Performance anxiety: More and more young men experiencing erectile difficulties

File image.

Binge watching porn is leading to erectile difficulties in young men who believe they should measure up to the male actors they see online, writes Áilín Quinlan.

Erectile dysfunction, or impotence, not only affects a man’s sexual prowess, it can damage his self-confidence, his relationship, and upset his partner — and it seems, the problem is increasing.

Research indicates that erectile dysfunction or impotence — which is the inability to get and keep an erection firm enough for sex — is a problem which appears to be on the increase in men in their 20 and 30s.

Medical conditions such as diabetes, heart disease, obesity, high blood pressure or high cholesterol, which interfere with this communication and blood flow process are often linked with ED.

However, it’s believed that psychological factors such as stress and anxiety are also connected to the problem.

A study last June of 2,000 men for the Coop Pharmacy in Britain found that almost 50% of those in their 30s had reported difficulties in getting and maintaining an erection.

Of those, almost half blamed stress, about 25% attributed the problem to heavy drinking and 36% blamed tiredness followed by anxiety at 29%.

What may often lie at the root of many cases of erectile difficulty is performance anxiety.

Sexologist Emily Power Smith is dealing with a lot of young men worried about their inability to maintain an erection.

She says that erectile difficulties and premature ejaculation are common problems affecting males.

International research is telling us that it looks as if ED is increasing in young men in their late teens and early 20s.

However, many young men often misdiagnose erectile dysfunction.

The vast majority of men Power Smith sees do not have ED, which occurs when a man experiences, for a period between three months and six months, repeated ongoing erections that are not sufficiently hard for penetration to occur. Instead, she says, they often have an erectile difficulty.

Male clients who consult their GP about the problem can often just be given a prescription for Viagra, she comments.

However, it’s important to look into the root cause of the difficulty, which, she has discovered, is often linked viewing porn.

“We’re looking at causes and there’s a definite correlation with the introduction of high-speed broadband, because the nature of how young men watch porn has changed as a result of high-speed broadband.”

Faster broadband speed brings instant access to a very diverse range of pornography and allows the viewer to continually ‘switch’ forward and backwards between highly stimulating scenes, thus continually stimulating themselves.

File image.

“Young men focus on porn to learn what to do,” explains Power Smith.

The downside of this is that the apparent rampant sexual prowess of male porn stars often gives young men an unrealistic perspective on what is expected of them.

Research shows, she says, that young men who watch hard porn tend to primarily focus on the penis; its size, how it moves and how long it stays hard.

However, as Power Smith also points out, male porn stars often use Viagra to remain erect in front of the cameras.

“Guys head into real life having watched porn, and they can end up comparing themselves — their penises — with those of porn actors,” she says.

A young man who enters into a sexual encounter with this mindset can end up feeling inadequate, she points out: “He may feel he does not measure up to the porn actors in terms of his penis not being big enough.”

Psychologist and psychotherapist Sharon Travers is also “seeing more and more young men with erectile difficulties.”

Porn is often at the heart of their problems.

If young men watch a lot of porn, she says, it can lead to a sense of inadequacy in terms of their own physique — and it can also cause intimacy difficulties with a partner.

If a young man is experiencing erectile difficulties, she warns, it can affect his confidence around sex and his sexual performance may be affected.

“Sex is a big part of a man’s identity and it can cause problems in terms of his internal psyche, particularly with younger men,” she says, adding that while older men may accept erectile difficulties or erectile dysfunction as part of life and ageing, it can be a big problem for younger males.

Power Smith believes many young men assume they have ED when what’s actually happening is that, under pressure from porn to be great sexual performers, they may have become over-anxious about their sexual prowess.

This can affect their ability to have an erection and they may end up mistakenly self-diagnosing with ED.

Add to this, says Travers, if a young man is experiencing difficulties in maintaining an erection he may avoid sex which in turn may cause intimacy difficulties with his partner, who may feel that she is not attractive enough for him, or that their relationship is not sound.

File Image.

The fact that pornography often objectifies women can also have adverse implications for a relationship.

If a young man is experiencing problems, she says, it’s important that he sees a GP to rule out any physical cause, and if there may be underlying psychological causes, the next step is to consult a psychosexual therapist to explore his difficulties.

However, a minority of young men who watch excessive amounts of porn via high-speed broadband can experience significant issues, according to Power Smith, who points to the widely viewed TEDx talk, The Great Porn Experiment, by Gary Wilson.

This fascinating, and often humorous, address shows how excessive use of internet porn and the high-speed internet connection can result in over-stimulation to the extent that it can actually cause erectile dysfunction.

Many young men, Wilson explains in the talk, use high-speed broadband to watch very large amounts of porn.

They may have several windows open on a device simultaneously, clicking through pornographic scenarios with one hand while masturbating with the other.

Each time they click, he explains, they get a dopamine hit.

