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06 Feb 2004

Scared penis
I am in a new relationship after many years of celibacy, 5 years to be exact. My wife died suddenly after only 6 months of marriage and I was heart broken. Now I have met a wonderful woman and I think I am ready to commit again, but I can not perform sexually. This has now happenned twice. I am 32 years old, very fit and healthy, don't smoke, social drinking, cholestrol is 4 and blood pressure is 120 / 80. What is happening? Doc, can this all be in my head?
Answer 416 views

01 Jan 0001

Performance anxiety or fear of performance is a common sexual problem in which anxiety about engaging in sexual activity becomes an overriding block to the spontaneous flow of sexual feelings and thoughts.

The fear of sexual performance, or, more accurately, the fear of not performing sexually, can affect sexuality in a variety of ways. Performance anxiety can result in avoidance of sexual encounters, lowered self esteem, relationship discord and sexual dysfunction.

Typically, an awareness of performance anxiety produces so much preoccupation with the anxiety itself that the person becomes less fully involved in the sexual interaction, bringing about the very failure that is feared.

In one common scenario, as the anxious person worries about how to be sexually responsive and spontaneous (how to be a "good lover"), he or she focuses on each detail of the lovemaking. The person may focus on how rapidly the partner is breathing, whether a shift in position is required, or how much lubrication or erection is present. The sexual interaction is dissected so deliberately that enjoyment is virtually impossible.

Sexual encounters that proceed in this fashion have a high probability of being unfulfilling for one or both partners. Anticipation of the next sexual encounter arouses the same anxiety coupled with the memory of the previous failure and often leads to avoidance of sexual activity altogether, or at least to minimizing the amount of sexual interaction that occurs.

This may result in one member of a couple mistakenly interpreting the situation as a form of rejection. The underlying avoidance, however, is usually not to reject one's partner, but to save face in a way that helps the person feel more in control and less guilty about being inadequate.

Erectile Dysfunction
Take, for example, erectile dysfunction. It is a disorder that can develop as an outgrowth of performance anxiety. Isolated episodes of not getting an erection or of losing an erection at an inopportune time are so common that they are almost a universal occurrence among men.

Such isolated episodes do not mean that a man has a sexual dysfunction. They may occur as a result of a temporary physical stress (having a cold, being tired, having consumed a large meal or too much alcohol), or may relate to other problems like tension, lack of privacy, or nervousness about a new partner.

If the man does not take such incidents in stride and becomes upset by his failure to respond physically, he may set the stage for difficulties in future sexual experiences by worrying about his ability (or inability) to perform.

Fears of sexual performance ("Will I lose my erection?" "Will I satisfy my partner?") are likely to put a damper on sexual arousal and cause loss of erection. Eventually the fears may become so pervasive that they will become a self-fulfilling prophecy and the man will experience an actual inability to get or keep an erection.

Fear of Performance Can Lead To...
Over the long run, performance fears may lead to a lowered interest in and avoidance of sex, loss of self-esteem, and attempts to control the anxiety by working hard to overcome it (which usually reduces sexual spontaneity and causes sex to be even more of a "performance").

In addition, fears of performance often cause one or both partners to become spectators during their sexual interaction, watching and evaluating their own or their partner's sexual response.

When in the role of spectator because of performance fears, a person usually becomes less involved in the sexual activity itself. The reduced intimacy and spontaneity of the situation combined with the pre-existing fears usually stifles the capacity for physical response. This cycle tends to feed on itself: erectile failure leads to performance fears, which lead to the spectator role, which results in distraction and loss of erection, which heightens the fears of performance. Unless this cycle is broken there is a strong possibility that sexual dysfunction will be firmly established.

Fears of sexual performance are not limited to men or to worries about physical responsivity such as the speed with which vaginal lubrication or an erection is attained, or the length of time that it is maintained.

Fears can also reflect anxiety about one's sexual response on a broader level, such as how much passion, tenderness, intimacy and sensitivity a person feels toward his or her partner. In these cases, a person having no apparent problems in the physical side of sexual responsiveness may be distressed by an internal perception of inadequate or inappropriate sexual performance.

A Lack of True Desire
In some instances, of course, these feelings are a true reflection of a lack of affection for one's partner. But in other cases, a person who expects that sex should always be a monumental, blissful communion with his or her partner, then acts on surging passionate impulses, may feel anxious about having been too selfish and not concerned enough with his or her partner's feelings and response.

Paradoxically, reigning in the spontaneous sexuality in favor of a more measured and synchronized style of lovemaking often backfires, resulting in a disappointing and sterile sexual experience.

Fears of sexual performance are very common and can usually be easily resolved, especially when professional help is sought early in the discovery of the fears. Sex therapists generally agree that the best approach to breaking the cycle of performance anxiety is to talk about the fears or concerns with your partner. This simple suggestion, though often difficult to do, can be the beginning of improved communication and better sexual functioning.

If the problem persists, seeking the help of a qualified therapist would be the next step in the treatment of performance anxiety.

Call SA Sexual Health Association on 0860 100 262 for a referral in your area.
The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical examination, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.
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