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Trying to kick performance anxiety

Eisenhower

New member
I struggle with sexual performance anxiety and it's really depressing. A couple low T tests (235 and 434) caused me to finally go see Dr. Mariano, who said it's actually probably my E2 causing libido issues (it was only 10 while my T was 460). He's got me on lots of nutritional supps and stuff trying to get my sleep and diet right in an effort to better regulate hormones.

Before I went to Dr. M I'd been taking supps like Argenine and Zinc and had actually started getting nocturnal and spontaneous erections again (hadn't had nocturnals in a few years and had started to use Viagra to ensure good erections when I needed them). I actually stopped using Viagra for sex - it was great. After about six months though, I thought I noticed it was taking longer to get erect for sex and the old performance anxiety started up again. That's when I went to see Dr. M who keyed me in that it was probably E2 not the T that was causing erectile issues (lack of nocturnals, slow to get hard, etc.)

I started using Viagra again recently just because I hate worrying about how fast I'll get hard. But for some reason (probably because I'm only 37) I feel really bad about myself for taking Viagra ... And the sad thing to me is that I know the anxiety limits what would probably be decent performance without Viagra. For instance, I'll get hard just hugging and kissing my girl, but if I KNOW we're about to have sex, it will take oral or direct stiulation to get hard because I'm nervous.

I don't really know what I'm trying to say, I'm just sick of being anxious about sex ... to date, I've never failed to get it up and have good sex, yet every time, I'm anxious beforehand. How can I break this cycle of negative thinking? It's a real drag? Any ideas?

Thanks,
Eisenhower
 
Hey, I don't have an answer for you but I can sympathize... its a mind game... I get worried about sex instead of just having fun like I used to. If I am in a very relaxed mood to begin with, things are ok.

Your labs sound very similar to mine... my E2 is 12 and total T 500 (I am 34 yo). I also have erection difficulty and performance anxiety (along with general anxiety and insomnia unfortunately). I've been taking a little estradiol cream to bring my E2 up to about 20. Its tricky because I don't want to lower T, but I don't know of another way to raise E2 without TRT. I think mine is low due to a zinc/copper imbalance (biounavailable copper).

What is Dr. Mariano doing to help your low E2? What is your SHBG? Sometimes lower E2 is ok if your SHBG is low.
 
Dr. M isn't specifically targeting the E2 or the T, he's trying to fix a larger probelms with nutrition and sleep ... I believe he thinks the hormones will sort of correct themselves if we address these two things. I suppose down the road, if that's not working, he might try to target T and E2 more directly - frankly, I like his approach though, I wasn't chomping at the bit to become dependant on supplemental T. I would consider this in the future though.

I guess I'm just depressed that the psychological anxiety of erectyle issues seems to be really hard to kick and I hate to think it might be with me for the rest of my life.

Eisenhower
 
Eisenhower said:
Dr. M isn't specifically targeting the E2 or the T, he's trying to fix a larger probelms with nutrition and sleep ... I believe he thinks the hormones will sort of correct themselves if we address these two things. I suppose down the road, if that's not working, he might try to target T and E2 more directly - frankly, I like his approach though, I wasn't chomping at the bit to become dependant on supplemental T. I would consider this in the future though.
Click to expand...

Wise plan.

Eisenhower said:
I guess I'm just depressed that the psychological anxiety of erectyle issues seems to be really hard to kick and I hate to think it might be with me for the rest of my life.
Click to expand...

I think once your hormones are optimized, you'll get the confidence back and the performance anxiety will be forgotten. I'm counting on this as well :)
 
Eisenhower said:
I struggle with sexual performance anxiety and it's really depressing. A couple low T tests (235 and 434) caused me to finally go see Dr. Mariano, who said it's actually probably my E2 causing libido issues (it was only 10 while my T was 460). He's got me on lots of nutritional supps and stuff trying to get my sleep and diet right in an effort to better regulate hormones.

Before I went to Dr. M I'd been taking supps like Argenine and Zinc and had actually started getting nocturnal and spontaneous erections again (hadn't had nocturnals in a few years and had started to use Viagra to ensure good erections when I needed them). I actually stopped using Viagra for sex - it was great. After about six months though, I thought I noticed it was taking longer to get erect for sex and the old performance anxiety started up again. That's when I went to see Dr. M who keyed me in that it was probably E2 not the T that was causing erectile issues (lack of nocturnals, slow to get hard, etc.)

