Posted in Mental Health, Sex & Intimacy

Men and Mental Health: Problems “Downstairs”

Sexual dysfunction can affect relationship development

Most men will go through some sort of sexual dysfunction at some point – you will experience premature ejaculation, sudden loss of erection (or not even be able to get one in the throes of passion) – often caused by nerves, pressure and other issues. It is pretty normal to happen sometimes and when those occasional relapses occur, it’s not something to worry about… most of the time.

But we can experience long-term problems that affect us mentally and in turn, will affect our most intimate relationships, even potentially leading to depression and in some cases. What are these problems?

  • Loss of libido (No interest in or indifference towards sex)
  • Inability to get or maintain an erection
  • Premature ejaculation
  • Inability to orgasm

The above problems can happen for physical or psychological reasons. If they are physical then you will definitely need to get yourself checked out. Physical reasons can include diabetes, too much alcohol intake, cardiovascular disease, high blood pressure, thyroid problems being amongst the most common.

Psychological causes include:

  • Stress / fatigue
  • Worry / anxiety
  • Depression

Sometimes, these things will get worse as you start to worry about performance problems or your partner (or you perceive that your partner) is getting frustrated and impatient.

Ordinarily, they will correct themselves as certain stresses and anxieties disappear on their own. Other times, if you can learn to relax (such as using mindfulness techniques) then you will overcome them yourself. Otherwise, you may need professional psychological help and I would strongly advise you to seek help and advice from a Doctor who may put you on to a counsellor if that’s what’s required.

Sometimes these issues are longer term. If caused by extended periods of depression or other mental health problems then they could take a long time to correct. They may eventually correct themselves… which is what happened to me.


My Story

Even now with all the precautions I take at protecting my anonymity, I am slightly embarrassed to write the following sections; embarrassment is the major stumbling block to us men seeking help for our problems and there is no greater cause of anxiety for men than sexual dysfunction.

My ex-wife and I always had problems in that department. I have mentioned before that we were together some five years before we had sex and we had a few occasional false starts, though we later discovered I didn’t get on with regular condoms – but we soon found some that were much better. When we did eventually get down to it, I felt she put me under enormous pressure going from holding me off for so many years to being demanding and pushy the next moment, all the while I was feeling embarrassed at struggling with the condoms we used.

I developed physical problems around the time our marriage started to break up. Sex between us briefly improved but died off immediately when she told me that she had been having a virtual affair. I didn’t struggle getting an erection… just maintaining one and if I am honest I didn’t have one for several years after we broke up (I’ll let your imaginations fill in the details there).

When Mirror Image and I surprisingly got busy on our second date and I couldn’t “perform” I started to worry, of course I did. We brushed it off as nerves and pressure of being with somebody new and a lack of experience, but inside I was starting to make a mental note that maybe I should consider seeing the Doctor for those little blue pills.

Our third date (the five days she came to spend with me) got off to a similar start and the worry set in again. Whereas on date two I struggled to get an erection, this time I did “rise to the occasion” and suffered premature ejaculation. I mentioned before that we had sex several times while she was here, and that is true. All of a sudden the problems I had had and was worried might put a dampener on our sex life just disappeared. I can’t explain how… perhaps I felt more relaxed, perhaps the fact that we had been so open in those interim weeks about our collective lack of experience helped to break down a few more barriers.

That’s the key to addressing the problem: talking to your partner

I feel differently when around her, I would even go so far as to say that I feel far more desire for Mirror Image than I ever did for my ex-wife – it feels weird to admit that but it is true. My libido, repressed during  the early years of my previous relationship, has returned now and the sexual dysfunction I had before – however fleeting, however mild – has gone. I know from now on I am not going to be concerned about my performance in the bedroom and that in itself, is a relief.



NHS Choices – Male Sexual Problems
A study on male sexual dysfunction
Suicide and sexual anxiety on performance anxiety – Tips on overcoming it



I go by the name of Frank Speaking. My blog "In the Mind of Men" (former name Chin Up, Chest High) started out as a chronicle of my mental health recovery. Now it is a forum where I discuss issues related to male mental health.

4 thoughts on “Men and Mental Health: Problems “Downstairs”

  1. I too had problems “downstairs” during my marriage. I never had a full-blown mental health diagnosis, I did see a counselor for anxiety and depression. I got on some anti-anxiety meds that seems to make my plumbing problems even worse.

    About 1 year after my ex and I separated, I gradually weaned myself off the meds. today, I’m in a new relationship, happier than I’ve been in years and amazingly enough, my problem downstairs seems to be a thing of the past.

    I’m not saying all this to say meds don’t work. Far From it, I think my mental health issues – and in turn plumbing problems – stemmed from (or at least exacerbated by) my shitty marriage. Erectile problems and anxiety/depression are a rough paradox to be caught in. Treating one definitely makes the other worse.

    1. Thanks for sharing your story 🙂

      After my separation, I had a different problem while on anti-depressants. I would get occasional orgasms at inopportune moments (such as at my work desk). That was embarrassing, especially when I was not having any sexual thoughts. I looked it up and apparently it is rare when taking SSRI but far more common in women than men

  2. That is brave to admit. The author of “The Men on My Couch” said something about how a man’s sense of worth is connected to their sexual performance. But having a partner you can open up to is a big part in the ‘healing’ of it.

    1. That last bit is absolutely true. I’ve just returned from a few days with Mirror Image and we both agreed that already we have a good sex life and feel in tune with each other. No hint of the physical problems mentioned above.

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