Essentially, what’s happening is that they are teaching their penis to stay tumescent with repeated small dopamine hits.

However, says Power Smith, when a young man is having real-life sex with a woman, he’s gets just one dopamine hit, so if he has used an excessive amount of porn to ‘train’ his penis to expect a series of dopamine hits, it may affect his ability to maintain an erection in real-life sex.

Although this would generally affect only young men who watch a very significant amount of porn, the habit can potentially result in clinically diagnosed erectile dysfunction.

The good news, says Power Smith, is that recovery is possible through the gradual reduction of exposure to porn, and eventually stopping it altogether.

She says:

Problematic porn use can have these effects on reactions in real-life encounters.

However, performance anxiety may also result from a young man’s fear that he will be made fun of by the woman he sleeps with.

“With younger men, there is a real fear that the women they sleep with will talk about them, tell their friends and have a laugh about how small the man’s penis is, how bad he was in bed, or that he experienced erection problems,” she says.

“They have a fear that their erection will not work properly and that word could get around.

“Young men say it (the fear) comes from their experience of hearing young women slagging off other men.

“In all, about 70% of the males I see do not have erectile dysfunction.

“They have erectile difficulties which can be due to stress, anxiety, lack of confidence, poor sexual skills, or sexual shame.”

Many young men can find it difficult to talk about ED and may feel isolated as a result — while they often operate well in a ‘pack’, men are not always effective at supporting each other when it comes to intimate problems.

File Image.

Another issue which can affect a man’s ability to have or maintain an erection is his own masturbatory style, says Power Smith.

“Some men can have a strong grip on their penis and hold and touch themselves with a high level of pressure and speed in order to ejaculate,” she says.

If the man’s partner, is not aware of his strong masturbatory style he or she may touch the man’s penis too gently, causing him to lose his erection.

Because of increased awareness of the problem, and the fact that it is more acceptable to talk about it, over the past 10 years, family doctor Ivan Martin is finding that more people are reporting problems with erectile dysfunction.

ED can result from a number of causes, both physical and psychological, observes Martin, a GP in the West Cork village of Rosscarbery, who has a particular interest in men’s health.

He finds, however, that psychological causes are more common in young men, in particular in relation to performance anxiety. He too believes that watching a lot of internet porn can result in young men developing unrealistic expectations of what their sexual performance should be.

“We encourage people to come in and talk about it. It is about getting to the root cause, whether the cause is psychological or medical.

“For a lot of young men, there is generally no physical cause.

“It comes down to anxiety about performance or negative expectations following a situation where things did not work once or twice.

“This can lead to negative reinforcement about the issue.

“Sometimes there may be pressure from a partner which can cause more difficulty — an understanding partner makes things much easier,” he says, adding that alcohol abuse can also have an effect on a man’s ability to have an erection, as can lifestyle factors such as stress, anxiety, and depression, while certain medications can also play a role.

See your GP, he counsels. “In young men, the cause is usually psychological. Maybe it did not work and then didn’t work again. The head goes down about it and they lose confidence, so it’s less likely to work the next time. It can turn into a negative spiral.”

A doctor can look for underlying issues, takes blood tests, and will often be able to rule out physical causes, he points out, adding that the ruling out of medical causes can be a reassurance for many young men.

“There are psychological supports to help with the problem. However, a lot of it is about seeing the GP and getting it off your chest and ruling out anything serious. The sheer reassurance of knowing nothing is physically wrong can be a big help.”

Lifestyle Matters

"With young men in their 20s or 30s, erectile dysfunction is often down to negative stress or performance anxiety,” says Dr Mark Rowe, GP, author and lifestyle medicine expert.

“The classic situation is a young man who goes out binge-drinking and gets what they used to call ‘Brewer’s Droop’,” he says.

“He gets anxious about it, and the anxiety can kick in and affect his ability to have an erection and that goes into an anxiety loop.”

It’s important to take a holistic approach. “Have a look to see whether any lifestyle issues may be at play,” he says.

And consider your weight and belly size.“If you have a 42in waist across your bellybutton, you are 50% more likely to have erectile dysfunction that if you have a 32in waist.

When you are carrying excess fat it interferes with the body’s hormonal system, which in turn can impact on your ability to have an erection.”

More on this topic

No protocols to manage hospital waiting lists

Testosterone reboot: How to boost men's hormones in midlife

GPs vote for acceptance of €210m Government deal

Investment needed for healthcare reforms to work, HSE director general says

More in this Section

H&M has announced its latest incredible designer collaboration – and it goes on sale tomorrow

Ask an expert: What’s the best way to quickly potty train my toddler?

Album review: Flying Lotus - Flamagra

Special delivery: Rare postbox among items at Sheppard’s auction


Latest Showbiz

Spice Girls dazzle in Dublin as first arena tour in a decade kicks off

More From The Irish Examiner