Im in my early 20's and am having problems getting fully hard when with a woman. I have no trouble getting hard when watching porn or anything like that. Ive only been with 4 women and have only gotten about half way erect. Is this considered E.D.? Should I get medicated for it, or are there other options? I have been taking anti-depressants for a few years now, Im sure that might have something to do with it.Any advice would be greatly appreciated.

Dear primetime8505,

If you are in your early 20s and "have no trouble getting hard when watching porn or anything like that," chances are that you are experiencing some good old-fashioned PERFORMANCE ANXIETY, in addition to the possible effect of antidepressants. It would only be considered erectile dysfunction if you had difficulties getting hard under any circumstances. No responsible physician will medicate you for situational e.d., particularly not if you're in your early 20s. If you had nerve damage, were disabled, diabetic, etc. and had dysfunction no matter what, it would be a different story.

If I were you, I'd also make a call to my friendly psychiatrist and discuss the possibility of the antidepressants possibly interfering with my sexlife. This is so common that most physicians don't think it's odd or unusual to switch the patient to a different medication if possible, if that indeed is the case.

What you can do - try to relax as much as possible. Do NOT masturbate or get into a self-stimulating state before your date, in fact, don't do anything sexual for a few days just to get a little more hyped for the occasion. If you find a nice girl/lady that you connect with otherwise, do set up future meetings with her...sometimes mastery is subject to familiarity and the more in control you feel (of your own responses, not of her, mind you), the easier and more fun your encounter becomes.

The other issue is that some men feel very pressured to DO SOMETHING when engaging in sexual activity with a partner. One thing you can do to take the pressure off yourself is to let her be the aggressor. Another one is to engage in paradoxical intentions, i.e. tell yourself that you absolutely don't care about getting a hard-on and that you're only hanging out for the sake of some casual fun. The problem with being inexperienced when it comes to women, is that with providers, you only have a set time-limit and life doesn't usually work that way. Relationships, even sexual, tend to evolve over time. The pressure to get something to happen in less than one hour can feel enormous. If you can afford it, try to spend at least 2 hours instead of just one, and do something fun and non-sexual for the first one.

If you are in your early 20s, it would also be a good idea to work on your social skills so that you won't just be restricted to having sex with providers. Not that there's anything wrong with it, but it can limit your options for intimacy and emotional evolution. Try to join something where you'll meet civilians as well. Social activity is good for keeping depressive symptoms at bay, even if you have to force yourself to get out of the house sometimes.

One last caveat - sometimes it's just easier to masturbate and call it a day instead of getting all worked up to meet with a girl. Bottom line, however, is that many guys end up using porn and masturbation as their chief sexual outlet while still wanting to have intimacy with a woman. And when they finally get it, they don't know what to do with it, which can create frustration and disappointment for both parties. You're still young and have life ahead of you. Please try to maximize your social opportunities with civvies first and foremost. Providers are great, but when they become your main source of sexual and emotional satisfaction, it can get both expensive and heartbreaking in the end.

Lastly, I'd like to recommend Bernie Zilbergeld's book "The New Male Sexuality." Bernie was a good guy who wrote some very helpful things for men. There may be something in there for you that might help as well, so go find him on the used bookshelf at Amazon.com or the like.

Good luck to you,
the Love Goddess

Hi primetime8505.  You need to see your PCP (primary care physician).  Only he or she will be able to diagnose this problem correctly.

Good luck and I hope everything works out for you.

LG,

I am curious about something. I know from experience that ED drugs work perfectly well for performance anxiety. Why is it considered improper to use them for this particular kind of ED? In a situation where nothing else seems to work, and assuming there are no other medical issues preventing the use of the drug, why not take it for situational ED?

Thanks for your always insightful replies.

Dear jmadden,

Because ED meds are not designed to fix psychological erectile dysfunction, they are designed to aid assisting with physiological e.d.

Since performance anxiety is psychological, it could be that you get a placebo effect from taking ED meds. The only way we'd know is to do a double-blind study with half the group receiving e.d. meds and the other one getting a sugar pill. But if you're telling your brain that the e.d. meds do something for you psychologically, AND your doctor sees no harm in prescribing them, then s/he is responsible for that treatment protocol. But please rest assured that e.d. meds do NOT work on the amygdala, the limbic system or the hypothalamic brain structures.

The other issue is that someone who does have performance anxiety should try to work on relaxation exercises and do things that will help reducing the anxiety rather than take pills. This is always the first response. You could work this out with a cognitive-behavioral therapist. This is a cognitive-behavioral issue more than anything else. It's no different from having phobias and thus becoming immobilized. We try to solve problems - and very efficiently, I might add - with behavioral treatment protocols before we rush to pills - particularly pills that are designed to help with a physiological problem, not a strictly psychological issue. Of course, the minute physiology creeps into the problem, ED meds aim to work very effectively. But we shouldn't confuse the two issues, that's all.

Cheerio,
the Love Goddess

Im with Jmadden on this one LG.

