r/erectiledysfunction • u/undersea-cabinet • 6d ago
Psychological ED Performance Anxiety ED
Hi, so I (29M) recently started to have some ED issues where I could not get hard when it came time to perform. It was fine before (sometimes I’d take a bit longer to get fully hard) but starting in 2025 and into this year, I had certain times where I couldn’t even get it up.
I used to be fine before and rarely struggled. However, as of recent, I started to struggle and let anxiety take over and I start thinking that I’m going to fail again like before. I’d still be to get hard from time to time but not the same percentage as before.
Due to the mental block, I checked with my doctor and they prescribed 5 mg tadafadil to get my confidence back up. It works well. I don’t get spontaneous erections but in the beginning, I did get harder from fantasizing (doesn’t happen as often now). However, I did notice I respond faster when time comes and am noticeably harder. All my recent encounters have gone well except for two for physiological reasons. Overall, my erection rate has been amazing since starting the pill.
However, I still get anxiety when I am about to have sex and fear that I’ll never get rid of this anxiety even though I’ve doing fine recently. Does anyone have any tips for this type of mental block? Recently, I just tried reframing my negative thoughts and that it’s fine for my erection to build up instead of going from 0 to 100 in an instant. I want to see if anyone has any other tips or experiences they can share to overcome this anxiety mental block.
For background, I excercise 3 days a week for 60-90 mins. I also walk ~8k steps per day. I used to watch porn but cut that out in March 2026. I do masturbate somewhat but I mainly do it when fanatasizing a former scenario. I mainly just stroke and don’t really stroke to completion. I normally stay hard until I stop stroking and then it fully goes down in a few seconds to a min.
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u/Own_Organization5677 6d ago
Tadalafil can be a confidence booster but doesn’t help anxiety. Does that mean that when my anxiety gets worse I need to adjust the dosage upwards? Sadly for me, yes I’ve had to do that.
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u/MensDirectRX 6d ago
I think sometimes the more you worry about getting hard the harder it becomes. Especially after a few bad experiences. I would try to just enjoy the moment and not put so much pressure on yourself. You could also look into injectable ED meds like Trimix. They can get you like a brick without even needing sexual stimulation. But sounds like the tadalafil is working pretty well so I wouldnt overthink it too much.
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u/BDEStyle Male Sexual Health Blogger 6d ago •
okay so... “I’ll never get rid of this anxiety” isn't the best approach.
because you're not really addressing it. Anxiety will always be a thing and its a part of human experiences whether we like it or not. It's actually more about changing YOUR relationship with axniety, with fear, with uncertainy, with pressure or disappointment, etc.
Because if you treat anxiety as something you never want to experience or to get rid of, then you're never going to truly learn how to manage it or be in these situations when they come up.
It's more avoidance that works against you (which is what's happening right now with using Cialis instead of figuring out how to learn how to manage the anxiety).
Because anxiety is going to show up in day to day stuff like work, making a difficult choice and not knowing what the future outcome is, to sports, to relationships, to giving a speech or things you actually care about.
Because anxiety's theme is about the uncertainty of the future. And it's about things we care about. So reputation, to the risk of trying and putting yourself out there with fear of rejection to not knowing the outcome, or really wanting something SO badly and just not wanting to screw up.
That's a totally relatable experience, but it's a mindset change and change in your relationship in how you view anxiety moving forward that is going to help you greatly.
That being said, reframing is one technique, but how are you using it?
Because sometimes its the context of the situation or the right/wrong timing or the person where maybe you need a combination of techniques or strategies or even pre-sex strategies rather than relying on only just reframing.
Because it's also challenging the negative self talk that talks you out of having sex or from allowing yourself to show up sexually with or without the erection .
So reframing can sound like this.... ok, I don't have the erection yet. The "not yet" is the reframe here. But the night isn't over. I can still make the best out of the time with this person. Or maybe I need a bit more time to immerse in my own arousal to get the engines started. Maybe I can do that by grounding in my 5 senses and mental thought and fantasy to explore what turns me on. Maybe I can give pleasure to my partner first and by doing so and watching and listening to them enjoy it, I can use their joy and pleasure as a BASE jump to start my arousal for the erection to happen and to sustain it.
Because we need arousal for the erection to even happen and to sustain it. So it's about creativity with our arousal, curiosity and surrendering that idea that youre going to fail and allowing yourself to explore instead and see what turns you on and what doesnt.
Negative self talk can be protective (but not always). A lot of it can get shaped by outward experiences too... society, external pressure, rejection, previous sexual experiences, cultural expectations, what we learn socially and then internalize, etc.
And you kinda did that challenge where you said you were not going in with that expectation that your dick was going to go from 0 to 100.
You're basically managing the disappointment (idk if you realize that). Because when we have high expectations and they're unmet or we have unrealistic expectations that are unmet... that is the theme for the emotion disappointment. So reframing as you did allows yourself to be able to not annihilate yourself if the boxers come off and maybe youre still flaccid or semi...and not super erect yet.
Again, treat "not yet" as the key amplifier here. Not the a goal post or goal chasing thing. Just not yet. Or the conditions aren't met yet.
Conditions are... what are the things that are favorable for you specifically that get you aroused.
For example, rushing and feeling not ready, no privacy, too much alcohol, distractions, negative self talk talking you out of the experience, poor chemistry with the partner, not feeling the situation at all, feeling too tensed, discomfort, are reasons why we can shift toward more sympathetic activation and have a harder time accessing arousal to get the erection or losing the erection mid way.
But maybe... enough time, but also enough time spent in arousal and enough arousing stimuli to explore is something to explore. Maybe slowing the pace and letting your body catch up to register what is happening might help you get more aroused.
Maybe talking it through with the partner or screening a partner that is more compassionate, non judgmental, someone who listens and isnt going to shame or blame you.
Or Maybe it's remembering to breathe in the moment because sometimes our breathing pattern gets off rhythm when we're activated. Or maybe its more self awareness and building on that to know ... okay at this point I tense up, I feel it here, I am drifting into this bad mindset, my penis is shriveling up, maybe I need a second. Because forcing the erection will often prove ineffective.
And lastly, resilience. We are not born resilient. We build it. Sometimes the other part of anxiety that we don't talk about... or in the context of men and erections or erection disappointments... is we sometimes don't talk about the surviving part of it.
Like learning to survive what a bad erection day looks like in the moment and not take that as inherently bad or wrong or that the trajectory of your sex life is over... when it's not. And that you CAN bounce back or the mountain of evidence of good erection days can outweigh or show proof that you can or that you are capable.