Lack of erection
We've all been there, without any doubt: the moment where
ou're in bed with a woman, but unfortunately your penis is resolutely soft and
there's no sign of an erection anywhere.
Why does this happen? First of all, we men are
under pressure to perform.
After all, we tend to think that sex cannot
happen without an erection, so sex must depend on our being hard, upstanding and
ready. But this discounts the possibility of mutual masturbation, finger
penetration, oral sex and simple skin-to-skin intimacy, all of which can be
rewarding forms of sexual behavior.
If you want to try a
fun quiz to show you how you might be seen by the woman in your bed, click here!
Second, our self-esteem may rest on our ability
to get an erection on demand: if a man's penis remains flaccid when a woman
wants sex, it means he's less of a man - or at least, we seem to assume it does.
And yet, statistics show that on average one time
in every five sexual encounters a man fails to get an erection. With such a high
rate of non-erection, how can a guy's failure to get an erection possibly mean
anything about his manliness?
Third, there's an idea created by the tabloid
press and magazines, and indeed popular culture in general, that "real men" can
satisfy a woman on demand every time she wants sex. So if you don't live up to
this image of maleness as presented in popular culture, once again you're less
of a man, aren't you?
The paradox is most women define manliness by
virtues other than the hardness of a guy's penis: strength, tenderness,
consistency, compassion, clarity and directness being just some of these
The simple fact is that this fear of inadequacy
or performance anxiety is the greatest emotional problem in effective
sexual functioning. (There are some other, physical, reasons for not getting
hard, like diabetes damaging the nerve cells and cholesterol narrowing the
arteries of the penis.)
The way it works is this: you feel anxious, and
you detach from what's happening. Instead of being right there, in the
experience, it's almost as if you're watching it, evaluating and observing it
with a critical eye. Fear of failure crowds out the sensual pleasure you could
be getting from sex, and without any sense of sexual pleasure or arousal, your
anxiety grows, your erection can't happen, and you then get into a cycle of
negative expectation ("I'll never be hard again, so I won't even try to have
Performance Anxiety is a common male sexual problem in which anxiety about
the thought of having sexual relations becomes an insurmountable block to the
natural expression of your sexual feelings and thoughts. The fear of not being
able to perform sexually, can affect your ability to express yourself sexuality
in a several ways.
Sexual performance anxiety can make you want to avoid all
sexual encounters, it can cause a reduction in your self-esteem, it will
certainly produce disharmony in your relationship, and of course it causes
When a man has this problem, he usually spends so much time
thinking about it that he is much less engaged in the process itself - he has,
effectively, removed himself from the situation and disconnected from his
partner. Naturally this makes the failure he fears even more likely.
As the anxious man worries about how it is possible for him to
be sexual responsive to his partner, he tends to focus on the smaller details of
the lovemaking - so much so that any kind of enjoyment of the bigger picture is
diminished. Sex that starts from this emotional position isn't likely to be very
satisfying for either partner.
And of course, anticipation of what will happen next time
produces more anxiety, which will be stronger if there was a failure to perform
adequately (i.e. get an erection) last time.
This tends to make a man want to reduce his sexual encounters
to a minimum - usually zero, in fact, which will probably make his woman think
he is rejecting her. It is important for a woman to understand that this is much
more about him feeling in control and avoiding guilt than rejecting her.
By the way, feeling anxious about sex will only make you
ejaculate faster as it increases the general level of arousal in your nervous
system. If you need to know how to relax during sex, calm down, and take things
more slowly, try
From recent times right back to the 1950's, sex
therapists helped their clients overcome performance anxiety with a technique
called Sensate Focus, a process about getting back in touch with yourself -
It means losing the pressure of the expectations
around sex by agreeing with your partner that for a couple of weeks, you'll
enjoy touching and caressing, but you quite definitely won't be sexual.
This allows the partners to recapture the
sensuous experience of touching each other without any suggestion of sexual
expectations, and to overcome any fear of intimacy that may have developed after
an erection didn't appear on demand.
The partners take turns to give and receive
touch, focusing on being right there in the moment, not emotionally detached and
watching what's happening from some higher psychological viewpoint.
More recently, though, sexual therapists
have seen the advent of Viagra and other drug-related answers to the problems of
performance anxiety. I believe Viagra can be a great help in cases of loss of
confidence, since it promotes an erection and allows a guy to get his
There's more to curing performance anxiety
than taking Viagra, though. For one thing, every man has bouts of sexual anxiety
at some point in his sex life without finding his penis subsequently
wilting every time he has sex. To cut a long story short, therapists now believe
that the lack of erection may be telling its owner something important.
report that a flaccid penis seems very often to be associated with five major life changes:
a relationship that's going off track, divorce or separation, death of a spouse
or partner, employment problems, and poor health.
The last four are obvious, but the first one may be significant.
If you're with a partner
and none of the other factors apply, and you're not tired or stressed, maybe the
message your penis is giving you is that your relationship is past its sell-by
date. For information
on how to control anxiety see
control your anxious feelings and be more relaxed
- not just during sex, but all the time.
In some cases the relationship never reached its
best-before date; in fact it should never have been a relationship at all. A
colleague who works with teenagers finds boys of 15 or 16 coming to him saying
"I was with a girl I really liked, and I was really turned on, but when we
started to have sex I just couldn't get it up".
He thinks many of these guys should still be
playing with their skateboards; they're just too young to be having sex, or deep
down they know they don't like the girl they're with. In short, he says, you can
try and fool yourself, but the penis never lies.
