Firstly, let me talk about the giggles. I used to find this a difficult subject to talk about, but nowadays, I find myself completely at ease with the subject, so I fully appreciate if you initially find it hard to start this conversation with me.
These sessions work very well over zoom, which may be preferable for some of you.
The common types of psychosexual issues impacting men are:
- Erectile Dysfunction
- Premature Ejaculation
- Delayed/No Ejaculation
- Low libido
Sex is a fundamental human drive, so issues here can impact all areas of the man’s life, potentially leading to the following:
- Anxiety, confidence, and self-esteem issues
- Reluctance to form relationships
- Willingness to put up with abusive, manipulative, or exploitative relationships
- Sexual unhappiness for all parties
- Lack of regular sex leading to a drop in testosterone, which leads to: weight gain; mood issues; inadequate production of relationship/bonding chemicals
- Difficulty having children
1 – Erectile Dysfunction
“Struggling to get or maintain an erection.” This is very common – a recent survey in the UK (healthline.com) concluded that this effects:
- more than 33% of men under 30
- about 50% of men in their 30’s
- slightly over 40% of men in their 40’s and 50’s
There has been such a huge rise in ED in the under 40’s that the medical profession has coined the term “Millennial ED” to describe it.
- This can be caused by several physical health issues, which we will go over. (So also see a doctor.)
- It can also be caused by stress, anxiety, depression – but also by past experiences, relationship unhappiness, and unrealistic expectations. It is important to understand that even though we consciously know that porn is unrealistic, our subconscious doesn’t know that, and gets mislead & miss-trained.
- It can also be caused by external factors, e.g. various drugs & medications.
2 – Premature Ejaculation
According to a study by the Mayo Clinic, as many as 33% of men say they experience this at some time.
In a 2008 survey of sex therapists, “too short” is defined as less than 2 minutes after penetration, “adequate” is 3 to 7 minutes”, “desirable” is 7 to 13, and the reported range for “too long” went up to 30 minutes. Interestingly, back in the 1980’s, PE was only counted if ejaculation happened before penetration.
- This can be caused by diabetes, high blood pressure, thyroid problems, and prostate disease. (So also see a doctor.)
- It can also be caused by anxiety, excitement, and learned behaviour. It is important to understand that even though we consciously know that porn is unrealistic, our subconscious doesn’t know that, and gets mislead & miss-trained.
- When humans first started having sex, we weren’t the dominant species, so we couldn’t afford to spend much time doing this.
3 – Delayed/No Ejaculation
This is rare, to the point of anecdotal, so that many doctors do not believe it is an actual issue. But obviously, it’s pretty hard for a man to father children if he doesn’t ejaculate during penetrative sex…
Also, some (but not all) of these men find the quality of their orgasm reduced if/when it takes more than 30 mins.
Fortunately, one of the practitioners in my supervision group had this, so I am able to get some direct insight into this.
- This can be caused by several physical health issues, which we will go over. (So also see a doctor.)
- It can also be caused by stress, anxiety, depression – but also by past experiences, fears associated with sex (e.g. religious or social taboos) and unrealistic expectations. It is important to understand that even though we consciously know that porn is unrealistic, our subconscious doesn’t know that, and gets mislead & miss-trained.
- It can also be caused by external factors, e.g. various drugs & medications. Anti-depressants can regulate mood so effectively that the user is unable to generate the spike of neurochemical arousal of an orgasm.
4 – Low libido
This often happens with age, and may or may not be a problem.
However, it can also be a response to stress, either in general, or about relationships specifically, or about sex specifically.
It is also a common side effect of many drugs, including antidepressants.
This may be a natural change with age, in which case you (and only you) can decide if the issue is the low libido, or how you feel about your lower libido.
- There are some physical health issues which can cause this – e.g. weight issues, lack of exercise, . (So also see a doctor.)
- It can also be caused by stress, anxiety, depression, lack of confidence/self-esteem issues – but also past experiences, misleading comparisons on social media, or imagined social taboos.
- It can also be a side effect of medication, e.g. Dapoxetine – an antidepressant (SSRI), or other drugs.