should help. If it’s and orgasmic phase issue, relaxing and enjoying the pleasure will also help.

Here’s how performance anxiety works. Say a fella has a less than satisfying sexual experience for one reason or another. Before he know it, he replaying the incident over and over in his head, till that’s all he can think about. The proverbial molehill becomes a mountain. He brings his anxiety to his next sexual encounter. His hyper-consciousness primes him for more disappointment. And he’s ready to interpret all disappointment as a failure. And this can interrupt either the arousal phase or orgasmic phase of our sexual response cycle.

Well, you can see where I’m going with this, huh? His fears become self-fulfilling. Before he knows it, he begins to avoid sex. His relationships suffer. He develops a full-blown sexual dysfunction. And his self-esteem takes a nosedive. His preoccupation with his problem makes it less likely that he’ll be fully present during sex with his partner, which pretty much fucks up his sexual responsiveness and any hope for spontaneity.

It sounds to me like performance anxiety is putting a damper on his sexual arousal and thus short-circuiting the rest of his sexual response cycle, including orgasm.

This is nothing to fool around with, especially for someone at his tender age. 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 a great deal of the pressure off the couple. From there we begin to rebuild the partnered psycho-sexual response one step at a time. We begin with sensate focus training, stress reduction, and relaxation exercises. I have the greatest confidence in this method. It succeeds over 90% of the time.

Good luck

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