A 35-year-old man reports problems with maintaining an erection during sexual activity. He appears anxious and mentions that he worries a lot about his sexual performance. How could his symptoms be explained?
This patient seems to be experiencing performance anxiety, a common form of psychological or situational erectile dysfunction. Anxiety can initiate the release of adrenaline, a stress hormone that contracts blood vessels and can inhibit erections. Psychosexual counseling, cognitive-behavioral therapy (CBT), and possibly short-term use of anti-anxiety medications can be considered to manage his symptoms.