Category Archives: Psycological Health

What scientists know — and don’t know — about sexual orientation

What scientists know — and don’t know — about sexual orientation

2016-05-02

Over the last 50 years, political rights for lesbian, gay, and bisexual (LGB) individuals have significantly broadened in some countries, while they have narrowed in others. In many parts of the world, political and popular support for LGB rights hinges on questions about the prevalence, causes, and consequences of non-heterosexual orientations.

In a new report, a team of researchers bring the latest science to bear on these issues, providing a comprehensive review of the scientific research on sexual orientation.

“We wanted to write a comprehensive review that was ‘state of the art’–in doing so, we also wanted to correct important misconceptions about the link between scientific findings and political agendas,” explains psychology researcher and lead author J. Michael Bailey of Northwestern University.

The report is published in Psychological Science in the Public Interest, a journal of the Association for Psychological Science, and is accompanied by a commentary by psychological scientist Ritch Savin-Williams of Cornell University.

Based on their review of the latest science, Bailey and colleagues draw several conclusions about the nature of sexual orientation:

— Across cultures, a “small but nontrivial” percentage of people have non-heterosexual feelings. The specific expression of sexual orientation varies widely according to cultural norms and traditions, but research suggests that individuals’ sexual feelings are likely to develop in similar ways around the world. — Men’s and women’s sexual orientations manifest in different ways: Men’s sexual orientation is more closely linked to their patterns of sexual arousal than women’s sexual orientation is. — Various biological factors–including prenatal hormones and specific genetic profiles–are likely to contribute to sexual orientation, though they are not the sole cause. Scientific evidence suggests that biological and non-social environmental factors jointly influence sexual orientation. — Scientific findings do not support the notion that sexual orientation can be taught or learned through social means. And there is little evidence to suggest that non-heterosexual orientations become more common with increased social tolerance.

Despite these points of consensus, some aspects of sexual orientation are not as clear-cut. While Bailey and colleagues describe sexual orientation as primarily falling into categories–lesbian, gay, or bisexual–Savin-Williams argues that considerable evidence supports a sexual continuum. He notes that the label ‘bisexual’ serves as a catchall for diverse sexual orientations that fall in between heterosexual and homosexual. As a result, his estimate of the prevalence of the nonheterosexual population is double that of Bailey and colleagues.

From their review, the authors also conclude that gender nonconformity in childhood–behaving in ways that do not align with gender stereotypes–predicts non-heterosexuality in adulthood. According to Savin-Williams, the degree to which this is true could be a consequence of how study participants are typically recruited and may not be accurate among more representative samples of nonheterosexual individuals.

The report authors and Savin-Williams agree on most issues, including that a major limitation of existing research relates to how sexual orientation is measured. Most researchers view sexual orientation as having several components–including sexual behavior, sexual identity, sexual attraction, and physiological sexual arousal–and yet, the majority of scientific studies focus solely on self-reported sexual attraction. The decision to use these self-report measures is typically made for pragmatic reasons, but it necessarily limits the conclusions that can be drawn about how different aspects of sexual orientation vary by individual, by culture, or by time.

Additionally, individual and cultural stigma likely results in underreporting of non-heterosexual behaviors and orientations across the board.

Perhaps the most prominent question in political and public debates is whether people can “choose” to have non-heterosexual orientations. Because sexual orientation is based on desire and we do not “choose” our desires, the authors argue, this question is illogical.

Ultimately, these kinds of debates come down to moral issues, not scientific ones: “People have often thought unclearly about sexual orientation and the political consequences of research,” Bailey adds. “The question of whether sexual orientation is ‘chosen’ has divided pro- and anti-gay forces for decades, but the question of causation is mostly irrelevant to the culture wars.”

The fact that issues related to sexual orientation continue to be hotly debated in the public arena underscores the need for more and better research.

“Sexual orientation is an important human trait, and we should study it without fear, and without political constraint,” Bailey argues. “The more controversial a topic, the more we should invest in acquiring unbiased knowledge and science is the best way to acquire unbiased knowledge.”


Story Source:

The above post is reprinted from materials provided by Association for Psychological Science. Note: Materials may be edited for content and length.


