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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!

I Can’t Cum, dammit!

Name: Jayme
Gender: female
Age: 23
Location: ??
I have a pretty major question that I think you’d be perfect to answer, with your credentials. I’ve not had the best relationship history. My second boyfriend, right after I graduated high school, was abusive in every way but physically. I stayed with him for 7 months before getting wise and getting out. A few months after the breakup I was almost raped at a party. I found afterward that I was unable to do anything sexual with anyone, unless I was drunk. It was 4 years before I tried hooking up with anyone.

It’s now been 4 years and 6 months since all that happened, and I’m finally starting to get more comfortable with being sexual. I went through some minor therapy over the summer that really helped me to get past the near-rape I experienced in college. Because of that, I was finally able to have sex for the first time a few weeks ago. I’ve been hooking up with a good friend semi-regularly, and it’s been mostly great. The only problem I’ve run into is that I can’t relax enough to cum with this guy, from anything. He’s fingered me, gone down on me, and we’ve had sex, and I just can’t get off. I’ve had no problems ever bringing myself to orgasm, and when I’m with this guy I can feel like I’m just about to, but I can’t get all the way to that point. Do you have any suggestions for me?

Jilling off

Hey there, Jayme.

Thanks for your message. I do have one really important suggestion for you. This is the same suggestion I make to other women who, for whatever reason, are not getting off with a partner.

You say you have no problems bringing yourself to orgasm. This happens during masturbation, right? Do you use your hand, or do you employ a toy of some sort? Perhaps you do both. Whatever your pattern is, it is successful, and that’s the important part.

My suggestion to you is that you masturbate with and for your partner. I am a huge proponent of a couple masturbating together. There is a wealth of information that each can share with their partner about technique and sensitive areas of one’s body. This is a particularly effective means of resolving issues like the ones you have. And I hasten to add that these masturbation events don’t have to be some boring clinical affairs; they can be totally hot. Put on a show for him and he for you. Read erotica aloud to one another. Incorporate toys, whatever.

If you were my client I’d insist on a fucking moratorium. I’d have you and your partner do lots of playful masturbation together — dry hand, wet hand, toys, whatever. Once you get into a rhythm of orgasmic filled masturbation events, I’d have you move on to mutually masturbating each other. When this is successful you could move on to oral, just as long as you also use your hands. Then and only then would I allow you to incorporate full-on fucking to your sex play.

Eliminate the performance anxiety, share your Jack & Jilling off technique and make your sex play fun; that’s your homework.

Good luck

Shape Up Or Ship Out

Name: Bill
Gender: Male
Age: 51
Location: Knoxville, TN
I was listening to one of your Q&A podcasts recently. In it you responded to several women who were in relationships with men they liked (or even loved) but who didn’t sexually satisfy them. Your advice was for the women to tell their men to essentially “shape up or ship out.” Even considering the reasoning you gave in the podcast, is this really the best advice? I’ve heard similar advice from other “sex positive” commentators, which makes it seem that “sex positive” is a synonym for “relationship negative.” It didn’t appear as if any of the women involved were looking for a way out of their relationship, just a way to improve the sexual aspect — and it’s not entirely clear how the approach you suggested would do that. If the men didn’t have performance anxiety, a blunt discussion would almost certainly provoke it. If I remember correctly, one of the women was about my age — early 50s. Surely you must know the ever-increasing difficulty women have finding a happy relationship as they get older, and that a woman must know how lucky she is just to be with a man she likes, even if the sex could be better. Besides, there are probably very few women these days who need to be told they can leave a relationship if they choose. If the women’s sexual complaint had seemed to be just the tip of an iceberg of unhappiness, I could see the efficacy of your advice — but that’s not how their queries came across.

Listen Bill, I stand by my advice. And yes, I think it was the best advice I could give these two women. And ya know why I say that? I say that because had it been a couple of men writing in about the same concern, I would have given them the very same advice. If you are unhappy in your relationship because the sex has dried up then that’s a pretty serious concern in my book.

shape-up-or-ship-outBeing sex positive is not being relationship negative. But, settling for the lowest common denominator in terms of sexual expression is. Here’s another thing I know for certain, by the time someone makes an appointment to see me or writes to me about their sexual complaint, I can be pretty certain that they’ve struggled with it on their own for a long time. This is particularly true for women.