I started using Viagra again recently just because I hate worrying about how fast I'll get hard. But for some reason (probably because I'm only 37) I feel really bad about myself for taking Viagra ... And the sad thing to me is that I know the anxiety limits what would probably be decent performance without Viagra. For instance, I'll get hard just hugging and kissing my girl, but if I KNOW we're about to have sex, it will take oral or direct stiulation to get hard because I'm nervous.

I don't really know what I'm trying to say, I'm just sick of being anxious about sex ... to date, I've never failed to get it up and have good sex, yet every time, I'm anxious beforehand. How can I break this cycle of negative thinking? It's a real drag? Any ideas?

Thanks,
Eisenhower
Click to expand...

How long have you been with your ol lady? I used to have a similar problem, it would go away real fast. My problem was solved when I cycled and did a proper PCT at age 22 (better late than never). I've also been with the same girl for three years, and I don't know if it was a combination of all the above, but I don't have the problem at all anymore and if anything I have a problem lasting. The more you think about it definitely doesn't help, but for me it was an inevitability.
 
Grassroots082 said:
How long have you been with your ol lady? I used to have a similar problem, it would go away real fast. My problem was solved when I cycled and did a proper PCT at age 22 (better late than never). I've also been with the same girl for three years, and I don't know if it was a combination of all the above, but I don't have the problem at all anymore and if anything I have a problem lasting. The more you think about it definitely doesn't help, but for me it was an inevitability.
Click to expand...

You're recommending that the dude turn to a cycle, when his system is amiss. C'mon bro. It sounds like he's in good hands, and is approaching the issue responsibly.

I'm happy for you that your method worked, and I know your intentions are good, but I would say that your successes will rarely be duplicated. If anything, he should turn to TRT, but I think that he should start with the essentials, a balanced diet and getting his arms around the sleep monster.

Hang in there, Eisenhower. You'll get there.

Best,
J
 
C'mon bro, read what I wrote. Where did I recommend it? That wasn't my intent at all, and just gave a personal experience. Obviously my hormone levels were ****ed from the start, just like leanguy said once your hormone levels are optimized I think he will be okay just like mine after a proper PCT. I never recommended that nor would I.
 
Eisenhower said:
I struggle with sexual performance anxiety and it's really depressing. A couple low T tests (235 and 434) caused me to finally go see Dr. Mariano, who said it's actually probably my E2 causing libido issues (it was only 10 while my T was 460). He's got me on lots of nutritional supps and stuff trying to get my sleep and diet right in an effort to better regulate hormones.

Before I went to Dr. M I'd been taking supps like Argenine and Zinc and had actually started getting nocturnal and spontaneous erections again (hadn't had nocturnals in a few years and had started to use Viagra to ensure good erections when I needed them). I actually stopped using Viagra for sex - it was great. After about six months though, I thought I noticed it was taking longer to get erect for sex and the old performance anxiety started up again. That's when I went to see Dr. M who keyed me in that it was probably E2 not the T that was causing erectile issues (lack of nocturnals, slow to get hard, etc.)

I started using Viagra again recently just because I hate worrying about how fast I'll get hard. But for some reason (probably because I'm only 37) I feel really bad about myself for taking Viagra ... And the sad thing to me is that I know the anxiety limits what would probably be decent performance without Viagra. For instance, I'll get hard just hugging and kissing my girl, but if I KNOW we're about to have sex, it will take oral or direct stiulation to get hard because I'm nervous.

I don't really know what I'm trying to say, I'm just sick of being anxious about sex ... to date, I've never failed to get it up and have good sex, yet every time, I'm anxious beforehand. How can I break this cycle of negative thinking? It's a real drag? Any ideas?

Thanks,
Eisenhower
Click to expand...

There is light at the end of the tunnel. I would recommend that you consider going to a qualified sex therapist in addition to what you are currently doing. I had a similar pattern, where I would get hard fine but then would start worrying and lose it, even masturbating. It felt like my life was over. Like you, I would use Viagra or Levitra with success but it made me feel extremely bad about myself as a guy around the same age as you are. The whole thing depressed the hell out of me, the anxiety was overwhelming, and I was constantly thinking about it.

