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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4484
Experience:  MD Psychiatry
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How do I overcome sexual performance anxiety? I am 27yrs. old,

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How do I overcome sexual performance anxiety? I am 27yrs. old, male, and healthy other than high blood pressure, which is under control with Lisinopril which is not supposed to cause ED. My main problem is, I lose my erection just before I try penetration. I have no problems getting and maintaining an erection or climaxing during masturbation/foreplay/etc... but immediately before penetration, it just dies, completely or if I am lucky, only half way. I am in love with her, and know it's nothing to do with her. Even though I have become very comfortable with her, it seems I am locked in a vicious cycle of anxiety where I either consciously, or subconsciously think "Well, you failed last time, you will fail this time too!" I try SO hard to just relax, and stop worrying, and I am getting better, but I STILL can't penetrate her. How do I break free from this? How do I rid myself of anxiety? Do you suggest I temporarily try ED meds like viagra to get me thru this? It makes me so depressed!

Hi there ,


Welcome to Just answer !


Well, first of all let me clarify that ED is different from performance anxiety as ED can be due to medical as well as psychological causes including stress and Performance anxiety , BUT , you do not have ED , as you are able to get an erection , it is only when you get anxious and conscious about your performance during sexual intercourse that you loose an erection , so it is basically a psychological cause of Performance anxiety that is leading to all this , and it is certainly not ED.


So, i suggest that you get started on a mix of Drug therapy and psychotherapy ...


Psychotherapy that is counseling , you can seek from a psychologist who is well versed in Cognitive behavioural therapy ( CBT ) , which is a type of counseling technique which suits best for anxiety disorders like performance anxiety.


Secondly , along with CBT , you shall get 1 anti anxiety drug such as Buspar ( BUSPIRONE ) prescribed by your family doctor , and in advance i shall tell you that buspar unlike other anti anxiety drugs or anti depressant drugs does not have sexual side effects , and so is safe and very effective to be used to alleviate anxiety during performance.


So, a combination of CBT and Buspar will surely alleviate your performance anxiety , but this may take some time , say a month's time for full revival , but i believe the wait will be worth it.


I hope this helps..


I wish you all the best..




Customer: replied 6 years ago.
Thanks for the answer, I will click the accept button for sure, but I have one more question. Do you think if I just went to my primary care doctor and explained my situation to her, that she would prescribe the Buspar without me seeing a psychologist first? The only reason I ask, is because I am not sure how much psychotherapy costs. I can certainly afford to see my primary care doctor, but I am not sure I can afford psychotherapy. I have no idea how expensive psychotherapy is, or if my insurance will pay for it. I just want to be prepared either way.I know my doctor was willing to prescribe me anti-anxiety drugs in the past, but that was several years ago. I think it was called Xanax or something like that, but that's probably a different drug than Buspar. Thanks again.
Well, yes your primary care doctor should be able to prescribe you buspar , if she would have prescribed xanax before , which again is an anti anxiety drug , but i would want you to try buspar first , as it is non benzodiazepine anti anxiety drug unlike xanax , which is non addictive and easy withdrawal can be achieved with it , unlike other anti anxiety drugs like xanax , however one flip side to its use is that it will take a around three weeks for it to reach its peak action and alleviate your performance anxiety which in comparison to xanax or ativan or klonopin ( all of these are benzodiazepine anti anxiety drugs , also used for performance anxiety , but to be left as a second option ) a bit longer tim e, but , safer and effective remedy.

So, no issues with the prescription of buspar from your primary care doctor .

I hope this helps..


I wish you all the best..




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