Journal Reference:

  1. J. M. Bailey, P. L. Vasey, L. M. Diamond, S. M. Breedlove, E. Vilain, M. Epprecht. Sexual Orientation, Controversy, and Science.Psychological Science in the Public Interest, 2016; 17 (2): 45 DOI:10.1177/1529100616637616

Survey: Mental health stigmas are shifting

Survey: Mental health stigmas are shifting

2016-04-25

Mental health has a long-standing public perception problem, but the stigma appears to be shifting, at least in the United States, a new survey reveals.?Results from a national online survey on mental health, anxiety and suicide indicate that 90% of Americans value mental and physical health equally.

“Progress is being made in how American adults view mental health, and the important role it plays in our everyday lives. People see connection between mental health and overall well-being, our ability to function at work and at home and how we view the world around us,” said Dr. Christine Moutier, chief medical officer of the American Foundation for Suicide Prevention.
The foundation commissioned a Harris Poll with the Anxiety and Depression Association of America and the National Action Alliance for Suicide Prevention to gauge public opinion on mental health, anxiety and suicide awareness.
In August, the Mental Health and Suicide Survey was emailed to a random sampling of individuals age 18 and older who live in the United States.
Despite recognizing a link between mental health and overall well-being, the majority of survey participants view access to mental health care inaccessible and costly.?

How Americans view mental health conditions

Although most people surveyed identified life circumstances, depression, post-traumatic stress disorder and bipolar disorder as risk factors for suicide, more than half — 53% — did not know that people with anxiety disorders are also at risk for suicide, the survey found.
“The findings provide key insights into how Americans view mental health conditions, life circumstances, barriers for seeking help and their understanding of the risk factors for suicide,” said Dr. Doryn Chervin, executive secretary of the National Action Alliance for Suicide Prevention.
Though psychiatrists say women are more likely than men to have suicidal thoughts, the survey indicates that women are also more likely than men to receive mental health treatment and more likely to report experiencing anxiety and depressive disorders.
Men, the survey reveals, are less likely to report anxiety and depressive disorders and more likely than women to report substance-related conditions.
Between 1999 and 2013, nationwide suicide rates have increased 19.9%, according to the Centers for Disease Control and Prevention. “Men are four times more likely than women to die from suicide and rates are especially higher for middle-aged, white, non-Hispanic men 35 to 65 years old,” said Dr. Alex Crosby, branch chief with the CDC’s Division of Violence Prevention.
Despite the statistics, nearly all survey respondents — 94% — think suicide is sometimes or often preventable.
“Effectively diagnosing and treating both anxiety disorders and depression, especially when they co-occur, are critical pathways to intervening and reducing the suicide crisis,” said Dr. Mark Pollack, president of the Anxiety and Depression Association of America.

Seeking care seen as a sign of strength

The survey also revealed that people ages 18 to 24 are becoming more comfortable with seeking medical help and are more likely to consider it a sign of strength to see a medical health professional, compared with older people.
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“There are many steps people can take to help if they know someone who is suicidal,” Moutier said. “Reach out to mental health providers, call the National Suicide Prevention Lifeline — 1-800-273-TALK (8255) — and make sure the person is not alone until they can get help.
“Talking helps saves lives.”
While psychiatrists affiliated and not affiliated with the survey acknowledge the steady shift in people wanting to understand mental health better, many say more research needs to be done because a stigma still lingers.
“It’s a great step forward to see a public increase in awareness on mental health issues, but there are still limitations when it comes to gaining access to care,” said Dr. Ranna Parekh, director of the Division of Diversity and Health Equity at the American Psychiatric Association?, which was not affiliated with the survey.
“There needs to be an increase in the number of trained mental health professionals, proper facilities and first-response support across the nation in order to treat all the patients who need the special care.”

“Small Penis Syndrome” All Inside Your Head

“Small Penis Syndrome” All Inside Your Head

2015-12-03

With the pervasiveness of internet porn, a lot of men today have the mistaken impression that a seven inch penis is the norm. In fact, it is a behemoth. Male porn actors are carefully selected for their size. In fact, the entire process of making a pornographic film is unnatural, from start to finish. This is not a very good source for learning about human sexuality, or the male anatomy.

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Small penis syndrome for the vast majority of men is psychological, not physical. One British study found that of 63% of men interviewed about their penis size claimed to be inadequate. But when physically examined, researchers determined that each was within the average range. Average is considered between 5.5 and 6.2 inches in length and 4.7 to 5.1 inches in girth. Meanwhile, a survey of women on the subject found the vast majority, 85%, were satisfied with their partner’s size.