After suffering like this for too long, I finally went to a sex therapist. Results were not quick and it was difficult at first. It took me about three months of weekly visits, but I have improved dramatically, to the extent that we recently stopped the therapy because I did not need it any more.

In my own inexpert opinion, it sounds most likely that your problem is psychogenic, and therefore amenable to sex therapy (although sex therapy can be helpful even if it is not completely psychogenic). Most men can get good erections even with lowish testosterone, and your nocturnal erections were probably there all the time even if you were not aware of them (I also thought I hadn't been having them for years and only started noticing them this year because I started paying attention to the issue during middle of the night wake-ups).

But you should have a good urologist confirm that there is not a physical problem. If there is a physical problem, you should know of some studies that suggest that ED can be *cured* by *daily* administration of lower dose Sildenafil or Tadalafil for a *limited* period, after which the patient does not need it any more. See article 17187165 on Pubmed (I'm not allowed to post links on here).

Improved spontaneous erectile function in men with mild-to-moderate arteriogenic erectile dysfunction treated with a nightly dose of sildenafil for one year: a randomized trial.

Sommer F, Klotz T, Engelmann U.
​

which is reviewed in the article with the name

Long-term Nightly Sildenafil Promotes Normal Erectile Function

Paula Moyer, MA
​
which you can google.

In this study, a group of patients maintained good erectile function for at least six months after treatment. Also, Google for a powerpoint presentation by Yoram Vardi, "Chronic PDE5 Inhibitors use for sexual indication only?",
which has some dramatic graphs from the Sommer study and suggests similar things for Tadalafil (Cialis). In these cases, the important issue was that the dosing be every day (evening in case of the shorter-acting Viagra) so that nocturnal erections would be improved, which caused rehabilitation of the endothelial tissue in the penis. On-demand usage, on the other hand, had no such "curing" effect.

Finally, be careful of L-Arginine. I was also using it for a while, and I thought it definitely helped some, but in the same way as Viagra it was a crutch. I stopped when I got scared off by this study that made me worry that it might possibly cause harm to the erectile tissue in the long run:


L-Arginine Supplementation in Peripheral Arterial Disease
No Benefit and Possible Harm

Andrew M. Wilson, MBBS, PhD; Randall Harada, MD; Nandini Nair, MD, PhD; Naras Balasubramanian, PhD; John P. Cooke, MD, PhD
​
 
Eisenhower said:
I struggle with sexual performance anxiety and it's really depressing. A couple low T tests (235 and 434) caused me to finally go see Dr. Mariano, who said it's actually probably my E2 causing libido issues (it was only 10 while my T was 460). He's got me on lots of nutritional supps and stuff trying to get my sleep and diet right in an effort to better regulate hormones.

Before I went to Dr. M I'd been taking supps like Argenine and Zinc and had actually started getting nocturnal and spontaneous erections again (hadn't had nocturnals in a few years and had started to use Viagra to ensure good erections when I needed them). I actually stopped using Viagra for sex - it was great. After about six months though, I thought I noticed it was taking longer to get erect for sex and the old performance anxiety started up again. That's when I went to see Dr. M who keyed me in that it was probably E2 not the T that was causing erectile issues (lack of nocturnals, slow to get hard, etc.)

I started using Viagra again recently just because I hate worrying about how fast I'll get hard. But for some reason (probably because I'm only 37) I feel really bad about myself for taking Viagra ... And the sad thing to me is that I know the anxiety limits what would probably be decent performance without Viagra. For instance, I'll get hard just hugging and kissing my girl, but if I KNOW we're about to have sex, it will take oral or direct stiulation to get hard because I'm nervous.

I don't really know what I'm trying to say, I'm just sick of being anxious about sex ... to date, I've never failed to get it up and have good sex, yet every time, I'm anxious beforehand. How can I break this cycle of negative thinking? It's a real drag? Any ideas?

Thanks,
Eisenhower
Click to expand...
I am 68yo now.

8 years ago I found my self in similar situation to yours.
Possibly worst, because I had number of times where I failed with sex, and number of times when I was desctructive because of depression.
--------

Dr marianco is excellent choice.
After you are with him for three to four months,
if you are still having problems (I hope that you will not),
try what I did try for my self with rather good success.