Especially if it is performance anxiety. What better ego boost is there than sporting a massive hard on after your partner just came 7 times and is having trouble catching her breath. That scenario would cure any performance anxiety I ever had for life. Then the next time I was involved in conversation with an attractive girl, I would know deep down she wanted what I had. And then chances are she would...

PCP's will give you Cialis at the drop of a hat. Just breathe the word ED and youll have your scrip in no time. You dont even need to see a doctor really, PA's can prescribe almost anything but narcotics.

I'll throw my non-professional $.02 right in with the Love Goddess. She gave lots of good advice on many related issues. I'll give some from a guy's point of view, perhaps not that different than your own.

If everything physically works fine during masturbation, then it is in your head. That doesn't make it any less frustrating. I feel your pain, as I've been there. Lying naked next to an attractive woman, wondering what the hell is wrong with me. Getting frustrated at yourself because you know that she isn't having a good time either. It isn't fun. But the more you think about it, the worse it gets. Trust me, I've been through that cyclical thought pattern.

What has been helping me over the hump, so to speak, is patience. As she mentioned, book a longer session. If that means less often (for financial or scheduling reasons), so be it. Tell the lady the deal, so she can adjust accordingly. Then, do your best not to have an agenda. Don't make a mental list of all the things you are going to do with/to her. Try to go with the flow and just do what feels good.

For example, I've found that one thing I really enjoy is kissing. In some ways, that works better on my brain, and therefore the rest of me, than many other things. If I walk in the door and we spend some time kissing, that helps. If she starts running her hands over me while we are kissing, so much the better. There are times where this is much more effective than a sloppy, slurpy BJ. That isn't to say I don't enjoy that too, or wouldn't go for that a bit later once I'm ready.

I'm not saying kissing is your thing, or the ultimate answer. That is just one thing that gets me going. Your answer will likely be different. It could be her talking dirty to you. It may be you licking her breasts. Whatever. Neither the LG or I know what turns you on. That is for you to find out, and it won't be the same every time, or with every woman. But slowing down and worrying less about the erection and coming, and more on simply what feels good will be a more productive approach. Don't worry if you end up spending some time (and money) learning to do this. The effort will pay you back over a long and enjoyable time. So don't rush along with crazy expectations. Build patience and skills.

If you mentally get to the point where you would be perfectly content to spend the couple hours with a lady simply touching, exploring, licking and rubbing your body parts over hers WITHOUT intercourse, then your relaxed brain will get the hell out of the way and let your body do what it is pre-programmed to do. It is a zen thing, or like the children's retort of "when you least expect it, expect it". When you aren't worried about getting the solid erection, you will.

I haven't mastered these things myself. But I'm a couple steps farther down the road and I see the light. So give it time and, paradoxically, don't try too hard. And do give a read to the book the LG recommended. After she mentioned it in a different post, I picked it up used and have been working my way through it, with exercises. Good luck and enjoy the journey.

While I'm here, let me throw out two mentions of thanks. First, the Love Goddess, for the good advice she didn't even know she gave me, because I didn't ask the questions, but read the answers. Second, to any of the ladies I've seen or will see that happen to read this. Thanks for your patience while I've worked on mine.

Ren'man

LG has already stated, and correctly so, that ED meds are not prescribed and do not work effectively on psychological issues. What if this guy uses the meds and he still has problems-which he very well may.

These meds are designed to work in the bloodstream, not the brain. Oh, and by the way, pile-driving a woman into the mattress with a medically induced erection is not a "confidence builder".  Most women would actually consider it to be abusive and every provider I know would have you on her Do Not See list before you had your pants back on...

However... I mentioned nothing about "piledriving". Women rarely orgasm if they are not enjoying it. I defer to your experience BG. Thank you for responding to my post. I find your insights intelligent and thoughtful as always.~Felix

Don't take me too seriously, no one else does!

I'm having trouble understanding if you are talking about civvie women or escorts in your comments Sweatleaf.  My comments are based on relatively few civvie experiences, since I married young, and dozens upon dozens of provider experiences.  Hey, if you are with a lady and she wants to be pounded long enough to achieve seven orgasms I say stick with her.  The most I've ever managed was five and that was all oral and spread out over about a three hour session.

I think this is performance anxiety and yes, success breeds success.  IMHO, the best treatment would be an unrushed session with an experienced provider...  who understands the issues & is willing to do what it takes to slowly, patiently make it happen.  Plenty of time, comfortable, no distractions, total focus...  problems there can sabotage a guy with no problems.

This can not be sprung on a lady out of the blue.  She needs full disclosure & plan enough time to take effect.  

I'd be concerned that a blue pill might become a crutch.  
skb

I have had the same problem all my life and I am 55. I'm running out of time, but I have seen some improvement with therapy. I can get fully hard, but tend to lose it upon any kind of insertion in an orifice. Now that I'm older I have physiological, as well as psychological ED. Therefore, I need the pills to at least fix the physical problem. However, even with the meds, I still have problems.