Cut The Hush-Hush! Let's Talk Erectile Dysfunction & Performance Anxiety

Depression, hypertension, & substance abuse can lead to performance anxiety and erectile dysfunction.

Have you noticed how many people talk about the "flaws" they see when they look at themselves in the mirror, while you sit there, scratching your head, trying hard to find one?

In the movie Kamasutra, Rasa Devi (played by Rekha) says, “Honour and shame may be two sides of the same coin.” It's unfortunate that even though one might believe this dialogue when they hear it, they might still be unable to apply it in their lives.

The idea of being 'manly enough' is still portrayed and accepted as it was ages ago, even though people have been trying to break the shackles of such sex-related stereotypes. This is where topics like erectile dysfunction and performance anxiety come in. There is no shame associated with these words and we need to talk about them out loud.

In order for this to be better explained, The Quint spoke to Dr Ajith Partha, MBBS, Diploma in Psychiatric Medicine, Kindly. He broke down the topics of erectile dysfunction and performance anxiety while making us understand why we need to get rid of the stigma associated with them.

What could be the possible psychological reasons behind performance anxiety?

Anxiety has a lot of psychological aspects; when serotonin starts decreasing or dopamine starts reducing, it affects one’s functioning.

However, performance anxiety comes up if a child is not treated properly as a young individual or has dysfunctional families and went through trauma in any aspect of their life. This may cause the child to develop anxiety in the future with internalised beliefs like they're not worthy enough. Similarly, as one grows up, especially in marriages, if the individual feels unable to satisfy their partner, they may look for multiple compatible partners causing marital issues.

Secondly, porn addiction can be detrimental to one's health and affect one’s confidence as porn portrays a flawless experience of sex, whereas it is different in real life. Conditions like depression, hypertension, alcohol or cigarette addiction can lead to not only performance anxiety but also erectile dysfunction.

What are the other effects that performance anxiety could have? Does it always lead to erectile dysfunction?

Over 25 percent of cases of erectile dysfunction are related to performance anxiety. Since the receptors on the penis are unable to get enough blood supply and adrenaline, it causes poor self-esteem while having sexual intercourse.

A major concern is also premature ejaculation, which is again tied up with performance anxiety, where the receptors are unable to get enough oxygen leading to anxiousness which, in turn, may lead to erectile dysfunction. The patient often starts seeking sexual comfort outside of marriage, causing further health hazards like sexually transmitted diseases (STD).

Are sexual anxieties common?

From 16 to 18 years of age, when an individual is coming out of puberty, they may experience something called ‘dhat syndrome,’ where if a male masturbates, he feels that because he ejaculated the semen, he is now weak and depressed.

This may happen due to improper diet, personal habits, or lifestyle which can increase the chances of performance anxiety. However, due to social media and people opening up, individuals are making an effort to consult a doctor, therefore causing a rise in diagnosis of erectile dysfunction, sexual anxieties, and premature ejaculation.

When should one start getting concerned about it? Can it get dangerous?

Having anxiety around sex is common initially due to multiple reasons like porn perfection, boasting amongst peers, and the inability to satisfy one’s partner in bed, etc. Having anxiety at the beginning of a sexual relationship is very common when doctors counsel individuals.

However, if it continues for more than two weeks or over a month then one needs to consult a doctor and get concerned. In India, we predominantly see arranged marriages, where it can become difficult for partners to get comfortable with each other in terms of sexual intercourse. This can again lead to psychological conditions like anxiety, depression, etc.

Does It Require Medication or Psychological Help To Treat the Conditions?

While diagnosing an individual with erectile dysfunction and performance anxiety, it can be categorised on the spectrum of mild, moderate, and severe. In mild and moderate cases, patients are usually counseled with therapy. But in severe cases, both medication and therapy are used to treat the patient. It is important to evaluate each patient keeping in mind their medical and sexual history, to support them with treatment.

People usually hesitate to seek help when it comes to issues like ED and performance anxiety, what are your thoughts on it?

Men are pressurised by the society to be "manly" enough to have sexual intercourse and not face any problems. In such scenarios, the medical community can contribute by spreading awareness and recording the sexual history of a patient as protocol.

Whereas, social media can be used for spreading awareness amongst the masses. It would also be of great help if patients who have been treated or are in treatment, could share, and talk about erectile dysfunction amongst their friends and family members instead of being ashamed of it as there is nothing not manly about it. The narrative of manly needs to change from being ashamed to openly discussing these issues.