Posts Tagged ‘performance anxiety’

“Butterflies” In Your Penis: What You Need To Know About Performance Anxiety/E.D.

April 14, 2018

Andrew Siegel MD   4/14/18

“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

 

brain-303186_1280.png

The brain is the biggest and most important sex organ, the “conductor of the orchestra

( Thank you, Pixabay, for image above)

 

Every man at one time or another may experience a situational erection problem due to  circumstances. As intoxicating and exciting as a new relationship can be, situational erection problems are not uncommonly experienced because of the anxiety and concerns that can surface when encountering a new sexual partner.  Additional contributing factors can be other life stresses, fatigue, too much alcohol consumption, recreational drugs, etc.

Men are human beings and not robots that can always function on command. It is not always easy to “stand and deliver” and, unquestionably, the lion’s share of the sexual “burden” is on the male.  In the circumstance of failure to achieve a good quality erection in a new sexual situation, it is not a matter of insufficient male rocket fuel (testosterone), poor sexual desire,  malfunctioning plumbing or sexual orientation.  It’s all about chemistry and by this I do not mean the attraction and spark kind of chemistry between two individuals.

The brain is the most important sex organ and the mind-body connection is profound. One’s emotional state drives the release of a “cocktail” of chemicals that can make or break their ability to perform any pursuit, whether it is giving a speech, sports or in the bedroom. When it comes to the bedroom, one’s internal “biochemical environment” at any given moment in time can chemically promote a bone-hard erection or, at times, no erection at all.  The problem is not with the hardware, but with the software!

Performance anxiety is nothing other than stage fright—the stage the bedroom—due to emotional stress (whether conscious or subconscious) that causes the release of adrenaline, the “flight or fright” chemical that causes tightening of blood vessels and restriction of blood flow to the penis.

Adrenaline is an amazing chemical to have onboard when you are in precarious situation, such as being chased by a lion in the jungle. It causes your pupils to dilate, blood pressure to rise and pulse and breath to quicken.  This stress hormone that is churned out by the adrenal glands prepares you to confront the danger in a turbo-charged state so that you can react optimally.  However, adrenaline causes a restriction of blood flow to non-vital organs including the penis, so that blood flow can be directed to where it best serves one to deal with the precarious situation. The point is that stress does not belong in the same sentence as sex, and when it does, it is a formula for a losing situation. For some men, the stress of having to wear a condom can doom the erection to failure.

Fact: On the occasion that a man has a prolonged erection (a.k.a. priapism) that lasts for more than four hours, an adrenaline-like drug is injected directly into the erectile chambers of the penis to cause the erection to subside. 

The chemistry of erections and performance anxiety

The chemistry of erections: With erotic stimulation or touch, the erectile nerves release nitric oxide, which in turn causes the release of cGMP. This causes the erectile chamber arteries to expand 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 erectile chambers.  The chemistry of defeat: If enough adrenaline is present, the erectile arteries will narrow and the smooth muscle of the erectile chambers will contract. The presence of enough adrenaline trumps the presence of nitric oxide and cGMP.

The psychology of performance anxiety

What goes on in the man’s mind: Performance anxiety often “gets in the head” of the man plagued with it.   Excessively focusing and dwelling on the issue further decreases the likelihood of obtaining a rigid erection by creating a self-fulfilling prophecy of failure. When entering a sexual situation preoccupied with anxiety and doubts, one often ends up being a spectator of his own performance (Masters and Johnson referred to this as “spectatorating”), instead of being in the moment and present as one needs to be to be able to function properly, often dooming one’s erectile potential.

What goes on in the female’s mind: As they say, “It takes two to tango.”  Another big problem is the partner’s interpretation of the man’s inability to obtain and/or maintain an erection. The partner, confronted with the poorly functioning male, commonly thinks—erroneously– that the root of the problem is that the man does not sufficiently care for her,  find her attractive or that her sexual allure and proficiency is lacking.

So, the male not only has performance anxiety, but often experiences secondary anxiety from being consumed by the problem, creating a “vicious cycle.”  And the female now has anxiety and concerns about her looks, her skills in the bedroom, his feelings, the future of the relationship, etc.  This is clearly not a good combination for the start of a healthy relationship!  The truth of the matter is that the root of the problem is neither the man’s plumbing, his sexual orientation, nor his feelings about his partner and it is not a question of the female’s attractiveness, allure or sexual prowess.

Bottom Line: Performance anxiety is a common form of emotional stress that can be experienced with a new sexual partner.  Enter adrenaline in high enough levels and an erection will never occur, or if it does so, will rapidly be lost. Adrenaline may be your friend in life and death situations, but not in the bedroom!  Although oral ED medications (Viagra, Cialis, etc.) can chemically kick-start and often help counter performance anxiety and break the vicious cycle that has been established, adrenaline is such a powerhouse chemical that it can sometimes even doom an erection in a man who has taken performance-enhancing drugs.

The female in the relationship should understand that she is not the cause of the problem and she should not hold herself nor her partner accountable, which serves to further exacerbate the stress and anxiety.  Rather, she should stay calm, be understanding and supportive and realize that once her partner becomes more comfortable with the relationship, the anxiety and the problem will most often magically disappear.

Finally, it is important to understand that other common sexual issues, including premature ejaculation and delayed ejaculation, elicit virtually the identical psychological and emotional responses from both male and female partners as does performance anxiety.

