Sexual Performance Anxiety

Discussion in 'Men's Health Forum' started by Michael Scally MD, Aug 27, 2019.

  1. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Pyke RE. Sexual Performance Anxiety. Sex Med Rev 2019.

    INTRODUCTION: Sexual performance anxiety (SPA) is one of the most prevalent sexual complaints; yet, no diagnosis is recognized for either gender. Thus, research into treatment has been minimal.

    AIM: Review the prevalence of SPA and its relation to sexual dysfunctions and anxiety disorders. Compare SPA to (non-sexual) performance anxiety and social anxiety (PA/SA). Apply pharmacologic principles to the known properties of drugs and phytotherapies to hypothesize treatments for SPA.

    METHODS: Review SPA and PA/SA through PubMed searches for relevant literature from 2000 to 2018.

    MAIN OUTCOME MEASURE: Prevalence was estimated using population-representative surveys. For treatment results, controlled clinical trial results were prioritized over open-label trial results.

    RESULTS: SPA affects 9-25% of men and contributes to premature ejaculation and psychogenic erectile dysfunction (ED). SPA affects 6-16% of women and severely inhibits sexual desire.

    Cognitive behavior therapy and mindfulness meditation training have been proven effective for PA/SA and are recommended for SPA, but controlled studies are lacking. Phosphodiesterase type 5 inhibitors are effective for psychogenic ED and premature ejaculation, both of which include SPA as a major element.

    Drugs proven for PA/SA have adverse sexual and sedative effects, but serotonergic anxiolytics with prosexual effects (buspirone +/- testosterone, trazodone +/- bupropion) may have potential, and sage, passionflower, l-theanine, and bitter orange are anxiolytic.

    Nitric oxide boosters (l-citrulline, l-arginine, Panax ginseng) have the potential for increasing genital tumescence and lubrication, and plant-based alpha-adrenergic antagonists may aid sexual arousal (yohimbine/yohimbe, Citrus aurantium/p-synephrine).

    CONCLUSION: SPA causes or maintains most common sexual dysfunction. No treatments are well proven, although cognitive behavior therapy, mindfulness meditation training, and serotonergic anxiolytics (buspirone, trazodone, gepirone) have potential, and phosphodiesterase type 5 inhibitors are effective for psychogenic ED and premature ejaculation. Several phytotherapies also appear to have potential.
  2. Mac11wildcat

    Mac11wildcat Member Supporter

    A lot of guys need to read this before assuming gear causes their inability to perform.
    TideGear likes this.
  3. TideGear

    TideGear Member

    More than half the guys on this forum need some form of therapy anyway. You guys are fucked.
  4. Mac11wildcat

    Mac11wildcat Member Supporter

    Who you calling you guys? :confused:
    TideGear likes this.
  5. TideGear

    TideGear Member

    I won't name names but you've spotted them, I'm sure.
    Mac11wildcat likes this.
  6. johntt44

    johntt44 Member

    I like how you said "you guys". The ones over there.
    TideGear and Mac11wildcat like this.
  7. TideGear

    TideGear Member

    They are entertaining for sure. But yeah, let's keep them over there. No tranny hookers or weird Chilean dudes allowed at my place.
    ickyrica, johntt44 and Mac11wildcat like this.
  8. Mac11wildcat

    Mac11wildcat Member Supporter

    Oddly specific and amazing.

    But seriously. A LOT of performance threads posted lately with guys assuming it’s “muh drugs” and not “muh brain” causing it.
    johntt44 and TideGear like this.
  9. TideGear

    TideGear Member

    Yeah and it's painfully obvious. Even if it starts with drugs, it's the brain that keeps the problem hanging around. Weird how our noggins work and how allowing yourself to be driven by fear will affect you. Pretty fascinating stuff.
    johntt44 and Mac11wildcat like this.
  10. Tinytim

    Tinytim Member

    I sneek off and rub the first one out. Works for me.
  11. johntt44

    johntt44 Member

    I've had it once but it was guilt driven. It's scary how your mind can fuck with your body!
  12. kosp

    kosp Member

    it heals itself when you don´t give a fuck