I also want to take issue with your statement: “Surely you must know the ever increasing difficulty women have finding a happy relationship as they get older, and that a woman must know how lucky she is just to be with a man she likes, even if the sex could be better.” So you’re sayin’ older women can just kiss their sexual needs goodbye after they reach a certain age, because the relationship they have is as good as it gets? Is that what you’re sayin? Because, if it is, it’s hogwash! Women of any age don’t need a man to be happy or fulfilled and they certainly don’t need one who to tell them to suck it up and settle for what ya got.

Besides, if I remember my advice correctly, and I think I do, I suggested that my correspondent give her husband the right if first refusal. That means she offers her old man her sexual energy first. If he doesn’t rise to the occasion, so to speak, she’s free to take her sexual energy elsewhere. This strategy takes the pressure off the sexually uninterested partner, it can overcome the disparity in libido between the couple, as well as saving the relationship. No need to throw out the baby with the bathwater, right?

To my mind we do too much “settling for” as it is. Complacency is the real enemy. You got issues in your relationship; hash them out. If your partner won’t join you in that effort he/she is telling you that your needs don’t matter. And when that occurs, regardless of what else you may have in place, your relationship is in its death throws. And you can bank on that!

Good luck

Notching the belt

Hey Doc,

So I’ve asked you a question anonymously before and you were a huge help so here I am again.
My names Mike and I’m 17 years old. For some reason it takes me a ridiculously long time to “finish” with my girlfriend. It’s not her, because this has happened with about 4 or 5 other women before her. It’s an annoying flaw that it takes me about 90 minutes to finish, if I finish at all. My GF and I get tired and eventually just stop because it’s too tiring and just plain tiresome. Is it performance anxiety or something? My first time having sex was anal with a girl, and I have done anal with girls many times before so it was a lot tighter than vaginal intercourse, not sure if that affects anything… I am really tired of lasting so long; I just want to be done when she is, much earlier.

I’ll be glad to answer any questions or anything you might need to know,
Thank you so much in advance, Mike.

finger fuck00445Where to begin, Mike? You’re 17, you’re having performance problems with your GF and you have had with about 4 or 5 other women before her. Holy Cow! you certainly are a sexually precocious lad, aren’t you?

I can’t help but notice a bit of sexual bravado in your message. I don’t know if that’s intended or if it’s more of a subliminal message. Either way, I have a feeling that there is some belt notching goin on here and that may be the root of your problems.

Here’s why I say this. There is nothing in your message that communicates that the sex you’re having is fun, or that it’s play. All I hear is that you’re a young man on a mission. You want to get off in a timely fashion and you’re currently being frustrated in that pursuit. You sound so goal oriented and your sex sounds like a task, rather than a playful adventure.

Us men folk get like this sometimes; and we’re the poorer for it. We’re all about solving a problem instead of enjoying the moment. The curious thing about this is that enjoying the moment is often the best way to solve a sexual performance problem.bryan_tony_box

When I hear men and/or women talking about their sex life like it’s work, I know there will be problems ahead. And you, Mike, sound like your sex is way more work than fun. If you were a sex worker or a porn star, I’d understand your predicament. But I suspect that you are neither a sex worker nor a porn star. You are, however, a young man who has, for one reason or another, scuttled all the joy and wonderment from your sex play. And that, my friend, is a crying shame…and at your tender age too. How do you suppose you’ll behave when you’re an old man of 25?

This path you’re on will continue to lead you into a sexual wilderness. You will become increasingly frustrated in your efforts to cum “on time”…and I use that term in quotes, because you’re all about bangin’ something rather than pleasuring and being pleasured by someone.

The comment you make about the difference between butt sex and pussy sex also tells me a lot about the kind of tightness you need to get off. I’d be willing to guess that you have a death grip on your johnson when you wank; am I right? Obviously your average asshole is a tighter orifice than your average pussy. But, if you were really turned on and enjoying the mutual pleasure available to you and your partner, instead of worrying about busting your nut during the fuck itself, you could jettison all those “shoulds” you have when you’re supposed to be enjoying yourself in the company of your lover.

beltWhy not stop what you are doing and take a look at why and how you are doing it. You may surprise yourself with what you find. And if you are man enough, have a heart-to-heart chat with your GF and get her feedback on what she encounters when she fucks you. Again, I’d be willing to guess she’d have some timely advice to offer you on how to fuck and get fucked.

Good Luck

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.