Male Performance Anxiety: Why Does He Lose Erection?

During intimacy, my boyfriend sometimes loses his erection?

Hello doctor, I have a difficult question to ask.
I've been dating my boyfriend for six months, but during our intimate moments, he often suddenly loses his erection, which makes things quite awkward.
He is only thirty-five years old, in good health, and exercises daily.
It's strange because he loses his erection without ejaculation; for example, once when I was using my tongue on him, he was hard but suddenly went soft.
Isn't it common for men to enjoy that? The most frequent occurrence is when he is very hard and about to enter my body, he suddenly goes soft and can't penetrate.
Even when he finally manages to enter, if I get too loud with pleasure, he goes soft again, and there is no ejaculation.
He can watch adult films and pleasure himself to the point of being very hard and can ejaculate normally, but he loses his erection when we are together.
In the morning, he wakes up hard, but as soon as he climbs on top of me, even before we take off our clothes, he goes soft.
He insists he has no other girlfriends and likes women, not men.
However, when he feels too much pleasure, he suddenly becomes very scared, extremely scared, and then loses his erection.
He has experienced this since his teenage years, and it was the same with his previous girlfriends; he has never successfully ejaculated inside a woman.
I suggested he see a doctor, but he feels embarrassed and fears being found out.
When pressed, he claims it must be because he doesn't love me enough, which is why he goes soft when we are intimate, even though he has no issues when watching adult films.
I don't want to put pressure on him, but if we were to get married, we wouldn't be able to have children.
What should I do? Is this condition treatable? Which specialist should he see? Are there hospitals where he can make an anonymous appointment? Thank you, doctor.

Zhu Yin, 30~39 year old female. Ask Date: 2009/05/27

Dr. Zheng Jingming reply Psychiatry

In cases of general erectile dysfunction, it is important to first determine the underlying cause, whether it is organic or psychosocial in nature (most often it is psychosocial).
A proper diagnosis is necessary before appropriate treatment can be administered.
Whether his inability to maintain an erection is due to organic factors or psychosocial factors can only be determined after a physician's evaluation.
This is not an incurable condition; understanding the causes and working to overcome the barriers, along with appropriate treatment, can lead to improvement in many cases.

You can express your concerns in a caring manner by simply stating the facts and sharing your feelings without making any diagnostic judgments.
You might say that everyone should undergo a health check-up.
It is advisable to consult a urologist or a specialist in sexual medicine, such as Dr.
Wen-Rong Guang at Kaohsiung Tzu Chi Hospital.
As far as I know, most hospitals require patients to register under their real names.
Based on your description, it seems that your boyfriend's issues may primarily stem from psychological factors.

In terms of sexual activity, you can start by providing him with emotional support to boost his confidence, minimizing criticism, and avoiding putting too much pressure on him to reduce performance anxiety.
Mutual support generally yields better results.
Dr.
Cheng Ching-Ming at Qishan Hospital is also a good resource.

Reply Date: 2009/05/27

More Info

Understanding male performance anxiety, particularly the phenomenon of losing an erection during intimate moments, can be complex and multifaceted. It is essential to recognize that this issue is not uncommon and can stem from various psychological and physiological factors.
In your case, it appears that your boyfriend experiences performance anxiety, which is a common issue among men. Performance anxiety can manifest as a fear of not being able to perform sexually, leading to a cycle of anxiety that ultimately results in erectile dysfunction. This anxiety can be triggered by various factors, including past experiences, fear of judgment, or even the pressure to meet expectations during intimate moments.
Your boyfriend's situation, where he can achieve an erection during solo activities but struggles during partnered intimacy, suggests that the pressure of the situation may be overwhelming for him. The fact that he has experienced this issue since his teenage years indicates that it may be a long-standing concern rather than a reflection of his feelings towards you. It is crucial to approach this matter with sensitivity and understanding, as feelings of inadequacy can exacerbate the problem.

Here are some steps you can take to address this issue:
1. Open Communication: Encourage an open dialogue about sexual experiences without judgment. Let him know that you are there to support him and that his worth is not solely defined by sexual performance. This can help alleviate some of the pressure he may feel.

2. Reassurance: Reassure him that many couples face similar challenges and that it does not diminish your feelings for him. Emphasize that intimacy is about connection and pleasure, not just performance.

3. Seek Professional Help: Encourage him to consider seeking help from a healthcare professional, such as a urologist or a psychologist specializing in sexual health. A professional can provide a safe space for him to discuss his concerns and explore potential treatment options. Therapy, particularly cognitive-behavioral therapy (CBT), can be effective in addressing performance anxiety.

4. Relaxation Techniques: Suggest incorporating relaxation techniques into your intimate moments. This could include deep breathing exercises, mindfulness, or even engaging in non-sexual physical affection to reduce pressure and anxiety.

5. Gradual Exposure: Encourage him to gradually expose himself to intimate situations without the pressure of performance. This could involve spending time together in a relaxed setting, focusing on intimacy without the expectation of sexual activity.

6. Consider Medical Evaluation: If he is open to it, a medical evaluation can help rule out any underlying physiological issues. Sometimes, hormonal imbalances or other medical conditions can contribute to erectile dysfunction.

7. Anonymous Consultations: If he is concerned about privacy, many clinics offer anonymous consultations. He can explore telehealth options or seek out clinics that prioritize confidentiality.

In conclusion, it is vital to approach this situation with empathy and understanding. Performance anxiety is a common issue that can be addressed with the right support and resources. By fostering open communication and encouraging professional help, you can help your boyfriend navigate this challenge and strengthen your relationship. Remember, intimacy is about connection, and addressing these concerns together can ultimately enhance your bond.

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