Psychology Today: One Surprising Cause for Male Performance Anxiety

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

Dr. Emily Jamea originally published this article in Psychology Today.

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.

Find out what these scenarios mean in the full article on Psychology Today.