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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 5751
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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I am a 50 yr old man and I have been married to the same woman

Resolved Question:

I am a 50 yr old man and I have been married to the same woman since I was 25 and we have 4 grown children. I have had trouble achieving and/or maintaining an erection with a female since my teens. I also had trouble with what seemed to me to be fairly early ejaculation (just 3 to 5 minutes of intercourse). I don't think it is a blood flow issue that can be managed with ED drugs as I can have an erection quite easily when by myself looking at pornography. I think my problem is more psychological than physical. I don't want to go my whole life without exploring whether there is some treatment/therapy to help. I guess my question is: does this problem seem like something that could be treated successfully?
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Z replied 1 year ago.

Dr. Z :

Hello I believe I can help you with your concern

Dr. Z :

I am so sorry that you have this issue, I can imagine how distressing this is for you

Dr. Z :

You mentioned that you do not believe that this is a physiological problem because you achieve an erection easily (but cannot maintain it), but I would like to ask if you have seen a urologist to officially rule out a medical issue?

Dr. Z :

I do agree that this is most likely a psychological issue, sometimes called performance anxiety, and this can be treated successfully through therapy. The best type of therapist for this would be one who specializes in sex therapy or an official sex therapist

Dr. Z :

I can help you find a suitable therapist for this in your area if you like, all I would need would be your zip code.

Dr. Z :

In addition, sometimes the use of antidepressants like wellbutrin or remeron can help decrease performance anxiety (these two have the lowest incidence rate sexual performance issues as well, which is why I recommended them)

Customer:

I seem to be able to achieve and maintain an erection for a long time when viewing pornography (alone)....so no I have not seen a urologist. The performance anxiety sounds like real possibility. My zip code is 75062

Dr. Z :

Okay I will compile a list of good therapists for your issue, give me a few minutes. May I ask do you view pornography often?

Customer:

I go through periods when it is almost daily and sometimes go weeks or months without viewing. It seems like I use partly as some kind of crutch or emotional escape...maybe during stressful periods

Dr. Z :

When you go through months or weeks without viewing pornography, do you still have issues maintaining an erection with your wife?

Dr. Z :

So here are a list of certified sex therapists in the Dallas-Fort Worth area

Customer:

We never really have sex any more...its probably been a year since the last time. The last few times I used a direct penile injection type of ed med which certainly generated a long lasting hard erection. She has never initiated or even seemed particularly interested in the sexual side of life. Of course that doesn't help with performance anxiety if I think it is because I am not doing things well enough for her

Dr. Z :

Yes I can see why that would definitely not help with your performance anxiety, I am sorry to hear that. These sex therapists can also provide couples counseling to help with the issue of her not initiating as well

Customer:

ok, thanks for the advice and the list of therapists. any hints on criteria to help in selecting one versus another?

Dr. Z :

Well I think that Dr. Littlefield has the most extensive training to help you, but I also like Barbara Gold, Constance Engels, and Roz Van Meter as well because of their extensive training in helping couples with these issues. For you, I think it would be easier to talk to a male about these issues, but if you choose to go to a couples therapist, your wife may find it easier to talk to a female therapist. Still all of these I listed had to go to extensive training to be certified in this area which is not easy, so they are all definitely qualified.

Customer:

excellent, thanks again very much! I'll give you a top notch rating on the way out!

Dr. Z :

Anytime, I am always happy to help. Is there anything else I can do to assist you today?

Customer:

No...that's a good start. Have a great weekend.

Dr. Z :

You have a good weekend as well and I wish you the best of luck with everything. My goal is to provide you with excellent service, so if you ever have any further questions or concerns please do not hesitate to contact me at anytime.

Customer:

Will do. Goodbye for now

Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 5751
Experience: Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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Dr. Z
Dr. Z
Mental Health Professional
5751 Satisfied Customers
Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.