IT'S ALL IN YOUR MIND

Let's explore how your brain, your psychology and emotions impact your erections.

So let’s get started!

It’s important to remember that sex is more than just a physical response. Your emotions and thoughts have something to do with it, too. 

The dynamics between the physical and emotional factors impacting your health are not inseparable. For many men, erection difficulties start as a physical issue, but then become primarily mental and emotional.

So once you've considered at all potential physical causes of erectile difficulties, the most common of which we discussed in the last module, then we need to address your psychology.  Because what starts out as a problem in your head can manifest as a problem in your penis.

Statistics show that up to 20% of ED cases are psychological in nature and my work with men leads me to believe that it’s a much larger percentage.

 

There are a few signs to look for which may suggest that your erectile difficulties are psychological in nature. Ask yourself the following questions:

Are you interested in sex and attracted to your partner but have trouble performing?

Are you able to achieve an erection while masturbating?

Do you experience morning erections?

Are you under a lot of stress or experiencing an abnormal amount of anxiety?

Do you get nervous about pleasing your partner?

If you answer “yes” to any of these questions, your ED may well have a psychological link.

 

In some cases, men who experienced abuse or sexual trauma in childhood may develop erectile issues. If you have experienced this type of trauma, I highly recommend you seek out the help of a therapist you who can  help you resolve any lingering childhood abuse issues that may be impacting your erections or sex life. In this course we are focusing on the psychological issues that develop later in life. 

 

They say sex starts in the brain. It’s true. Your brain plays a key role in triggering the series of physical events that lead to an erection, starting with feelings of sexual excitement. If that’s the case, then anything that affects your big brain can affect the physical response of your little brain. 

 

There are many physiological factors that affect ED and premature ejaculation. These include, Depression, Stress, Anxiety, Relationship problems, Guilt, Low self-esteem, Performance Anxiety, and Pornography addiction, just to name a few. 

 

Please note that some of these are correlated, meaning you may be affected by more than one, as one often leads to another.

Now let’s take a closer look at each of these potential causes.

 

Depression

Unless someone has experienced depression for themselves, they may think of it as something akin to sadness. But depression goes much deeper and tends to linger well beyond any specific cause or trigger. 

Depression acts much like an anchor that can weigh you down in both body and mind  and affect all aspects of your life.

 

Some of the most common symptoms of depression include: feelings of hopelessness, a lack of energy, a constant underlying agitation, feelings of worthlessness, difficulty concentrating or making decisions, angry outbursts that aren’t really justified, and apathy. 

As you can imagine, these symptoms can make it difficult to take pleasure in much of anything, let alone sex. Studies show there's a clear link between depression and erectile dysfunction in men. 

Trauma and stress are major factors contributing to depression. Others include social isolation, abusive behaviors, family history and chemical imbalance.

Unfortunately, depression in males often goes unrecognized. This is because men who are depressed are more likely to talk about the physical symptoms of depression, rather than about actual emotions,<video> such as “feeling tired”. Outward symptoms of male depression are not always understood. Men are more likely than women to keep their feelings hidden, but they may become more irritable and aggressive.

Now some of the symptoms of depression are similar to what you feel when you are not showing up the world the way you are meant to. If you are not living your life with a sense of joy and passion that you know is possible for you, then you may need to consider making some brave changes in your life.

But if feelings like apathy, malaise and agitation persist everyday, you may be suffering from clinical depression and you should seek out help from a medical professional.

If you are being treated with antidepressants or anti-anxiety medications, it’s important to note that some of these medications have sexual side effects which result in difficulty achieving an erection. If your erectile difficulties began after you started taking one of these medications, please speak with your healthcare provider who can recommend one that is appropriate for men with ED. Please do not stop taking your prescribed medications without first consulting your doctor.

Erectile dysfunction and depression are often intertwined. Many times men associate their ability to perform sexually with their personal identity and value as a man. Sexual dysfunction can lead to feelings of failure and denial, which can lead to poor self-esteem and relationship problems. These things can all contribute to situational depression, which is different from clinical depression. So if you are experiencing symptoms of depression as a direct result of sexual difficulties, it's important that you do the internal work necessary to keep it in perspective and not allow it to overshadow all aspects of your life. 

---------

Stress

Stress is a leading factor impacting men’s ability to get it up. And the thing is, chronic stress leads to physical disorders in the body that further contribute to the problem.

So identifying sources of stress and taking steps to eliminate them is crucial to resolving any sexual issue.

Our modern lives were already full of stressors.  You may be experiencing economic or career uncertainty. Maybe you or a loved one is dealing with health issues. Maybe you're having difficulties in your relationship or are recently single and have to navigate dating again.

Whatever the case, many of us do not have enough opportunities for deep rest and relaxation, or to meet up with friends and have fun the way we used to.  And often there doesn’t seem to be enough time for slow sex and romance, which are great stress reducers.