What about women, do they prefer a larger size? Men’s Health sexpert Debby Herbenick, Ph.D. said that when it comes to the physical act of love, a larger penis may be prohibitive to a woman’s orgasm, rather than helping it to occur. A man who is too large may even need to accept shallower penetration. Otherwise, he may hit her cervix which can cause pain and bring the entire episode to a screeching halt. Women generally orgasm due to clitoral stimulation—usually through oral or digital contact, or through the use of a sex toy such as a vibrator.

The aforementioned British study found that instead of length, women prefer wider penises. This is because it better stimulates the area of the lower vagina during intercourse. Those with a thin penis can overcome it using certain positions to increase stimulation. One way is by using a circular motion when thrusting, or by taking part in certain positions during intercourse. When she is on top, place a pillow under your bottom. Try taking her from behind. When in missionary, hold up one of her legs for deeper penetration. For those men who still believe they do not measure up, steer clear of supplements or devices found online. These have been found to be dangerous. Instead, be sure to seek out a medical professional, such as a doctor or urologist, for a reliable evaluation.

Sex-ed programs that address gender issues more effective

Sex-ed programs that address gender issues more effective

2015-07-08

By Heidi Stevens, Chicago Tribune

Sexual education programs that discuss gender balance within relationships are significantly more effective at preventing sexually transmitted infections and unintended pregnancies than programs that don’t, a new study finds.

 

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The results are particularly compelling in light of Northwestern University researcher Alice Dreger’s live-tweeting of her son’s ninth grade sex-ed class, revealing a disheartening reliance on fear, shame and anecdotes about condom breakage.

The new study, published in International Perspectives on Sexual and Reproductive Health and authored by Nicole Haberland, a senior associate at the Population Council, spells out a more effective route.

After evaluating 22 sex-ed programs that took place from 1990 to 2012, Haberland found that programs that addressed gender and power were five times more effective.

“Fully 80 percent of them were associated with a significantly lower rate of STIs or unintended pregnancy,” she writes. “In contrast, among the programs that did not address gender or power, only 17 percent had such an association.”

What gives?

“Harmful gender norms have been correlated with a number of adverse sexual and reproductive health outcomes and risk behaviors, even after other variables have been controlled for,” Haberland writes. “Studies have found that individuals who adhere to harmful gender attitudes are significantly less likely than those who do not to use contraceptives or condoms. Also, compared with women and female adolescents’ reports of more equitable relationships, reports of low power in sexual relationships have been independently correlated with negative sexual and reproductive health outcomes, including higher rates of STIs and HIV infection. And women and female adolescents who have experienced intimate partner violence are significantly more likely than those who have not to have a host of adverse outcomes — from low rates of condom use to higher rates of pregnancy and STIs or HIV infection.”

But when adolescents and young adults are taught to consider and strive for gender equity, results improve.

“Some of the curriculums in Haberland’s study challenged young people’s thinking on gender roles by having them discuss the advantages and disadvantages of being male or female, or by analyzing media portrayals of men and women,” Julie Beck writes in the Atlantic. “They asked things like, ‘What is this ad saying to you about what a woman is supposed to look like and act like?’ Haberland says. ‘What are guys supposed to feel and act like?’”

Haberland continued: “Another thing people might do is use case studies,” she told the Atlantic. “Working with a class to critically analyze what is really going on between these two characters. Why is it that Jane isn’t able to use a condom? It’s not because she doesn’t want to, it’s because she can’t say it. He has the car, the money, and he doesn’t want to, and she’s afraid he’s going to leave her. Helping kids identify the inequality in those power dynamics and how it affects all of us in our relationships.”

Of the effective programs, Haberland writes in the study:

“They addressed gender and power explicitly, used participatory and learner-centered teaching approaches, facilitated critical thinking about gender and power in participants’ society, fostered personal reflection about how these concepts affect one’s own life and relationships, and helped participants value their own potential as individuals and as change agents.”

Sounds like a good road map for parents, too, as we tackle the complex topics of sexuality and gender with our own children. As with all things, equality should be at the heart.

Man’s Testosterone Level Drops after First Year of Marriage

Man’s Testosterone Level Drops after First Year of Marriage

2015-05-26

The seven year itch? The four year slump? What about the one year nosedive? The real test of a relationship, at least for the man, may come after just 12-months according to scientists. British researchers at Worcester University found that after one year of a relationship, a man’s testosterone levels drops significantly. During the first year of the couple being together, the man’s hormone level is high. He is ready to fend off competitors so to be the only one for his lady love. He may also be ready to engage in other sexual experiences early on, in case this relationship doesn’t work out. But after a 12-month period his testosterone level falls significantly. 75 male participants between the ages of 18 and 39 took part in this study. Each was queried about his relationship status and how long it had lasted. Then the men’s testosterone levels were measured. Those in new relationships saw their hormone levels sink after one year’s time, researcher’s discovered. For those in relationships for much longer, their testosterone level plummeted even further, by one-third.

