Sexual Performance Issues

Premature Ejaculation (PE) is an issue of sexual performance in which the man ejaculates before or almost immediately after commencing intercourse. Most men begin their sexual lives as premature ejaculators. As they gain comfort and experience, most men experience an improvement in sexual performance by developing ejaculatory control. For reasons that are unclear, about three in ten adult males fail to develop ejaculatory control and experience premature ejaculation as a lifelong problem. Not being able to control to their satisfaction when they ejaculate, they suffer silently, feeling an unremitting sense of shame and humiliation about their sexual performance that is reinforced by their partners' frustration and anger.

Erectile Dysfunction (ED) is an issue of sexual performance in which men have difficulty obtaining or maintaining firm erections. By the age of 40, about 90% of men have experienced difficulty obtaining or maintaining an erection adequate for intercourse at least once. By the age of 50 over 50% of men report the sexual performance issue of mild to moderate ED. If an erection problem does not remit within six months, the man and the partner become trapped in a cycle of anticipatory anxiety, performance failure, and sexual avoidance.

Delayed Ejaculation (DE) is an issue of sexual performance in which men have difficulty ejaculating during intercourse. Although Delayed Ejaculation is less common an issue of sexual performance than PE or ED, it is every bit as distressing. The more the man pressures himself during intercourse to reach ejaculation, the more anxious he becomes and the less likely he is to have sufficient arousal to reach the ejaculatory threshold.

Approach to Treating Sexual Performance Issues

I use a cognitive-behavioral approach to the sexual performance issues of PE, ED, and DE. The cognitive aspect refers to helping men counter the negative thought process that mediates performance anxiety, while the behavioral aspect refers to exercises that promote behavioral change.

I also find that hypnosis is a useful adjunct in the treatment of sexual performance issues. My way of using hypnosis is to invite people to move into a relaxed state by focusing on their breathing, and while they are in a suggestible state to make therapeutic suggestions that speak to the subconscious mind. Finally, I recommend medication as an adjunct to the treatment of sexual performance issues. When medication seems appropriate, I suggest that men discuss this with their physician.

If you would like more information regarding Sexual Performance Issues, please feel free to contact me at 604-873-0222 or at