Stress is your body’s natural response to changes in your environment. And that’s a good thing, in limited doses. But constant stress can damage blood vessels, and cause serious conditions like high blood pressure, heart disease, obesity, diabetes, and even stress-induced erectile dysfunction.

When your body perceives stress, your adrenal glands make and release the hormones adrenaline and cortisol into your bloodstream. So let's dive into this for a minute. 

Adrenaline is the “fight or flight” hormone.  It increases blood flow to major muscles to prepare you to fight or to run, while at the same time reducing blood flow to smaller blood vessels, including those in the penis. I guess nature decided if you were about to be eaten by a tiger, getting a hard-on is low priority. The problem occurs when our everyday lives have us feeling like we are constantly having to defend against tiger attacks, keeping our adrenaline on high alert.  

Remember, erections are largely about adequate blood flow. So a chronic high-stress environment will eventually damage the way your blood vessels function, severely limiting your ability to get and maintain an erection. So you’ve got to get out of the “fight or flight” so you can get to the fuck.

Cortisol is another stress hormone. It causes an increase in your heart rate and blood pressure. 

Normal levels of cortisol are released when you wake up in the morning or exercise. These levels can help regulate your blood pressure and blood sugar levels and even strengthen your heart muscle. In small doses, the hormone can heighten memory, increase your immune system and lower sensitivity to pain.

However, when cortisol levels are too high for too long, this hormone can hurt you more than it helps. Studies have increasingly revealed that moderately high cortisol levels can cause all kinds of problems.  These include, High blood pressure, Type 2 diabetes, weight gain, brain fog, anxiety, depression, headaches, problems with digestion, low libido and, you guessed it, erectile difficulties.

One of the biggest problems is that cortisol blocks testosterone. There is actually an inverse correlation between testosterone and cortisol - meaning if one goes up the other goes down. 

So if there's an increase in cortisol, your testosterone will drop.  

Low testosterone causes diminished sexual desire and erectile quality, particularly in morning erections. Low testosterone can also cause delayed ejaculation and reduced semen volume, which impacts fertility. 

We will be covering hormones in more depth in upcoming modules.  But for now let’s look at a few ways you can begin to lower your stress levels and consequently increase your testosterone.

Exercise

Exercise regularly, but not too much if you are just starting out. Depending on the intensity of exercise, it can either increase or decrease cortisol. Intense exercise increases cortisol shortly after exercise. This short-term increase helps coordinate growth of the muscles, including the heart, to meet the challenge. But over the long-term, the level of the cortisol response lessens with continued training. Moderate exercise does not increase cortisol in the short term, and leads to lower levels of stress hormones at night.

The takeaway, exercise is important to reducing stress, but, if you are new to it, don’t push yourself to exhaustion right of the gate. You need to build up your endurance. Otherwise you risk stressing your system even more.

So aerobic activities, like walking, jogging, swimming, biking, are great ways to recreate the "flight" outlet and burn up cortisol in your system.

 A little bit of cardio goes a long way: Just 20 to 30 minutes of activity most days of the week pays huge dividends by lowering adrenaline and cortisol and increasing testosterone. It also stimulates the production of endorphins, which are the body's natural painkillers and mood elevators, so you just feel better over all. Studies show that people who exercise on a regular basis have better stamina and much better sex lives in general. Also, regular exercise stimulates growth of blood vessels and increases blood flow to the penis. So it’s a win win!

 

Communicate

Sexual problems can lead to loneliness and hostility if you don’t share your feelings with someone. Since the majority of sexual problems start in the brain, and are typically the result of stress or anxiety, any treatment has to begin with having an outlet to voice these concerns. Simply sharing about the anxiety, stress, or depression with someone is often enough for major improvements. If you have a trusted friend, talk with them about how you’re feeling.  If you can’t do that, find a therapist.  You may find that going just a few times can have a huge impact.

And remember, included in this course are built-in opportunities to share your story with others who are having similar experiences, receive support, and find that you are not alone in this. Please take advantage of the resources available to you in this course and know that I am here for you.   

Maintain Healthy Relationships

Isolation from friends and family can lead to increased cortisol levels. Surrounding yourself with positive people who can support you when you are stressed is an important part of living a healthy life. It’s important to nurture healthy friendships and romantic relationships. Studies show that having an affectionate interaction with a romantic partner before a stressful activity lowered heart rate and blood pressure. If one of your primary relationships is full of conflict, it’s vital that you seek to resolve the core issues. If it can’t be resolved and you continue to experience stress as a result, it may be time to consider changing or ending that relationship.

 

Learn to Relax

Various relaxation exercises have been proven to reduce cortisol levels. Deep belly breathing is a simple technique for stress reduction that can be used anywhere. Just the interrupt of asking yourself, what is the quality of my breath right now, can help break a stress cycle.