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Dr. Daniel Farrelly led the study. He is a psychologist at the university’s Institute of Health and Society. Farrelly believes this may be a biological sign of certain external cues that the couple is expected to remain in a committed relationship. Another reason could be that less testosterone would make a man less aggressive, and so better at raising children and other aspects of fatherhood. Whether a man was single or in a relationship didn’t affect his hormone level. Only when he reached the year mark or beyond did he see his level drop. This adaptation may have helped men switch gears into becoming husbands and fathers instead of fighting off would-be competitors or scoping the scene for other females. The study was published in in the journal Evolutionary Psychology.

Would you go to a Female Urologist?

Would you go to a Female Urologist?

According to a WebMD poll only 8% of urologists operating today are female. That should not be a big surprise as women are making more inroads in what were considered traditional male occupations. Some male patients might be embarrassed at the thought of interacting with a female urologist. After all, examining penises is a big part of the job. Other conditions urologists treat include urinary tract, bladder and kidney problems. These tend to affect both sexes equally, hence the increase in women in the field. Dr. Leslie Rickey is the president of the Society for Women in Urology, an associate professor at the Yale School of Medicine and herself a practicing urologist. She says it isn’t just male genitals urologists’ deal with. In fact, a lot of her practice is helping women who have issues with leaking urine. The Society began in the 1980s, she said. At that time, few women were on the scene. Nowadays, there are a lot more. But there is still a great disparity in this and for many other specialists in the medical field.

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The number of female urologists is growing. Currently, 25% of medical school graduates who are working toward becoming urologists are women. It has been a slow growth rate, however. Many men shudder and ask themselves if they would go to a female urologist. Some say since it’s a medical professional, it shouldn’t matter what their gender is. Instead, their background, expertise, professionalism, patient rapport and conscientiousness are what are important. In other cases however, male patients feel uncomfortable about opening up to a female urologist. But usually, one female urologist is part of a practice. She is there to deal with women’s issues. Lots of women are hesitant to go to a male urologist. So having one that is female within a practice is a good draw and benefits female patients as well. Though being examined by a female urologist isn’t common, it may become more so someday as gender roles in our society flatten and more women enter into the practice.

What to Do after You’ve Had Unprotected Sex

What to Do after You’ve Had Unprotected Sex

2015-03-17

When it comes to unprotected sex, it’s easy to judge others. But most of us aren’t perfect. In fact, few people have not had some type of scare whether it is forgetting to use protection, a condom breakage or slippage, or some other situation. The first thing to do is to remain calm. Panicking is not going to help. Consider whether or not you have any symptoms. For men a discharge, pain when urinating and any sores or rashes in and around the genital area should be seen by a doctor. For women painful urination, a discharge, sores, itching and unexpected bleeding are symptoms that could indicate an infection. If your partner has symptoms and you don’t, get tested anyway. Chances are you have it too but aren’t showing symptoms yet. Remember that no matter where a woman is in her cycle, unprotected sex always has the risk of pregnancy. The rhythm method does not protect against it. For those who are concerned, emergency contraception is available at many clinics, hospitals, doctor’s offices and pharmacies.

fedup young man pulling funny face on white background
fedup young man pulling funny face on white background

Preparation is a good way to avoid this from happening in the future. Be sure to select condoms that fit. It is not as many believe one-size-fits-all. For those who incorporate sex toys or engage in oral sex, these too can spread sexually transmitted infections (STIs). Wash toys before and after using them with a gentle, hypoallergenic soap and warm water. For oral sex, use a dental dam. Don’t think just because you don’t have symptoms that you don’t have an STI. Half of men and 70-80% of women with chlamydia don’t experience any kind of symptoms. Many other STIs such as HIV and herpes can hide in the body for years, even decades without the person knowing they have it. After unprotected sex, get tested. It generally takes between two weeks and three months after exposure for an STI to show up on a diagnostic test. There’s no excuse for not protecting yourself. Everyone slips up now and then. It isn’t the end of the world. But be prepared, be vigilant and safeguard yourself against unwanted pregnancy and STIs.