By hook or crook get this numbers as follows (each number is important):
(also close your ears to nay-sayers)

BAT~575
E2,ultrasensitive=(20-30)
DHT=~75(upper range)
FreeT3~4(230-420)
DHEA~500
Progesterone~1.2
------------------------------------------------
Get 20mg Cialis, use 2x/week, need or not.
Full fluffy penis is very uplifting to the mind set.

Get (Betaine HCL), eat with each meal, max that you can tolerate.

Get good enzymes and probiotics, eat double dose of each.
------------------------------------------------

Give 3-4 months time.
If that will not relieve your anxiety and ED,
I do not know how else to help you.

This works for me.
---------------------------------------------

Good luck.

Test per my list, use Quest Diagnostics.
 
In this case I would use a different approach not even relating with hormones, but by reprograming subconscious mind through NLP.
 
I can say this,.. I had the same problem for about a year when I was 36. I had a couple reasons, performance anxiety, a new relationship with an aggressive girlfriend, and I was a vicious alcoholic. That being said, I saw a shrink and famiy Dr. I was given viagra in the short term(as my test level was 592, which is good), while working **** out in my mind, and allowing my body to recover. Today, at 37, I enjoy no performance problems at all without aids such as viagra. The psychological end of it helped me greatly.
So see a shrink, and also investigate wether or not it's psychological. Good luck!
 
bonscott said:
I can say this,.. I had the same problem for about a year when I was 36. I had a couple reasons, performance anxiety, a new relationship with an aggressive girlfriend, and I was a vicious alcoholic. That being said, I saw a shrink and famiy Dr. I was given viagra in the short term(as my test level was 592, which is good), while working **** out in my mind, and allowing my body to recover. Today, at 37, I enjoy no performance problems at all without aids such as viagra. The psychological end of it helped me greatly.
So see a shrink, and also investigate wether or not it's psychological. Good luck!
Click to expand...

like I said i would work at it from another angles psychologist or psychistrists would never even think off. Its a method that is not taught in any medical school. Shame it isn't because it would explain why alot of shrinks fail to get through to people more so even kids. Its funny that when a psychiatrists or psychologist can not get resolution they send patients to him and he finds the imbalances and causes whether mentally, or physically.
 
Grassroots082 said:
C'mon bro, read what I wrote. Where did I recommend it? That wasn't my intent at all, and just gave a personal experience. Obviously my hormone levels were ****ed from the start, just like leanguy said once your hormone levels are optimized I think he will be okay just like mine after a proper PCT. I never recommended that nor would I.
Click to expand...

My bad for misinterpreting your post.
 
To the two guys who used Cialis and Viagra short term: When you guys came off these meds eventually, what was your experience? Had you gotten used to the little extra revs? Did you have any performance hiccups when stopping these meds or were you just fine immediately without them?
 
JanSz said:
I am 68yo now.

8 years ago I found my self in similar situation to yours.
Possibly worst, because I had number of times where I failed with sex, and number of times when I was desctructive because of depression.
--------

Dr marianco is excellent choice.
After you are with him for three to four months,
if you are still having problems (I hope that you will not),
try what I did try for my self with rather good success.

By hook or crook get this numbers as follows (each number is important):
(also close your ears to nay-sayers)

BAT~575
E2,ultrasensitive=(20-30)
DHT=~75(upper range)
FreeT3~4(230-420)
DHEA~500
Progesterone~1.2
------------------------------------------------
Get 20mg Cialis, use 2x/week, need or not.
Full fluffy penis is very uplifting to the mind set.

Get (Betaine HCL), eat with each meal, max that you can tolerate.

Get good enzymes and probiotics, eat double dose of each.
------------------------------------------------

Give 3-4 months time.
If that will not relieve your anxiety and ED,
I do not know how else to help you.

This works for me.
---------------------------------------------

Good luck.

Test per my list, use Quest Diagnostics.
Click to expand...

Just have some questions here before I start asking question of my specialists

BAT~575 What is BAT?
E2,ultrasensitive=(20-30)So this range = you will have an ultrasensitive penis? If not correct can you correct me?
DHT=~75(upper range)
FreeT3~4(230-420) What do you mean Freet3~4 I dont understand. Is this something different to FreeT?
DHEA~500
Progesterone~1.2
 
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