One of my favorite topics to talk about is anxiety. Another is sex. As someone who has spent a large portion of her career examining gender variables, these topics tend to overlap when talking about men and sexual performance. Anxiety does not discriminate based on any variable and for many individuals, when anxiety hits sex starts to plummet. Sex is an innate part of humanity, without it, the species could not continue. But as we have progressed as a species, so have our difficulties. Men who have difficulty functioning sexually are stigmatized, humiliated, and frequently report feeling inadequate. But what role does anxiety have on sex for men? Let’s dive in shall we!
According to Masters and Johnson, sexual response occurs on a particular cycle:
When we discuss sexual functioning issues in men, we are talking about something not working somewhere in this cycle. Now, different sexual problems happen at different points. For example, the most commonly known sexual difficulty in men is erectile disorder (aka erectile dysfunction). This is the inability to obtain and/or maintain an erection for the desired length of time. For most, they think that it is an organic issue that can be treated with a pill such as Viagra or Cialis. However, for more individuals than you may think, the cause of ED is not organic. Psychological effects can be a major cause of sexual issues, particularly in men. One of the major areas I am going to focus on here is anxiety.
Anxiety can look differently for different people, but ultimately it is a sense of arousal (not sexual) where your body cannot turn off it ingrained flight, fight, or freeze response. Your body is preparing you for something bad whether it be anxiety related to intrusive memories of combat, fear of going over bridges, shaking from a fear of panic, stress related to obsessive thoughts; anxiety makes your body turn on and not in the fun way. When your body is anxious, it is often difficult to focus and this includes sexual focusing. When a man is anxious he may notice his erection not emerging or deflating quicker than he’d like . He may be able to “keep it up,” but not be able to have an orgasm. For some, the anxiety makes their system go into overload and they may orgasm extremely quickly.
So why does anxiety cause these problems and why is it that once they start to happen more often, it’s harder to fix them? The penis is very sensitive, both literally and figuratively. Anxiety can make a man even more sensitive to everything around him both internally and externally. A major area of concern I see in practice is the impact of Posttraumatic Stress Disorder or PTSD on erections. While not often discussed, it has been found that individuals with PTSD are at significantly increased risk of having sexual problems. Why you may ask? One major area is the body. When someone is going through a trauma, their entire body system is activated. They are more sensitive to sights, sounds, smells, tastes, and physical sensations, so when they are trying to make sense of what is happening, their brain is creating a pairing that tells it “when X body system happens, Y bad thing will happen so be prepared.” Ready for this: when your body is sexually aroused, the exact same physiological system being activated is the one that was activated during trauma that created that pairing. So, when your body “turns on” for sex, it’s also “turning on” for trauma. No wonder someone with trauma has difficulty functioning sexually! Their body is preparing for another horrible thing to happen even though the actual situation is one of pleasure. The pairing effect often results in increased fear and anxiety, intrusive thoughts about the trauma, disconnection from the situation, and physical touching difficulties to name just a few. This is only one example of how anxiety can cause difficulties in someone’s sex life, but for men especially, there is another layer to the anxiety.
Societal pressures about sexual performance and expectations in men are staggering, but not often discussed. Men are typically told that being a man means certain things and one of those things is having a functional penis. There are horrible messages given to men that if they don’t have sex that makes them weird, a freak, broken, not a man, and so many other completely wrong labels. Not being able to have sex, masturbate, or feel aroused with anxiety is completely normal, but it is also one of the things that makes someone feel not just anxious, but depressed. If a major area of your identity is your ability to functioning sexually and that goes away, what does it say about you? For many men with anxiety and sexual problems, it does not just go away. If anything, the longer you wait to treat the anxiety, the harder (pardon the pun) treating the sexual problem is as well.
Anxiety is a tricky thing to treat by yourself as are sexual problems, but what we know about treatment is that treating one can impact the other. Finding a provider who can address these interconnected issues is key in your overall recovery. If you would like to know more about how to treat anxiety and sexual problems in men, feel free to give me a call at 702-587-1573 or an email at jnspsychology@gmail.com. Having anxiety does not make you a freak, having sexual problems does not make you any less of a man, and seeking out treatment does not mean you are weak.