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One Surprising Cause for Male Performance Anxiety

Why it might be a good reason and what to do.

Couple disconnected in bed.
Source: vadimguzhva/Shutterstock

I’ve worked as a sex and relationship therapist for over a decade. Many people are surprised to learn that of the individuals (as opposed to couples) who call my office, the majority are men.

Typically, these men want help overcoming a sexual difficulty they experienced in their most recent relationship. Other times, the calls are from men in a new relationship who suddenly find themselves facing a new sexual problem. Most of the time, the issue they have is difficulty with erection or ejaculation (either rapid or delayed). They will say things like, this was never a problem in previous relationships, or things were going well when my partner and I first started having sex, and then all of the sudden, I couldn’t do it anymore.

The Typical Culprits

I always conduct a thorough biopsychosocial assessment to see what underlying issue might be causing the body to react in this way. More often than not, performance anxiety is to blame. Men (and women) put a lot of pressure on male partners to easily attain an erection and sustain it for a long period of time. These kinds of expectations create immense anxiety for men that they’ll let their partners down if, say, they don’t live up to the standard depicted in movies or (worse) pornography. Other times, we identify a health issue or medication side effect that may be contributing to the problem. Sometimes, I simply have to explain the role that external stress (like pressure at work) has on our body’s ability to respond sexually.

The Hidden Cause

There is one reason for erectile difficulty that isn’t so obvious to penis owners: A change in erection pattern might signal a fork in the road of the relationship. I’ve counseled countless men who initiate therapy 6-12 months into a relationship complaining about a sudden sexual shift. What used to feel fun and effortless suddenly feels different. It can feel different in one of two ways.

Scenario A. The first narrative is that they feel completely confused by what’s happening because they are really into their partner. So much so, that they feel like they are falling in love. The loss of their erection, therefore, makes absolutely no sense. A typical situation is that they are in the middle of making love when suddenly, the erection subsides, causing a great deal of distress, embarrassment, and confusion.

Scenario B. The second narrative—and this one sometimes takes a bit more unpacking—is that they are into their partner but don’t see the relationship progressing long-term. In other words, no emotional attachment is developing. They may want to continue to date and have sex, but the emotional connection just isn’t that strong.

Thus the fork in the road: I’m really falling for this person and see the relationship progressing versus I’m not that into this person, and it might be time to call it quits.

What This Means

In both scenarios, the sudden erectile difficulty signals the presence of deep emotion. In other words, the body is picking up on emotional signals that men might not be consciously aware of. And this is a good thing! It’s a learning opportunity.

Men are often taught to conceal or disconnect from their feelings, especially in sex. Many men (and women) believe that men should be able to get an erection whenever, with whomever, and under any condition. So when this doesn’t happen, many men feel at a complete loss of what to do. This kind of sexual blip can create a wonderful opportunity for men to strengthen their emotional intelligence and understand the mind-body connection. Let’s break it down further.

For men in Scenario A, the likely culprit is love. It is quite common for men to experience sexual dysfunction when the initial intensity in the relationship transitions into true intimacy and connection. Why? Because now the stakes are higher. There is more to lose. And many men don’t realize how terrifying this can be. This kind of relationship vulnerability creates both excitement and fear, which can have a temporary negative impact on sexual functioning. The good news is that there is usually a stronger, even more intense sexual connection waiting on the other side.

For men in Scenario B, the absence of emotional connection causes sexual functioning to go haywire. Many men don’t realize that having an emotional connection is necessary for their sexual function. Sexual dysfunction can also happen when there is conflict or turmoil in a relationship. In these cases, it may be an important signal that it’s time to call it quits.

In both scenarios, the neurochemicals released during the honeymoon phase of the relationship mask the emotions developing underneath. The initial surge of these chemicals makes everything “easy.” Little habits aren’t annoying; sex is intense; you can’t stop thinking about the person. But when the levels of those chemicals fall, usually six to 18 months in, what once felt effortless now requires insight, reflection, patience, and intention.

What to Do

Men in Scenario A should be patient and communicate with their partner about their experience. This is the time to tell your partner how you feel—not an easy task for many men. When emotional expression is met with compassion and empathy, intimacy and trust develop, which help sexual issues subside. In the meantime, a supportive partner will work with you to find ways of connecting sexually that don’t require an erection.

Men in Scenario B should reflect on whether casual sex and relationships fit for them. There is absolutely nothing wrong with casual sex, but it’s not for everybody. I’ve had several clients who feel like they “should” be able to have casual sex and even feel pressured by their peers to do so when what they really want is a stronger emotional connection. And there is nothing wrong with that.

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