Performance Anxiety (Stage Fright)

Andrew Siegel MD  6/6/15

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(Thank you, Wikipedia Commons for the use of the image above)

No matter how sexy you think sex is, it comes down to some very unsexy biology, chemistry and physics. I will briefly review the science of the male sexual response and how certain chemicals in the right place at the right time can cause you to be a real Romeo, or alternatively, doom you to having a soft-as-a-marshmallow, good-only-for-standing-up-when-you-pee penis.

“It is like a firstborn son—you spend your life working for him, sacrificing everything for him, and at the moment of truth he does just as he pleases.” Gabriel Garcia Marquez, Love In the Time of Cholera

“The penis does not obey the order of its master, who tries to erect or shrink it at will. Instead, the penis erects freely while its master is asleep. The penis must be said to have its own mind, by any stretch of the imagination.” Leonardo da Vinci

Sex Ain’t Simple Sex is a complicated event that depends upon a number of systems working together in harmony: The endocrine system (produces sex hormones), the central nervous system (where sensations of sexual arousal are experienced and processed), the peripheral nervous system (provides nerve control), the vascular system (blood flow) and the pelvic floor muscles (elevate penile blood pressure to provide rock-hard rigidity).

The Mind-Body Connection The mind-body connection is nothing short of profound and one’s emotional state—which obviously varies from moment to moment—is responsible for the release of a “cocktail” of internal chemicals that can make or break an erection, despite all of the aforementioned systems being in perfect working order. In other words, one’s internal “biochemical environment” at any given moment in time can influence these systems in such a way that may lead to a bone-hard erection or at times, no erection at all.

Stress—The Erection Killer Under certain circumstances—particularly stress—internal chemical release can cause a situational erection problem. Performance anxiety (stage fright—the stage usually being the bedroom) is often due to emotional stress that causes the release of adrenaline, the “flight or fright” chemical that causes tightening of blood vessels and restricts the blood flow to the penis. This is the same chemical that causes one’s pupils to dilate, blood pressure to rise and pulse and breath to quicken. Adrenaline is a great chemical to have onboard when you are in precarious situation, such as being chased by a lion in the jungle. By causing dilation of the pupils, a rise in pulse and blood pressure and rapid breathing, it prepares you to confront the danger in a turbo-charged state so that you can perform optimally. The last thing on your mind in this situation is sex, and by restricting blood flow to non-vital organs including the penis, blood flow is directed to where it will best serve you to get out of the precarious situation. So, stress does not belong in the same sentence as sex, and when it does, it is a formula for a losing situation. Emotional stress can have many causes including a new sexual partner, worry about getting an erection, guilt, work concerns, worry about child care or caretaking of parents, financial woes, unemployment, or life in general (who isn’t stressed?). For some men, the stress of having to wear a condom can cause the inability to obtain or loss of an erection, known as condom-associated erectile dysfunction.

Fact: On the rare occasion that a man has a prolonged erection (a.k.a. priapism), an adrenaline-like drug needs to be injected directly into the erectile chambers of the penis in order to cause the erection to subside. When anxiety strikes, adrenaline is precisely what dooms your erection. The adrenal glands pump out adrenaline, which circulates to all organs, including the penis, and presto, the blood flow to the penis is choked off and the erection is history.

The Chemistry Of Love With erotic stimulation or touch, the erectile chamber nerve (cavernosal nerve) releases nitric oxide, which in turn causes the release of cyclic guanosine monophosphate (cGMP). This causes the erectile chamber arteries (cavernosal arteries) to dilate and blood to gush into the penis and also causes the smooth muscle of the erectile chambers to relax, allowing space for blood to fill the chambers. You now have a plump penis, congested with blood. The pelvic floor muscles then engage and further increase the pressure within the erectile chambers, and voila, you have a rigid erection. After ejaculation, the enzyme phosphodiesterase (PDE) is released. PDE is the flaccidity chemical that by decreasing levels of cGMP, results in a return to the flaccid state by a reversal of the aforementioned chemical mechanisms. Viagra, Cialis, Levitra and Stendra work by inhibiting PDE.

Let’s say that you are emotionally stressed before entering an erotic situation or become stressed after it has started. Enter adrenaline in high enough levels and that erection will never occur or if it does so, will rapidly be lost. Adrenaline is your friend in life and death situations, but not in the bedroom!

Wishing you the best of health,

2014-04-23 20:16:29

http://www.AndrewSiegelMD.com

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”: www.HealthDoc13.WordPress.com

Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health: available in e-book (Kindle, iBooks, Nook, Kobo) and paperback: http://www.MalePelvicFitness.com

Co-founder of Private Gym: http://www.PrivateGym.com–available on Amazon and Private Gym website The Private Gym is a comprehensive, interactive, follow-along exercise program that provides the resources to properly strengthen the pelvic floor muscles that are vital to sexual and urinary health. The program builds upon the foundational work of Dr. Arnold Kegel, who popularized exercises for women to increase pelvic strength and tone. This FDA registered program is effective, safe and easy-to-use: The “Basic Training” program strengthens the pelvic floor muscles with a series of progressive “Kegel” exercises and the “Complete Program” provides maximum opportunity for gains through its patented resistance equipment.

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