Wishing you the best of health,

2014-04-23 20:16:29

A new blog is posted weekly. To receive a free subscription with delivery to your email inbox visit the following link and click on “email subscription”:  www.HealthDoc13.WordPress.com

Dr. Andrew Siegel is a physician and urological surgeon who is board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  He is an Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community.

Dr. Siegel has authored the following books that are available on Amazon, iBooks, Nook and Kobo:

MALE PELVIC FITNESS: Optimizing Sexual & Urinary Health

THE KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health 

PROMISCUOUS EATING: Understanding and Ending Our Self-Destructive Relationship with Food

Cover

These books are written for educated and discerning men and women who care about health, well-being, fitness and nutrition and enjoy feeling confident and strong.

Dr. Siegel is co-creator of the male pelvic floor exercise instructional DVD (female version is in the works): PelvicRx

 

 

 

Advertisements

You Can’t Think It Up, But You Can Think It Down

November 21, 2015

Andrew Siegel MD   11/21/15

IMG_1500

(Above fortune from Chinese fortune cookie relevant to this discussion.)

Q: What is the most powerful sex organ?

A: If you think it is the erect and throbbing penis, you are incorrect. The BRAIN is the bossman and the most influential force driving sexuality. The penis is a mere buck private soldier that responds and bends to the will of the five-star general and commander-in-chief of sexuality, the central nervous system.

Despite the authority and assertive presence of the brain, it is only under rare circumstances that it is capable of willing the limp penis to become erect. Some form of touch or erotic stimulation is most often necessary to get the erection process going, with the exception of nighttime-related erections associated with a phase of sleep known as REM (Rapid Eye Movement).

If the central nervous system cannot will the limp penis to become erect, it certainly can will the erect penis to become limp or will the limp penis to remain limp. This is the case with performance anxiety, a classic instance of the powerful mind-body connection. In this circumstance, stress or anxiety causes the output of high levels of adrenaline, which functions to constrict penile blood flow and erectile smooth muscle relaxation, resulting in a limp penis.

The central nervous system is the commander-in-chief of sexuality, but it demands working the way it likes to work, i.e., naturally, unhindered and unburdened by cognitive thought. Conscious and willful thought clearly can interfere with the smooth function of the central nervous system. When conscious thought enters the picture, the ability to perform many complex movements goes south. Much the same as a golf swing or any action like using a fork to feed yourself or walking down a flight of stairs, when it comes to sexuality, the brain works best when it is working subconsciously. Overthinking is the enemy of any complex motor activity. With all of these examples, one needs to be in the moment and engaged in the activity without conscious thought, in order to enable a smooth execution.

The moment one starts overthinking, the complex motion is virtually destined to be flawed. The golf swing is a classic example, with a poor shot almost guaranteed if one has too many swing thoughts that confound execution and performance. For the non-golfers, try walking down a flght of stairs at a good clip, stating to yourself in your inner voice each step in the process and you will likely trip up. When you are in a sexual situation, if you focus on thinking about your sexual function or lack thereof or reliving a previous problem, then your performance will most often be doomed to failure.

stupid-487043_1920

(Thank you, Pixabay for image above)

Too much thought is capable of empowering self-fulfilling prophecies and bringing them to fruition. If one has had erection issues and in a passionate moment starts thinking, assessing, evaluating and analyzing, he is almost certain to be incapable of obtaining or maintaining an erection. Likewise, if one suffers with premature ejaculation and his thought pattern becomes obsessively focused on this possibility instead of being in the moment and enjoying the situation, he is almost certain to ejaculate way sooner than desired. The same is true with the rarer but equally disturbing problem of delayed ejaculation. Focusing on trying to make oneself ejaculate will most often bring on the inability to ejaculate.

Masters and Johnson coined the term spectatoring, an intense self-focus during sexual interactions as opposed to immersing oneself in the sensory aspects of the sexual experience. Essentially, spectatoring is observing and monitoring yourself having sex as if you were a third party, often accompanied by an anxious internal, self-conscious dialogue with concerns about some aspect of your sexual performance. It is being a spectator instead of the player and it will DESTROY your game.

The solution to spectatoring is to “be present” and “in the moment,” totally immersing yourself in the experience without observation or conscious internal thoughts. When you lose yourself in the sensations and do not allow thoughts to interfere with the process, you maximize your chances for an optimal performance. When distracting thoughts uncontrollably float into the present like dark clouds in the sky, take a deep breath, exhale slowly and allow the thoughts to pass and return to a state of being present.

Bottom Line: Overthinking is the enemy of complex actions, including erections and ejaculation. Allow the central nervous system to do what it does so well– subconsciously– without trying to help things along with deliberate thought.  Let instinct prevail over conscious thought–you cannot make it happen, you have to let it happen. There is an  time and place for conscious thought, but it is not in the heat of the moment in the bedroom.  Be present without thought of the past or future. 

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 (Amazon Kindle, Apple iBooks, Barnes & Noble Nook, Kobo) and paperback: www.MalePelvicFitness.com. In the works is The Kegel Fix: Recharging Female Pelvic, Sexual and Urinary Health.

Co-creator of Private Gym, a comprehensive, interactive, FDA-registered follow-along male pelvic floor muscle training program. Built upon the foundational work of Dr. Arnold Kegel, Private Gym empowers men to increase pelvic floor muscle strength, tone, power, and endurance: www.PrivateGym.com or Amazon.

Performance Anxiety (Stage Fright)

June 6, 2015

Andrew Siegel MD  6/6/15

600px-Depressed_(4649749639)

(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.