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I wake up aroused – but can’t maintain it to make love to my wife

Anxiety is getting the better of me. What can I do to combat it and get my confidence back?

I often wake up with a good erection, but when I try to make love with my wife I get all hot and clammy and it withers. It’s a similar feeling to when I was learning to swim, or trying to ride a bike when the stabilisers were removed and you go all wobbly and anxious. How can I get my confidence back to stay hard?

The anxiety you feel at times when you are expecting your penis to perform is actually ensuring that you are less likely to achieve an erection. It’s a self-fulfilling prophecy. Some men find that learning to reduce their anxiety at such times can improve their ability to have erections. Others find that talking to their doctor about the possibility of being prescribed a drug to help erectile functioning can provide the erectile support they need, and reduce anxiety. Sometimes there is an underlying medical, relational or psychological issue that is inhibiting a man’s erectile capacity, so it is really worth having a medical workup and checking in with a sexual therapist. You do not have to continue suffering; seek some help.

Pamela Stephenson Connolly is a US-based psychotherapist who specialises in treating sexual disorders.

If you would like advice from Pamela on sexual matters, send us a brief description of your concerns to private.lives@theguardian.com (please don’t send attachments). Each week, Pamela chooses one problem to answer, which will be published online. She regrets that she cannot enter into personal correspondence. Submissions are subject to our terms and conditions.

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