Are you flubbing the Basics?

Are you flubbing the Basics?

2015-02-24

Some guys are confident in their performance. Others know they have a lot to learn. The truth is there are a lot of unsatisfied women out there, as a recent Reddit threat has shown. Are you flubbing the basics in bed? The truth is that the female anatomy isn’t the easiest to figure out. Each woman is different too in what she likes and how she likes to be touched. Still, there are some basic elements that if you master, your bedroom proficiency numbers will go through the roof. First, don’t skim over the foreplay. It takes a while to warm a woman up for sex. If you really want her to enjoy it and come back for more, foreplay is the key. Try kissing her all over, undressing her slowly, and giving one another oral pleasure before penetrating her. Second, communication is key during sex. Lots of guys are the strong silent type. But she’ll feel like she isn’t pleasuring you if she isn’t getting any feedback at all. Let her know how nice it feels. Be natural. But don’t give her the silent treatment either. Let her know how much she pleases you. It will make her feel warm, sexy and enthusiastic, all good qualities to bring into the bedroom.

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One thing about guys is they are very goal oriented. That’s why they concentrate on giving her the big-O. But for her it isn’t only about climax. It’s about the experience as much as the orgasm. Of course she wants to be satisfied. But rushing to the conclusion isn’t going to be sexy. It’s going to feel like a race. Instead of building a fun, arousing atmosphere you’ll be putting undue pressure on her and yourself, putting a damper on the whole thing. Instead, be patient. Live in the moment. Use your senses. Vividly enjoy the softness of her skin, the smell of her hair, that look in her eyes when she’s really turned on, the warmth of her body and other sensual happenings as things proceed. If you relish the experience she will too. You’ll both have a better time and orgasm will be far more easily achieved by both of you. If you are going down on her, make it an experience. You want to start off small and slowly build her desire and anticipation. Slowly work your way down. Get up close and personal. Tell her how beautiful it looks down there and how much you love to do this for her. Then take your time. Feel it out. See what she likes, using different techniques and stick with what she really likes once you find out what that is. Don’t be shy. Too many guys are too far away. Dive right in and you’ll notice the difference for both of you.

Does Romance Kill Men’s Sex Drive?

Does Romance Kill Men’s Sex Drive?

2014-11-26

Romance primes her body for the bedroom. But for men, it may have the opposite effect. (Dylan & Sara/Stocksy)

Turns out, there may be a scientific reason why movies based on Nicholas Sparks novels are called “chick flicks.” Watching romantic movies revs women’s sex drives — but it also dampens men’s desire to hit the sheets, according to a new study in the journal Archives of Sexual Behavior.

In the world of sex research, there’s a theory about sexual desire called the “incentive motivation model.” That’s a technical way of saying arousal starts with a rewarding stimuli (for example, seeing your partner naked), which automatically leads to a boost in below-the-belt blood flow. Once you realize your body is responding, your mind joins the arousal process, which only heightens your physical response, compelling you to seek sex.

As simple as that sounds, the first step — the sexual stimuli that kicks off the whole arousal process — can vary dramatically between men and women. Take porn, for example. “In a lot of research, when women watch porn movies, their body reacts — they’re genitally aroused — but they don’t feel anything,” lead study author Marieke Dewitte, an assistant professor of clinical psychological science at Maastricht University, told Yahoo Health. However, “we know that if you let women watch porn that is more female-oriented, embedded in a story, they respond with more sexual arousal.”

This suggests that, for women, it’s not just what the sexual stimuli is that matters, but also the context in which they encounter it. “Their sexuality is more dependent on the relationship context,” Dewitte explained.

That’s what inspired the design of her study: 86 men and 78 women watched three video clips — shots of a couple having sex; the scene from Titanic when Leonardo DiCaprio and Kate Winslet share their first smooch, along with a romantic clip from Indecent Proposal; and snippets of a documentary about English history. After watching each clip, the study participants rated how turned on they felt, both mentally and physically. They also completed a survey that measured how much they wanted and liked sex.

Women reported a greater desire for sex after watching theTitanic and Indecent Proposal clips, compared to the sex scenes. Men, on the other hand, were most inclined to do the deed after watching the explicit clips. And, surprisingly, they felt more desire after seeing the boring English documentary than after watching the romantic movies.

