FrankTalk.org

Tldr: 36 year old male. Formerly on lexapro for about 4 years. Been off for just under 2 months. Split 2 years ago from wife who was first and only partner. Marriage ended because she cheated on me. Didn't use to have a problem, but since seperation been with 3 women and oral/hand is fine but intercourse I always go soft and can't achieve penetration. Don't masturbate for several days before dates. Tried Cialis yesterday, 20 mg, still didn't happen.


Ex wife was disabled for a big chunk of our relationship, so intercourse was infrequent and carefully done when it did occur, but I did not have any erectile problems when it did. When I went on lexapro my sex drive did suffer, and it took a lot longer to achieve orgasm (and sometimes didn't) but not the problem I'm having now.


First woman I was with post marriage I was extremely physically and emotionally into. But she was religious and had those "this is sex and this isn't" rules that some religious people have. Penis in vagina was no go, penis up and down vaginal lips was ok. So penetration was never an option but I never had any concern about being capable of it. I never had any issue of maintaining an erection and even though I was on the lexapro I still had a desire and want.


Second woman I was with, we had been sexting and the like. But before we met she said she didn't want to have sex in the first date because in the past she had been with guys who couldn't get it up on the first date. I laughed at that idea but was like, whatever your boundaries are your boundaries I respect them.


I wonder if that's what put it in my head.


We did end up 3rd base in the car anyway without a problem but didn't even attempt intercourse.


When we did attempt on our next date though it... Just didn't happen. I'd go soft everytime I tried to enter her. I wasn't as attracted to her as I was the other woman, and we were FWB path, not relationship path, so I hoped it was a combo of lexapro, not enough attraction, and just getting used to being with someone else.


After 2 times with her where it happened I reached out to my therapist and we talked about how it is probably am anxiety feedback loop and I need to just get lost in the moment and just let it happen and not put pressure on myself because that makes it worse.


Anyway this woman and I met up once a month for awhile. She was understanding (said she had her own issues in the past) and we kept trying but it never ******* happened. Always soft when trying penetration.


Went off the lexapro then in August. Doctor supervised, I didn't just stop it.


Started seeing a new woman a couple weeks ago. Attraction is not an issue. In her mid 20's and definitely sexy. Very enthusiastic. I am crazy turned on - really want her. And yet, again, can't do the ******* deed. Worse, she says she can only cum when she son top. Oral/fingering don't work for her, has only came from penetration. I orgasm twice our first night together from her stimulation but everytime I try to enter her - it does, then springs back up immediately afterwards.


I mention to my doctor my issues. He gives me Cialis to try, stat with 10 mg but can use 20. Says it's probably a confidence thing, use a pill a couple times and I won't need them any more.


So I took 20 mg yesterday, because I don't want to risk just the 10, an hour before she gets here. Couple hours after she gets here we start fooling around. I'm very aroused. Go for it and... Whomp whomp. Try another couple of times, and same thing. Get up, go to go in, drop. Like my penis is allergic to vaginas.


She's not happy at this point, she doesn't say it, but she just stops cold and says she's done and doesn't want to fool around anymore. I apologize, stress that it's not her, and that there is something wrong in my head. We chat and cuddle watch some of a movie for another couple hours before she leaves. She texts me that she is home safe but otherwise haven't heard from her.


Anyone else have a similar issue? How did you get by it?

Yes, I most definitely had a similar issue. It's called coital anxiety and the good news is: it is easily treatable.

First and foremost, anxiety is a major erection killer. Sexual performance anxiety is extremely common, esp. among young men. You just need to learn how to feel your body and control your anxiety levels.

I endured this sex anxiety curse for more than a decade. Back in the 1990s there was very little information available and I didn't even know this was a medical condition. I just suffered in silence and barely had any sex in my 20s.

Today I am 44 y.o. and I have a perfectly normal sex life. And if I could do it, so can you.

Here are a couple of tips that can help you overcome this:

a) Choosing the right partner is obviously important, you will feel much less anxious with someone you love and trust.

b) The more you know about sexual performance anxiety, the less stressful it will be. Read books (check out the works of the brilliant American urologist Tom F. Lue), talk to doctors, visit good websites. Coming to franktalk.org was a smart thing to do.

c) Do some research on the famous 'sensate focus' technique: sex is not just penetration, don't rush things and in the first sexual encounters just avoid penetration. As you two become more comfortable with each other, you can then try penetration.

d) Lexapro and other SSRIs are erection killers, stay away from those drugs. There are much better antidepressants available today, e.g. tianeptine.

e) The right sexual position may also be helpful. In my case, I used to prefer the woman on top because she would be in charge and I didn't have to worry about anything.

f) I also tried a penis ring for some time: it is uncomfortable and your partner will see it but it may be helpful. Don't wear it for too long, though.

g) Nobody is infallible! It is perfectly normal to fail every now and then, that is nothing to worry about and it is not ED.

h) If you do have a negative sexual experience, just avoid sex for a while (one week, two weeks, one month, whatever you think is necessary). This will allow you to relax, clear your mind and forget about it.

i) A warm shower before sex can do wonders: it will relax you and widen the blood vessels that bring blood into the penis to form an erection.

j) No big meals before sex, of course. You need blood in your genitals, not in your digestive system.

k) Sleep and relaxation are essential.

l) Do some research on the role of the nervous system in the erection process, esp. the infamous 'fight or flight response'. When you get too anxious, adrenaline, cortisol and other chemicals are released in your body and they will block erections. This is a perfectly normal biological reaction: the last thing you need when you're facing a dangerous or stressful situation is an erection.

m) If your problem persists, go see a doctor (urologist). It's no shame to seek professional help and even if this is just psychological, a doctor will be able to help you. Self medication is always a risk.

n) In my case, oral meds were extremely effective. I take avanafil (brand name Stendra) + oral phentolamine (brand name Vasomax) 30 minutes before sex and it works beautifully. I intend to add apomorphine to this regimen, as well. I believe phentolamine is excellent in cases of sexual performance anxiety because it blocks sympathetic action in penis (the sympathetic nervous system mediates ejaculation and detumescence, whereas the parasympathetic nervous system mediates erections). These are, however, prescription drugs and only your doctor can say if they're right for you or not. Side effects may include hypotension, tachycardia and headaches.

