This podcast is for you, the Modern Man. I'm Dr Anne Truong,

your host. I'm an intimate health medical doctor and best

selling author of the book, Erectile Dysfunction Fix. I'll

do a deep dive into sexual health and performance and how

it affects men of all ages and backgrounds. So let's get

started, and be sure to visit my website at

sexualhealthformenpodcast.com for more information and

resources from the show. See you on the inside.

Hello there, Modern Man. I'm Dr Anne Truong. I'm a sexual health

specialist, treated over 7000 men. Have you ever wondered what

you need to do if you have performance anxiety that you

feel like you're lost? Well, in today's episode, we're gonna

talk about what you need to do to get effective treatment for

performance anxiety.

So what is performance anxiety? Performance anxiety is a feeling

of panic, feeling of worry, feeling of anxiety when you're

about to get it on, because maybe you had past experience in

that didn't go well and you didn't perform, or maybe someone

has made a comment, negative comment, that kind of lingers on

here (the brain). It's almost like a little PTSD, that you

keep thinking about and reliving over and over again. And the

reason why I'm talking about this is because I see this a lot

in my patients in the office, as well as in our coaching groups,

the Modern Man Club. Is that performance anxiety almost

follow physical erectile dysfunction, and then even if we

treat the physical part of ED, the performance anxiety still

somewhat linger, because it's in here (the brain). And the reason

why I stress that is because the largest sexual organ for you to

get the erection is really come from the brain. And even if we

work together and I treat erection, and then the erection

has better flow, but if the brain is not treated, then no

erection can happen.

So I try want to focus on today's session on performance

anxiety, and what's the research is showing and what I feel that

you need to know so that way you can find resources to help you.

And I feel that every man that has ED had some component of

performance anxiety. Now there is a treatment is primarily

recommended for men with ED with performance anxiety, and that is

called CBT, C like cat, B like a boy, T, like tall. CBT stands

for Cognitive Behavioral Therapy, and it stands out as

the most effective intervention because it directly addresses

the psychological mechanism that maintain performance anxiety and

affect erectile function. And researcher demonstrate that CBT

specifically targets the cognitive and behavioral factors

that create and perpetuate the anxiety performance cycle. Now

performance anxiety creates a vicious cycle where fear of

sexual failure lead to increased stress and anxiety, and then

anxiety causes physiological changes, including reduced blood

flow to the penis. And then poor sexual performance reinforces

the original fear, creating a self perpetuating cycle. And you

need to know that, because the further you think about your

erection, the more stress you're gonna get. And when stress is

high, erection goes down. Because when stress is high,

that's when you activate the sympathetic nervous system. And

at the sympathetic nervous system will lose the blood from

your penis out to your arms and your legs. So stress decrease

blood flow to your penis. CBT break this cycle that I just

mentioned, of the cycle of fear, failure, anxiety and poor

performance, and it reframe. CBT help men by reframe the negative

thought patterns and then help you develop healthier coping

mechanism to deal with performance anxiety. Studies

have shown in the landmark study, men receiving CBT

alongside with low dose PDE-5 inhibitors such as tadalafil

shows continued improvement in their ED months after CBT

treatment has finished. While those receiving just medication

alone without the CBT shows no further improvement or even

decline. Decline even if you stay just the medication alone.

Now, CBT has shown to reduce not only ED symptoms, but also

anxiety and depression that co-exist as well, and I want to

mention and stress at this point is that combining CBT with

breathing that I talk about, check out the episode where I

talk about breathing out of erection, where there are

several mechanism of breathing that will help lower your heart

rate. When your heart rate is lower, stress is lower, erection

comes back. Heart rate high, no erection. So the breathing

technique that I talk about, the box breathing technique where

you breathe in for four, you hold it for four, and you

breathe out to your mouth for four, and then you hold for

four. But make sure you breathe into your nose, because if you

go into your nose and go to the nasal sinuses up here, which

then help you create more nitric oxide. Breatheing to the nose,

help you create more nitric oxide. Nitric oxide bring in

more blood flow. And also box breathing will also decrease

your heart rate as well. So decrease heart rate, nitric

oxide, erection, all right? But high heart rate, stress,

decrease erection.

