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Bill
Bill, LCSW, Consultant, Expert Witness
Category: Mental Health
Satisfied Customers: 3706
Experience:  35 years treating individuals, couples, families with mental health and substance abuse prob's
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I have a hard time achieving an erection and ejaculating with

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I have a hard time achieving an erection and ejaculating with a partner but not when masturbating. It has always been that way and I am 51 yo male. I'm only interested in younger males (18-32) and only interested in performing oral sex. Am I a homo-romantic asexual?

Bill :

Hello- Thank you for asking the question. I have over 30 years of experience working with individuals, couples and families & am happy to reply.

Bill :

I am happy to help you with this.

Bill :

First- I don't think you are a homo-romatic asexual.

Bill :

My sense in what you have written is that you have the common problem that is faced by persons with all sexual orientations......

Bill :

Performance Anxiety.

Bill :

Millions of men, regardless of age, relationship or orientation suffer from sexual performance anxiety. This condition in sexual situations occurs when a man anticipates some form of problem occurring during the sexual act. As a result of this anticipation, the man becomes anxious or panicked while attempting to be sexually active. This translates into problems with erections, premature and delayed ejaculation or a lack of desire to have sex.

Bill :

Having anxiety about sex is a difficult situation to reverse. Unfortunately, it is very common and can happen to anyone at any age and at any time. Sexual performance anxiety can start from a very brief simple event even in very stable, emotionally healthy individuals. Sometimes even a single time in which the man loses an erection can be enough to raise doubts and cause anxiety the next time. Although this happens to every man at certain occasions, it can begin a downward spiral causing problems of confidence in and out of the bedroom. The more frantic you become the worse the problem will become. This can be a very slippery slope!


Anxiety is intended by Nature to be a warning system of a threat or danger. In such cases, your brain becomes alert, your muscles tense for running or battle and other parts of your body, such as digestion, shut down while you are in stand-by mode. In the sexual situation, if our warning system tells us that there may be a problem then we are more likely to have a problem. The warning system causes the problem. This is a self fulfilling fear.

Bill :

So, if a man's brain warns him that there may be a problem during sex, there will be a problem because of the warning. A man's warning system releases chemicals that interfere with his sexual performance. We were not made to be anxious and have sex at the same time.


Sex therapists use a technique called sensate focus to help men with performance anxiety. This technique encourages a couple to remove all stress from the sexual act. Sensate focus was first used by Masters and Johnson and aims to get a man to stop thinking about erections and his performance. Instead, the goal of sensate focus exercises is to get the man to focus on the feelings and sensations of sexual arousal. Rather than thinking about performance, the goal is to experience each touch, sensation, smell, movement, sound and taste of the sexual act.

Bill :

Performance anxiety causes the man to focus on the mechanics of sex rather than the pleasure, sensations and excitement. They are thinking about sex rather than enjoying it. Sex is best when you can shut the mind off and stop thinking.

Bill :

When the couple feels relaxed in this situation, the next step might be for them to communicate, caress and touch without clothes. The focus however is always on the pleasure and the enjoyment. Without worry about the erection or his performance, sex for the man is not a job that needs to be done. It can be a positive and pleasurable experience.

Bill :

In summary, many men with sexual difficulties tend to over-think about their performance rather than staying in the moment and enjoying the sexual sensations and feelings.

Bill :

This is something that can be treated with Expert trained in Sex Therapy.

Bill :

If you send me your Zip Code- I will be happy to identify experts in your area that can help you with this issue.

Bill :

Other information can be found here on the problem of performance anxiety.

Bill :

Should you have a follow up question feel free to ask- I am happy to help.

Bill :

Kindest regards, Bill

Bill :

Please leave Positive Rating so that I receive Credit for my time.

Bill :

Thank you

Bill :

-follow up questions- no additional cost

Customer: replied 3 years ago.

Thank you, XXXXX XXXXX Code is 92264. Is performance anxiety treated with medication or would it be weeks of questions and answers with a therapist?

Hi Nick-

I typically suggest that people talk to a Therapist first (this should not be long term therapy). The focus is on getting past cognitive barriers that impede sexual activity.

Unless you have a history of Anxiety Disorder.......medication would be a second step.

The following is a link to qualified Experts in your area:

http://therapists.psychologytoday.com/rms/prof_results.php?sid=1362592299.7588_20146&zipcode=92264&spec=3&spec=17

Call and discuss your issue and schedule an appointment with someone you feel comfortable talking to. Detail about each expert is provided.

I wish you the very best.

Kindest regards, Bill
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