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What’s going on? Simple: Women may use romantic scenes as a jumping-off point to conjure their own sexual fantasies — say, imagining being seduced by someone like Jack Dawson in Titanic. By contrast, “men need more visual information,” said Dewitte. As a result, guys tend to favor explicit sexual stimuli (like pornography), possibly because they’re wired to reproduce with lots of partners, rather than nurturing a romantic bond with one woman. “For women, the attachment system is more important, so the partner stays with them and raises the child,” she said. “So it makes sense that sexuality is much more related to the relationship.”

We’ve all heard the “men are more visual” spiel before. But, more importantly, this study helps debunk the long-held theory that men are simply more sexual than women. Dewitte found that in a test designed to measure “implicit” feelings — that is, automatic responses, rather than thought-out replies — women liked sex just as much as men. “If you put women in the right context, they experience as much — or even more — sexual desire than men,” she said. “They don’t always like sex the way men like it. They like kissing, they like intimacy.”

So how can couples overcome this mismatch in cues for sexual desire?

Men: Invest in the relationship

You’ve heard it before: Foreplay starts outside the bedroom — and we don’t necessarily mean fooling around on the couch. “Invest in the relationship during the day,” Dewitte said, which can including sending a lovely message, bringing her a gift or telling her she’s beautiful. These little acts of romance help kick her arousal system into high gear: When a woman senses her partner is emotionally invested, she’s more likely to be primed for fun in the bedroom later. “Men, if you want to have sex with your partner, don’t wait until you’re in the bedroom, and then quickly caress her,” she said.

Women: Pay attention to your body

Learn to listen to your body: Can you feel your heart beating faster? Your arousal building? Make sure to do the same for your partner, too — if you try to detect when he’s aroused, you might just find your own body responding.

Women: Figure out what excites you

As a sex therapist, Dewitte often asks her female patients this question: In order to become sexually aroused, what do you need? “A lot of women don’t know what they need,” she said. “So I ask them to go on the Internet, read books, learn for yourself, ‘What turns me on?’” In her experience, erotic stories often do the trick for women since, unlike porn, naughty reading material allows them to conjure up their own visuals. “Men have to watch — they have to see a breast or an explicit visual cue,” she said. “For women, it’s much more about fantasy.”

Women: Take time to fantasize

If you feel awkward fantasizing, that’s totally normal — it actually can take practice. “Sometimes, in the beginning, it’s not spontaneous at all,” Dewitte said. Her advice: Set aside five minutes a day, and try to script your own sexual fantasies in your head. You may find it tough at first, but eventually you’ll get the hang of it. “You can learn to fantasize,” she said.

What really Causes Performance Anxiety?

What really Causes Performance Anxiety?

2014-10-28

It may feel like you are the only one. But there are millions of men of all different ages, relationship statuses, and sexual orientations that struggle with performance anxiety. Usually it occurs when a man pictures a negative outcome as a result of taking part in a sexual act. He soon becomes preoccupied with his anxiety. This triggers the fight-or-flight response which then disengages the body from the sexual mode, generally deflating his erection, and making him unable to engage in intercourse. For some, it is a vague fear that can occasionally stifle a man’s performance. For many however, the trouble is deeply rooted in general feelings of insecurity or inadequacy. But for many sufferers, these feelings have never been spoken about. Fear of being rejected by a partner, of being unable to satisfy, or being humiliated in the bedroom are the forms the anxiety takes.anxiety

Erectile dysfunction drugs like Viagra, LeVitra, and Cialis are effective for some men. They make having an erection a lot easier, and focus is then turned to pleasing his lover. But for others, where these feelings are deeply rooted, anxiety can still degrade or inhibit performance. Though many men experience anxiety from time to time, one instance of performance difficulty will often reinforce negative feelings, making performance that much harder the next time, creating a vicious cycle. For those with deep seeded performance anxiety, it is important first to get checked out by a urologist to make sure no physical issues are at fault. Once physiology is ruled out, psychology becomes the concern. Seeing a psychologist or a sex therapist can help. One technique therapists employ is called sensate focus. This is positioning the couple where all focus on erection and intercourse is removed. Instead, the attention is placed on arousal, fun, pleasure, and the emotional state both partners inhabit when enjoying physical play. Couples engage in touching, long bouts of foreplay, and oral and digital stimulation without any mention or regard to insertion. The couple focuses on enjoying their time together. Generally speaking, when all pressure is removed, the man’s confidence can be built up. Once that occurs, the ability to perform returns and anxiety is eliminated.