Studies also show that massage therapy can reduce cortisol levels by 30%. I truly believe receiving regular massages should be a part of everyone’s health protocol. If you don’t have someone else to rub their hands all over you, at the end of this module I will be leading you through a sensual stress relieving massage that you can do to yourself

Relaxing music is another proven tool that can be used to decrease cortisol levels. Music can trigger a variety of chemical reactions in your brain that contribute to relaxation. From reducing stress hormones to stimulating feelings of happiness, music can almost instantly translate to a good mood. These feel-good effects also produce a number of positive long-term benefits for your body, such as lower stress and anxiety levels, better sleep patterns, and improved overall health and well-being.

In one study, researchers found that patients who listened to music while undergoing surgery had lower levels of cortisol and required less sedatives to reach sedation when compared to patients who didn’t listen to music during the procedure. Now that's powerful!

 

Natural Stress Relievers 

Practices like mindfulness, meditation, breathing exercises, yoga, and qigong all lead to muscle relaxation and reduce stress and tension. So make sure you are doing the exercise videos available to you as part of this course. There are a lot of practices out there that help support stress reduction.  If you are looking for an easy meditation solution, try Waking Up by Sam Harris. I have friends and clients who swear by this phone app.  It’s free and it starts with 10 minute meditations.  That’s all you really need if you make a habit of practicing daily. You can find a link to Sam Harris’ app in your resources page.

Simply taking a few deep breaths engages the Vagus nerve which triggers a signal within your nervous system to slow heart rate, lower blood pressure, and decrease cortisol. Just a few mindful breaths can immediately drop you into a relaxed state.

Last week I taught Ujjayi breathing which is a powerful stress reducing exercise. But another simple breath you can do anytime is Wave Breathing.

Let’s do it together right now. 

As with all exercises we do together, if you feel strange in any way, dizzy, tired, out-of-breath, or any other symptom, stop, relax and try again. 

Wherever you are, place one hand on your belly and the other on your chest.

Inhale through your nose into your belly, up to your ribs and into the chest. Exhale Chest, Ribs, belly. Again, Inhale belly ribs chest. Exhale chest, ribs, belly. Like a wave the breath moves in and then flows back out.

With this next breath I want you to take a slow deep breath in through the nose, but this time exhale through your mouth with an audible sigh. One more time, Inhale through the nose and Exhale through the mouth and feel all your whole body relaxing.

How do you feel?  This simple practice always makes me feel better.  By just taking a moment to notice and deepen your breath when you find yourself in a stressful situation that may be activating your "fight-or-flight" response can help your nervous system relax and decompress.

Sleep 

You gotta get enough sleep.I know this was mentioned in a previous video, but it’s worth mentioning again as our culture tends to be sleep deprived as a whole. 

Studies have shown that insomnia and other forms of sleep deprivation cause your body to secrete more cortisol during the day, perhaps in an effort to stimulate alertness.

In addition, your body produces testosterone during the night. Not getting enough sleep can reduce testosterone levels, leaving you with poor erections and decreased libido. It also impacts  your moods and outlook on life.

You must prioritize sleep. If you have problems sleeping, consider adjusting your bedtime rituals to optimize your chances of getting a good night's rest or go get yourself a sleep study.   From personal experience, many people are surprised by the results of their sleep study and have benefitted from addressing some of these issues.

We now know that blue light emitted from electronic screens can delay the release of sleep-inducing melatonin. So you may find it helpful to shut off all electronics for an hour or two before bedtime. I know, an hour or two? What are you going to do with that time you are currently using to watch Netflix or scrolling social media right before bed?

Well, you could finally pick up that guitar you always wanted to play, read or listen to a book, but not on a blue light emitting screen. Give or receive a massage, even if it’s a self-massage. I find nighttime walks through the neighborhood relaxing when I am winding down from the day.

There are a lot of other tips out there on creating bedtime rituals and getting a good nights sleep. I encourage you to do your own research on the subject and find what works best to you.

If you still have trouble sleeping, I suggest you talk to your doctor. If needed they can refer you to a sleep lab to see if there is a deeper problem, such as sleep apnea or restless leg syndrome.

Sleep is critical for health. It is an essential biological process that is now appreciated as vital to both physical and mental health. It’s also important for a good sex life because it reduces stress lowers cotisol levels and optimized testorone levels. 

Tend to Your Spirituality

Developing a spiritual practice can also help improve cortisol. It can be, but doesn’t have to be religiously based. There are many ways to connect with divine or universal energy that gives us a sense of belonging to something bigger than ourselves. Studies show that adults who expressed spiritual faith experienced lower cortisol levels in the face of life stressors such as illness or loss of a loved one. Prayer and gratitude is also associated with reduced anxiety and depression. If you don’t consider yourself spiritual, these benefits may also be attained through meditation, developing a social support group and participating in community service.