Another thing you might care to keep in
mind is that focusing too much on your partner (as opposed to focusing on your own
pleasure) can be bad for your sexual performance. You have to have a certain
amount of selfishness to get highly aroused, and if you're highly aroused your
partner will be too. Spending too much time thinking about her will not help
you; so if you're having erectile problems, you might want to be a bit more
selfish in getting your needs met.
An ignominious problem, indeed, for many
of the same reasons that I mentioned above - pressure on men to perform, social
expectations, and fear of failure. This time, even though you have an
you ejaculate far too early for either you or your partner to be really
satisfied. Often the problem is fear or anxiety.
But coming too quickly isn't just caused by
anxiety, of course. Among young men, premature ejaculation is so common that
it can be considered normal.
There are basically two methods to use at
home for curing your tendency to ejaculate quickly, both of which depend on
lessening your sensitivity to sexual stimulation. In the first, you get aroused
by masturbation, then when you feel you are about to come, you stop stimulating yourself
and wait until your arousal has dropped.
In the other, your partner gives you a
firm squeeze just underneath the coronal rim of your glans till you're less
excited. It's not a method I recommend, as it is simply rather unpleasant.
Failing that, go to your doctor and ask
him if he knows about anti-depressants and ejaculation. That's not because
premature ejaculation will make you depressed, though it may do, but because SRI
drugs given out for depression slow down the sexual responses. He might be
willing to help you if he's fully informed about how the drugs can help.
Delayed ejaculation - or inability to ejaculate
This might sound delightful to you,
especially if you're a premature ejaculator, but to a man who can't ejaculate
during sex it's not a bonus in any way at all. This is anorgasmia,
the inability to reach orgasm.
Like everything about human sexuality, it isn't a
simple problem. For one thing, it's several problems which look similar. But for
some men, the problem only occurs with their long-term partner; if they have an
affair, they can come normally.
For others, the problem is not partner-specific.
Generally, sexual therapists think that there's a big emotional aspect to this,
of which the man concerned is often very unaware. It comes down to his attitude
to women in general or his partner in particular.
in this position often seem compelled to try and satisfy their partner, even
when they don't experience her presence or touch as sexy or stimulating.
It's about a reversal of priorities, a belief in the
man's psyche that his partner's pleasure is more important than his own, or a
sense that he has a duty to please her at all costs.
He may resent doing so, or feeling so driven, but he
still seeks to please her at the expense of his own pleasure. In essence, his
penis is no longer his own: it somehow has no sexual function other than to
satisfy his partner.
In considering delayed ejaculation the following information is always relevant:
Diagnostic and Differential Diagnostic
The evaluation of psychological factors in patients with delayed ejaculation does not
substantially differ from the usual diagnostic procedures established for sexual
The symptomatology must be clarified by means of a detailed sexual
history, preferably with inclusion of the partner, which forms the basis of a
proper diagnostic classification including the usual formal criteria like
lifelong versus acquired, and situational versus global.
The main goal of the diagnostic assessment is
to determine the conditions under which orgasms are possible or impossible for
the individual patient. As usual, the level of immediate, here-and-now causative
factors should be explored first, through a detailed analysis of the patient's
thoughts and feelings during sexual encounters. Important aspects include:
What are his "start conditions"? Does he
experience enormous pressure to succeed right from the beginning or does this
pressure emerge later during intercourse?
What is his degree of spectatoring?
What is the relationship between subjective
sexual arousal and penile erection?
Does he want and receive sexual stimulation from his partner?
Are there sexual fantasies and can they be
used without feelings of guilt?
the patient monitor his own feelings and emotions during the sexual contact with
his partner or is he totally focused on satisfying her?
Does he have the feeling that his partner
becomes frustrated, bored, or annoyed during prolonged intercourse or that she
is doing it just for his sake" (mercy sex)?
Are there apprehensions in connection with
the experience of orgasm/ejaculation or with the loss of control of which the
patient is aware?
Can the partner
achieve a coital orgasm, and if so, how quickly? Does the patient continue
intercourse after his partner's orgasm?
Another focal point to be addressed during
the evaluation process relates to how the patient masturbates. Again, the inner
processes, the masturbatory technique, and especially the erotic imagery
involved should be explored. Are there sexual fantasies (possibly paraphilic)
about which the patient feels conflicted and which he tries to suppress?
Examination at the level of immediate causes
is followed by an evaluation of more deep-rooted intrapsychic or dyadic
variables. Given the low degree of specificity of these factors, the clinician
should consider the above-mentioned categories and scrutinize them in a
It should be determined if feelings of anger or hostility
toward the partner can be identified or if they should be interpreted as a sign
of more fundamental conflicts. In most cases, hypotheses can be derived from
sexual history, which may then be assessed more closely by targeted questioning.
However, these psychodynamically complex issues, predominantly unconscious to
the patient, often are revealed only in the course of a longer therapeutic
process. Therefore, the investigator should not try to enforce rapid
In terms of
differential diagnosis, delayed ejaculation causes no particular problems.
Attention should be paid to differentiating delayed ejaculation from erectile
dysfunction, since some men lose their erection and don't ejaculate and may
regard this as ejaculatory inability. As with all sexual dysfunctions, it should
be determined if DE is secondary to a psychiatric illness (depression, anxiety
disorder, obsessive-compulsive disorder) or is caused by drugs or medication.