I hope this helps. Good luck and keep us posted on your progress!

I agree with what anotherlogin says, except I would visit the urologist sooner rather than last.

For decades medical professionals have attributed erection difficulties to anxiety or psychological factors. As medical practice and medical assessment has improved, we find that many of the disorders that were "all in your head" really have a physical cause. Sometimes "its all in your head" really means "I don't know the cause of the problem."

One of the classic stories about this involves George Gershwin, the song composer. Near the end of his life he was troubled with disabling headaches. His psychoanalyst believed that it stemmed from repressed anger against his father. Doctors could find nothing. And shortly after he died of a brain tumor.

Good points from both Flavio and limpbiscuit.

I suspect that Flavio is closest to the mark. It's an anxiety issue. If you can get hard and stay hard and climax normally by any sexual activity apart from penetrative sex, I think it's a psychological thing.

Like Flavio, I have been to the movie. When I was about age 42, i had just come out of a long term (and only to that point) relationship. My first gf after that was a real sexy babe in her 20s. Almost intimidating. She had more sexual experience than I. I suffered from insecurity and performance anxiety. Like you, we could do just about anything normally, but Willie would wilt when confronted with a willing vagina. Sometimes he'd get in, but quickly turn to jelly.

There were occasions with that girl when I could perform normally if I brought her to orgasm manually or orally first. Somehow my dick seemed to draw courage from the fact that she had already been satisfied. He could then pound away for 10 or 20 minutes in that enticing pussy. But it wasn't really great sex. My girl was one of those who can only manage one orgasm in a time frame of about 2 or more hours, so once she had come, she was a willing, but not enthusiastic, participant. Not really ideal for either of us. This went on for a couple of years, including many times when my did stubbornly refused to go inside. Scared of the dark or something.

At one point, I received the suggestion that I consult a sex therapist. I was living in Los Angeles and the person said to be the best was, I think, in San Francisco. Not in LA in any event. I contacted him. He said we could do therapy by long distance phone. I had some doubts. So, before embarking on the course, I went to a men's clinic in LA. A doctor there examined me and did an ulrasound and pronounced by dick healthy. He thought the issue to be psychological and gave me a sample pack of 5 Viagra pills.

I took the pills home and put them away for a few days. I was scared to try them, since I did not want to be disappointed. I harbored doubt as to whether some pill would really fix what had been a plague for so long.

One morning I got up my courage. I popped one of those 50 mg. puppies and went back to bed, next to my girl. We both always slept naked. I starting spooning her and within a few minutes I got a feeling in my dick and in my brain that told me this was really going to work, and it did! It was amazing, really. A miracle. We had great sex regularly after that until we parted company a few years later. We parted because her work took her to a location in which I shared no interest. Not because of any issue - sexual or otherwise.

I was soon in a new relationship with a young woman I found very attractive. I took the pills as a matter of course. I considered them a necessity. Worked well and reliably as always. It took me maybe a year to realize that with my new girl, the pills were not needed. My dick and long got over that feeling of terror and wanting to hide from beckoning pussy lips.

You have tried Cialis with no positive result. It has worked for me, but not nearly as well as Viagra. Flavio reports success with avanafil. I have not tried that, or Levitra. I gather that some work for some guys and others work for others. So try them all, if you can, or find the need.

malibog wrote: When I was about age 42, i had just come out of a long term (and only to that point) relationship. My first gf after that was a real sexy babe in her 20s. Almost intimidating. She had more sexual experience than I. I suffered from insecurity and performance anxiety. […]

I had a similar experience. It was the most beautiful girl ever, maybe in her late 20s, very dominant personality and heaven knows why she wanted to have sex with 40 y.o. me. I was able to attain an erection but came too quickly. I was a bit angry and frustrated at the time but it was no big deal and I quickly forgot about it.

Thanks for the replies coming in.

I will definitely look up the author recommended.

My doctor said to keep using the Cialis for now. One time isn't enough to judge the drug needs a few more incidents before he will prescribe/recommend anything else

My therapist has recommend a 12 week free therapy program my public health provides. My GP needs to sign the forms though to apply. It's not for the ED, it's for various things - anxiety, trauma, depression - the provincially assigned therapist would determine the best course to take - but obviously working on these underlying issues would hopefully have an effect on the symptoms of them - such as this ED.

Anotherlogin wrote:- the provincially assigned therapist would determine the best course to take

Where are you located, if you don't mind saying? Mention of anything "provincial" does not sound very American, which seems to be (not surprisingly) where most here are located.

malibog wrote:

Anotherlogin wrote:- the provincially assigned therapist would determine the best course to take

Where are you located, if you don't mind saying? Mention of anything "provincial" does not sound very American, which seems to be (not surprisingly) where most here are located.

Ontario.

My work benefits cover about 6 therapy appointments per year. This program is a 12 session free program paid by the province but you still have to buy work books. My therapist works on the program so it may be him but probably not.

Thanks anotherlogin. I am in BC.