It's important to note here that many of my clients can attribute their sexual issues to the religion or culture that they were brought up in. Many religions abound with taboos and shame around sex. It may be important to examine the beliefs you were brought up with and see if they align with who you are now. They may be interfering with your ability to experience sex as a natural and joyful expression of being a human. It's my belief that we came into this incarnate body so that we can enjoy the pleasures of the flesh. Sex is one of the most beautiful, intimate, and connective experiences that we can have. For me, it is the closest experience I have to connecting directly with the Divine. You deserve loving, intimate, shame-free sex. 

 

Eat Healthy Foods

Nutrition can influence cortisol for better or for worse. Sugar intake is one of the classic triggers for cortisol release. Regular, high sugar intakes may keep your cortisol elevated which means your stress levels become less manageable, and we’re likely to feel exhausted, wired and anxious. So be mindful of your sugar intake. This also means sugar in the form of carbohydrates like muffins, pasta, breads and the like. So many people start their day with a sugar bomb like a croissant or bagel and a beverage of juice or a cup of coffee with sugar added. 

I like to start my morning with a warm glass of water with a little lemon juice to hydrate and alkalize my system. Then I eat a breakfast of sauteed onions and garlic, lightly cooked greens like Swiss chard or spinach and topped with a couple of pasture-raised eggs. This provides me with steady fuel to burn that won’t spike my blood-sugar levels or cause a mid-day crash .

Here are a few specific foods to decrease cortisol levels:

Dark chocolate Cocoa polyphenols, the antioxidants found in dark chocolate, have been shown to reduce stress in highly stressed, as well as healthy individuals. Choose a high quality dark chocolate. Traditional candy bars don’t count. <popup image of “bad candy bars” with red circle backslash over it >

Black and green tea A study of 75 men found that 6 weeks of drinking black tea decreased cortisol in response to a stressful task, compared to drinking coffee. 

Probiotics and prebiotics Probiotics are friendly, symbiotic bacteria in foods such as yogurt, sauerkraut and kimchi. Prebiotics, such as soluble fiber, provide food for these bacteria. Both probiotics and prebiotics help reduce cortisol because there is a direct correlation between good gut health and mental wellbeing.  

WaterDehydration increases cortisol levels. Water is great for hydrating while avoiding empty calories. Often when we think we are hungry, we are actually thirsty. Make sure to be drinking a clean source of water free of contaminants. I recommend drinking 1/2 of your body weight in ounces of water. So if you weigh 200 pounds. That would be about 100 ounces of water daily. I like to measure out the quantity of water I need to drink in the morning by filling up jars and then make sure to pace my consumption throughout the day. It’s too easy to get to the end of day and realize you probably didn’t drink enough. <Keagen water plug>

 

Have Fun

Okay, this tip may seem overly simplistic, but one of the best ways to reduce stress and keep cortisol down is to Be Happy!

And look, I realize that can be hard when you are not getting hard, but you have to keep everything in perspective. Letting this one part of your life overshadow the rest of the goodness in your life will only drag you down and contribute further to your stress levels. Which will not benefit your erections in any way.

I’ve worked with a lot of men who have experienced erectile dysfunction. And I know it’s easy to become fatalistic. But you must fight against it so that we can get your stress levels down and optimize your system for high performance. A positive outlook on life is associated with lower cortisol, as well as lower blood pressure, a healthy heart rate and a strong immune system. 

Developing hobbies or participating in activities that you truly enjoy can promote feelings of well-being, which translate to lower cortisol. What is it that you do during the week that brings you joy? Are you carving out time to do things YOU enjoy and not just going along with the family or what others want? It’s okay to be a little selfish here. Your happiness will benefit those around you.  I really want you to start considering what activity you could add to your life or do more of that would bring you a sense of joy and happiness. You really do deserve it.

And if that activity is done outdoors, then all the better. Research shows that just 20 minutes a day in nature can reduce stress hormones. I try to take a daily walk to the ocean and back each day. And if I don’t have time to make it all the way to the ocean and back, I at least walk to my neighborhood park and back. Along the way I make it a point to notice the beauty of nature. Even if you are in a city, notice any trees or plants around, find a cloud in the sky and take it in. 

Laughter is also a great way to reduce stress.  And one of the best ways to laugh more is to take a child-like attitude towards life. This is something I actively try to cultivate in myself. We don’t have to be so serious all time. Just smiling more is a good start.

As you can see, there are many physiological factors that can impact your ability to get and keep an erection. You can never discount the importance of the mind-body connection on all facets of your health, especially that  of your erectile function. As you know your biggest sexual organ is your brain.

What’s most important is that you take a realistic look at your life and identify sources of stress and take real measures to eliminate them. This is vital for your overall health and the health of your erections and a joyful sex life.