Not unlike the problem of low sexual desire that I discussed in my previous blog, erection problems can be caused by physical, emotional and relationship reasons as well as a combination of these factors. I could tell you the main reasons men have erection issues who come to see me for help.
- Medical issues such as diabetes or certain medication side effects
- Low testosterone
- Performance anxiety
This list is in increasing order of frequency of what I see in my office. When it comes to # 1 above, there are certain things that can be done to help a man who has medical issues such as changing medications that hopefully have less sexual side effects. Also using Viagra, Cialis or Levitra might be very helpful. (I still like to use these medications as a last resort) Lastly, sometimes acceptance of limitations is necessary. When acceptance is necessary, clients are taught and encouraged how to have a good sex life even if it is not centered on a rock solid penis.
Men with low testosterone can often be helped with testosterone injections or patches. In some cases, the change is pretty significant and rapid. Not all people are helped even with testosterone patches. This may mean that there are now some performance anxiety issues as well.
The most frequent factor is performance anxiety. Our culture has instilled in men the idea that we are sexual machines and our sexual purpose is to prove we are “men who can perform under any circumstances in the bedroom” Some women do not help by assuming that if the man had an erection issue, it automatically means that he is not attracted to that woman. A frustrated, disappointed woman can put even more pressure on the man who is having these challenges. I have helped many men take the pressure off themselves, change their mindset and learn to shift their sexual purpose from performance to connection. I have helped women change their mindset and feel better so that they help create an environment that is free of performance pressure.
The other factor that I did not mention is when a man comes to my office for erection issues but in reality he has low sexual desire. That requires a different set of interventions so it is important to be assessed accurately by a skilled sex therapist.
In conclusion, I will go one step further and say that the benefit of having erection problems due to performance anxiety is that it often helps the person learn to be kind and less perfectionistic in ALL areas of his life; not just in the bedroom. I will be happy to help any men and couples out there who are struggling with this issue. Often, it is not a difficult problem to treat and the man (or couple) can enjoy a wonderful and connected sex life again or maybe for the first time.
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