So the key CBT component addresses performance anxiety at

this point. So keep that in mind, that if you mix it with

breathing that I talk about, and then maybe just low dose, five

milligrams of tadalafil or Cialis daily will actually treat

your ED, and it may even last once you finish the therapy.

Now, how long should you do CBT therapy? Between 8 to 12 weekly

sessions for optimal results. About two to three months.

Pretty fast if you're with a partner doing a couple days.

You're also going to be given homework and exercises. And CBT

addresses the root cause of performance anxiety, and it has

longer lasting effect beyond just medication, and, of course,

no side effects, and it's holistic. You can even do this

on Zoom. You don't even need to come in and see a therapist in

the office. So where can you find therapists that are

certified? I really like therapists that are certified by

the American Association of Sexuality Educators, Counselors,

and Therapists. Now the AA is certified sex therapist, and the

very rigorous process, they spend 150 hours on sexual

education, 60 hours sex therapy specific training, and 300 hours

of supervised clinical experience and 50 hours of

direct supervision by another AASECT certified supervisor, and

also advanced clinical degree with psychotherapy training as

well. Now check out this link right here, or you can go

directly to their website at www.AASECT.org, or the link that

I have on here, check it out. Just you can find a certified

therapist that are qualified to treat your performance anxiety

with CBT. All right?

So I hope that help, and I can't stress to you how important it

is to also treat the psychological component of ED

and the physical part, because they are intertwined, and they

probably 99% of time coexist. And I see this a lot, where my

patients get better physically, but they're still unable to

perform because they're still need to go get rid of the

performance anxiety, which they have lifted for years, and going

through doing CBT, is about to do that. And I know as men, you

know my husband's same way. They're like, going to see a

therapist. It's nothing wrong with going to see a therapist.

It doesn't mean that you're weak. It doesn't mean that

you're any different. It just means you need help all of these

therapists are no different than going to see physical therapy to

do therapy on your back. And so there is no difference, now

you're going to have chance to do it on Zoom and on virtual, or

do you not have to come in for an office evaluation. And some

insurance will cover for this as well. You have to kind of find

out, and you can go on their website, type in your location,

and you can find out therapists that are certified, that are

feel you or work with a therapist that you feel that you

like to work with, because now it's all virtual. So I just want

to be a resource for you and give you a resource for

performance anxiety, because it's very, very common, and I

don't want you to miss out. Okay?

So I hope you find this useful. Let me know if you have any

questions, and it will mean the world to me if you get notified

and subscribe and share this with somebody that you care

about. A lot of our viewers are non-subscribers, so I hope you

guys will subscribe to our channel. It will mean the world

to me and don't forget, do not suffer with ED in silence. You

do not have to suffer alone. We have a resource for you that's

called the Modern Man Club. It's a space where I will coach you

and together with community of men that has ED, where we work

together and getting you out of ED breakthrough to sexual

confidence and sexual clarity and performance anxiety as well.

And so check it out at noedman.com at the link right

here. So I'll see you in the next episode.

Okay, Modern Man, you are not alone and you don't have to

suffer anymore. ED can feel isolating, frustrating, and even

defeating. The endless guessing, the quiet shame, the weight of

not feeling like yourself is exhausting. But here's the

truth, you are not broken. You are not alone. You don't have to

figure this out alone anymore. The Get Wood Now Boost Program

is your step by step, path to sexual confidence and

restoration. No more suffering in silence, no more trial and

error, just real solution, real result and the confidence you

deserve. It's time to take back your power on your term. Let's

get this journey started together. Check out the course

at getwoodnow.com. I'll see you there.

Thanks for listening to the Sexual Health for Men Podcast.

If you love this episode, then please take a screenshot on your

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and be sure to tag me and let me know why you like this episode

and what you like to hear in the future. That will help me know

what's great for you and I would love to give you the most

incredible free gift designed to help you improve performance

quickly. Go to my website at sexualhealthformenpodcast.com to

get the book, The Five Common Costly Mistakes Men Make When

Facing ED. I would appreciate if you subscribe, leave a review on

Apple podcasts or wherever you listen. And just know that you

can have sexual vitality for life. I appreciate you until

next time.