Sex is meant to be enjoyable and pleasurable, but when one attaches worry, anxiety or stress to the equation, the balances tends to falter. Having a sexual problem, for a male, can be quite disturbing to them, they tend to feel stressed out and upset over not able to perform or unable to ejaculate on time or have an erection. 

“A sexual problem, or sexual dysfunction, refers to a problem during any phase of the sexual response cycle that prevents the man or couple from experiencing satisfaction from the activity. The sexual response cycle has four phases:

  • Excitement.
  • Plateau.
  • Orgasm.
  • Resolution.”

Most of the problems are not major and can be solved by counselling and medication.


  1. Performance Anxiety.
  2. Premature Ejaculation.
  3. Erectile Dysfunction.


When an individual is undergoing anxiety, there is a worry, fear and negative thoughts about things and situations. Performance anxiety occurs before or while engaging in the sexual act and the worry about having sex or not meeting one’s expectation or anticipating that you won’t be able to perform leads to performance anxiety. In men, performance anxiety may be fear of having erection problems or fear of premature ejaculation. However, it is this preoccupation with the performance that often prevents people from relaxing and enjoying a satisfying relationship. 

Every individual has certain expectations from themselves or their partner when it comes to sex, and when these personal sexual expectations are not met, it may lead to a downward spiral of feeling unworthy or incapable. These feelings may be influenced by body image, penis size, or by perceptions about manliness or a man's role. More generalized negative thoughts about one's life may also contribute to performance anxiety.

The symptoms of Performance Anxiety are:

  • Premature Ejaculation.
  • Unable to have an orgasm.
  • Loss of interest in sex.

  • Poor body image.
  • Premature ejaculation.
  • Low self-esteem.
  • Feeling inadequate.
  • Worry about one’s own physicality or the size of the penis.
  • Relationship issues.
  • Worry about not having an orgasm.
  • Worry about not being able to satisfy their partner.


According to the Mayo Clinic, “Premature Ejaculation occurs when a man ejaculates sooner during sexual intercourse than he or his partner would like. Premature Ejaculation is a common sexual complaint. Estimates vary, but as many as 1 out of 3 men say they experience this problem at some time.

The symptoms of Premature Ejaculation are as follows:

  • Always or nearly always ejaculate within one minute of penetration.
  • Are unable to delay ejaculation during intercourse all or nearly all of the time.
  • Feel distressed and frustrated, and tend to avoid sexual intimacy as a result.

There are various types of ejaculation disorders among men:
  1. Premature Ejaculation.
  2. Inhibited or Retarded Ejaculation.
  3. Retrograde Ejaculation.


  • Relationship problems.
  • Stress.
  • Abnormal hormone levels.
  • Anxiety.
  • Depression.
  • Sexual abuse.
  • Erectile dysfunction.
  • Performance anxiety.
  • Guilt feelings.
  • Issues related to body image.


Erectile Dysfunction is defined as the inability to attain and/ or maintain an erection suitable for intercourse.

The symptoms of Erectile Dysfunction are as follows:

  • Trouble getting an erection.
  • Trouble keeping an erection.
  • Reduced sexual desire.

  • Nerve disorders.
  • Heart disease.
  • High levels of blood pressure and cholesterol.
  • Substance abuse.
  • Diabetes.
  • Disorders that tend to affect blood flow like Atherosclerosis which is the hardening of the arteries.
  • Obesity.
  • Peyronie’s disease.
  • Tobacco use.
  • Psychological issues like stress, depression, anxiety or other mental health conditions.
  • Parkinson’s disease.
  • Injuries to the spinal cord or the pelvic area.
  • Relationship problems.
  • Multiple Sclerosis.

  1. Stress, Anxiety or Depression.
  2. Relationship problems.
  3. Embarrassment.
  4. An unsatisfactory sex life.
  5. Difficulty in conception.
  6. Low self-esteem.


In order to make a diagnosis one may have to undergo certain tests to recognize and rule out underlying conditions:

1. Blood tests: Blood tests are required in some cases:·

  • Serum Testosterone.
  • Serum Prolactin.
  • Penile Doppler.

2. Ultrasound.

3. Urine tests.


  1. Seek professional help: When it comes to performance anxiety, there may be certain underlying issues which one needs to confront. Consulting a Psychiatrist or a Psychologist would help in identifying and dealing with these issues. 
  2. Communicate with your partner: It is highly imperative to maintain communication with your partner in these circumstances, refraining from communicating with your partner can do more harm than good. Talking about what you feel can help you feel better, finding a solution can become easier and emotional proximity can also bring you closer as a couple.
  3. Explore other means to get intimate: Sometimes it’s better to just take the pressure off yourself to perform sexually and try other means to get intimate.
  4. Exercise is important: Exercise is a stress buster, not only does it help you physically, it also helps one improve their mood. Exercising regularly will help one feel healthier and will also improve stamina.


  1. Behavioural techniques: There are certain behavioural techniques that tend to help with premature ejaculation. Techniques like stop and start, the squeeze and pelvic floor exercises would help.
  2. Medication: Dapoxetine is the first line of treatment when it comes to premature ejaculation. If there is an underlying depression, anxiety or other psychological disorder, then medications may be prescribed in order to treat these conditions.
  3. Wear a condom: Condoms may desensitize you enough, which can help delay ejaculation and one can last longer. These condoms contain numbing agents which are made of thicker latex to delay ejaculation.
  4. Seek professional help: Consulting a Psychiatrist or Psychologist will help in a number of ways. Firstly, if you have certain issues that you would want to talk about which is bothering you or creating stress and anxiety within you. Secondly, if there is a psychological condition like depression, anxiety or any other psychological condition, then seeking help and treating the condition will be important. Thirdly, if you and your partner as a couple are facing relationship issues then opting for couples therapy would help in sorting out these matters and improve the relationship as a whole.

  1. Medication: Sildenafil and Tadalafil is the first line of treatment when it comes to erectile dysfunction. These medicines relax the muscles in the penis and increase the blood flow which allows one to have an erection.
  2. Seek professional help: Erectile dysfunction can create stress in the individual. One can get worried and stress regarding why he is unable to have an erection. Consulting a Psychiatrist or a Psychologist in these times is of great help. Treating the erectile dysfunction, the stress and any other psychological condition like depression or anxiety are of utmost importance. Seeking counselling to take care of the stress, anxiety and depression would also help as one can understand the condition better and take measures and use techniques to deal with it.
  3. Hormones: Men who have low levels of testosterone may feel better with testosterone replacement therapy.
  4. Treating medical conditions: If there is a medical condition like Diabetes Mellitus, treatment should be done.

  • Follow your treatment plan and your doctor’s orders.
  • Smoking is a no-no.
  • Communication with your partner is of utmost importance.
  • Make exercise a priority and a part of your daily schedule.
  • Reduce alcohol intake.
  • Learn to de-stress.
  • A healthy you is a better you, so learn to adapt to a healthier lifestyle.