Sex File: My new boyfriend has performance anxiety

Mon, 12 Oct, 2020 - 08:17

I am 30 and have a new boyfriend who is 25. He is fit and physically confident in bed... until it comes to the moment of penetration when he regularly loses his erection. Then, he gets embarrassed and the whole thing ends. What can we do to get past this?

A. The mystery of the disappearing erection is a perennial problem. I'm obliged to advise you to tell your boyfriend that erectile dysfunction (ED) in younger men can be an early warning sign of cardiovascular problems, so he should consider a chat with his GP. However, the fact that he can get and maintain an erection through foreplay means that the issue is much more likely to be caused by performance anxiety.

Men aged 25 never expect to lose an erection during sex, but it happens, often after they have had too much to drink. It is invariably awkward, and the next time the individual concerned has sex he can't help worrying that it might happen again. Feeling anxious speeds up his heart rate and increases the amount of adrenaline in his body. This causes vascular contraction, which decreases blood flow. The more often this happens, the more worrying about it becomes a self-fulfilling prophecy.

That is the simple explanation and, as with most things in life, performance anxiety is often a lot more complex. In some, it is comorbid with physical health issues such as diabetes or mental health issues such as depression. It can also be an indication that the man is not comfortable in a relationship. It can happen, for example, if he is uncertain about his level of commitment, or is reluctant to become a parent when he knows that his partner desperately wants to get pregnant (or even if he just suspects this might be the case). Men who are cheating sometimes find it difficult to maintain an erection with their primary partner, too - it is a subconscious warped loyalty to the affair partner, but not uncommon. As I said, it's complicated.

Sexual dysfunction is not something that we usually associate with 25-year-olds because it is so much more likely to affect older men. However, that may be changing. In the 1994 Massachusetts Male Aging Study, for example, only 5% of men under 40 suffered from ED, compared with 50% aged 70 to 80. But when Anna Kessler at King's College London conducted a global review of studies that examined the prevalence of erectile dysfunction in 2019, the picture was very different. In the studies she looked at, young men had an exceptionally high prevalence of ED, and in one study 35.6% of men aged 18 to 25 had experienced it. Kessler suggests that this might be caused by psychological factors, and one example she gives is anxiety related to sexual inexperience.

If your boyfriend has not had many sexual partners, he may be feeling slightly intimidated about having one who is five years older than him, and his repeated inability to perform won't be helping to calm that anxiety.

He may also be worrying about you and what you want. Although it is not universally true, a lot of men - especially younger ones - misguidedly believe that once a woman hits 30 she becomes possessed by an intractable desire to have babies. It is nonsense, of course, but if you haven't discussed all the "big life stuff" with him, it might be time to quell that misconception. I would say it is worth just having a straightforward conversation with each other about what the relationship means to you both. Clarity removes uncertainty, which decreases anxiety. This might do the trick.