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Bill
Bill, LCSW, Consultant, Expert Witness
Category: Mental Health
Satisfied Customers: 3705
Experience:  35 years treating individuals, couples, families with mental health and substance abuse prob's
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I am a healthy 42yo gay male. I exercise 5-6 x per week and

Customer Question

I am a healthy 42yo gay male. I exercise 5-6 x per week and don't take any prescription medications. Im having erection issues and delayed ejaculation. I've been to my PCP and there is nothing functionally wrong with me. I received a prescription for Cialis and it works but I don't want to have to use it all the time.

I feel like it is psychological in nature. I've been seeing this guy for several months and sometimes it works and other times I don't have a response. Of course it's always on my mind and now have anxiety before having sex. I worry if I will get an erection or if it will take me an hour to ejaculate. I just don't k ow what to do.
Submitted: 1 year ago.
Category: Mental Health
Expert:  Bill replied 1 year ago.

Bill :

Hello- Thank you for asking the question. I have over 35 years of experience working with individuals, couples and families & am happy to reply.

Bill :

I see you are offline at this moment but if you come online- feel free to jump in and chat.

Bill :

In the meantime, I will respond and you can follow up with questions as necessary.

Bill :

I am sorry to hear about the very common problem in men you age.

Bill :

It could very well be anxiety based.

Bill :

I see you have entered chat.

Bill :

Let me ask you a couple of other questions.

Customer: Ok
Bill :

Are you able to achieve an erection spontaneously.....i.e. during the night while sleeping or at any other times outside of a sexual encounter?

Customer: Yes it does happen at night once in a while. . Usually has to happen with direct stimulation (ie my hand)
Bill :

Okay- if you are to achieve spontaneous erections- it most likely rules out a physiological issue --------and thus, you are most likely dealing what we refer to as sexual performance anxiety.

Bill :

The attached article addresses this issue in detail:

Bill :

This is a treatable issue and sometimes requires brief cognitive oriented therapy to resolve.

Bill :

Have you been in therapy before?

Bill :

Causes of Sexual Performance Anxiety


Many different kinds of worries can lead to sexual performance anxiety, including:



  • Fear that you won't perform well in bed and satisfy your partner sexually

  • Poor body image, including concern over your weight

  • Difficulties in your relationship

  • A man’s worry that his penis won't 'measure up'

  • A man’s concern about ejaculating prematurely or taking too long to reach orgasm

  • A woman’s anxiety about not being able to have an orgasm or enjoy the sexual experience

Customer: That's reassuring. No I've never been in therapy. Trying to find the best place to look for a sex therapist.
Bill :

I am happy to help you locate a qualified therapist------if you give me your zip code - I will check resources for you......?

Customer: 43215 thank you
Bill :

Hold just a second please....

Bill :

Hello again--------the following provides a list of qualified therapists in your area that can help you with this.

Bill :

You will see the detail on each therapist and contact information. I encourage you to call a couple of them and address your concern before scheduling an appointment so that you make sure you get the right connection and feel comfortable with the therapist.

Bill :

I see you have now gone offline- should you have additional questions, feel free to respond and I will be happy to reply.

Bill :

Kindest regards, Bill

Bill :

I appreciate your positive rating.

Bill :

Thank you

Bill, LCSW, Consultant, Expert Witness
Category: Mental Health
Satisfied Customers: 3705
Experience: 35 years treating individuals, couples, families with mental health and substance abuse prob's
Bill and other Mental Health Specialists are ready to help you
Customer: replied 1 year ago.
Do I look for a sex therapist in this group?
Expert:  Bill replied 1 year ago.
Hi David-

It is not essential that you see a Sex Therapist.
What is most important is that you see someone that understands sexual performance anxiety and and treating anxiety with cognitive behavioral approaches.

I trust this will help- let me know if you have additional questions.

Kind regards, Bill


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