Many men experience decreased libido and difficulty maintaining an erection not because of a weak body, but because of overthinking – excessive thinking causes stress in the brain, inhibiting erectile reflexes and pleasure.
A 34-year-old young man came to Dr.BS.CK2 Tra Anh Duy, Men’s Health Center, because of decreased libido, unstable erection, especially when he was with his wife, he “couldn’t concentrate”. He said he was often worried during sex, afraid of disappointing his wife, afraid of not reaching orgasm and being judged.
Test results showed that his testosterone was low, cortisol was high, his blood sugar index was pre-diabetic, and he slept an average of 4-5 hours per night. The doctor diagnosed erectile dysfunction due to prolonged stress with secondary endocrine disorders, treated it by adjusting hormones, improving sleep, exercising 30 minutes a day and combining cognitive-behavioral therapy (CBT).
After 6 weeks, testosterone increased and erections improved clearly. “The mind is blanker, the emotions are more natural when close to his wife,” he said.
According to Dr. Duy, sex is a delicate combination of psychology – nerves – endocrine. When men think too much about the other person’s abilities, performance or satisfaction, the brain goes into a state of alert, blood vessels constrict, blood flow to the penis decreases, and the body secretes adrenaline and cortisol – anti-stress hormones, but also “enemies” of pleasure. Cortisol, when high, will inhibit testosterone, reduce libido and erection ability, while increasing blood sugar, causing metabolic disorders, leading to chronic fatigue and sleep disorders – two factors directly related to sexual dysfunction.
Overthinking is a common cause of erectile dysfunction and premature ejaculation. Many studies show that men who focus too much on performance are more than 2 times more likely to have erectile dysfunction and 1.6 times more likely to have premature ejaculation than the group that relaxes and engages emotionally. The vicious cycle between stress – failure – worry prolongs the situation.
“Sex is a resonance between body and mind. If the mind is always in ‘survival mode’, the body will not be able to love, so the best way to stay in shape is to stop trying to prove your performance,” the doctor analyzed.
Premature ejaculation in overthinking people is sometimes not because the body is weak, but because the brain does not allow them to enjoy. As in the case of a 29-year-old male information technology engineer, he ejaculated after only about a minute even though his erection was still normal when masturbating. Obsessing over “performance” makes him always stressed like he’s taking a test every time he has sex. Tests showed elevated cortisol and severe stress levels despite normal testosterone and semen analysis. The doctor diagnosed premature ejaculation secondary to anxiety disorder and overthinking, treating it with medication combined with psychological counseling, “stop-start” techniques and relaxation exercises. After 3 months, ejaculation time increased to an average of 6 minutes, stress was significantly reduced and married life improved.
Testing for patients. Image: Quynh Tran
The danger is that many people turn to erectile dysfunction drugs to “cure the fire”, while the psychological root of the problem has not been resolved. Treatment for overthinking men is not just prescribing erection-boosting drugs, but multi-dimensional therapy, including cognitive behavioral therapy (CBT) to help identify and change distorted thoughts, relaxation therapy and mindfulness meditation to help the body return to feelings, couples therapy to help two people communicate more openly, reducing the pressure of “fighting alone”.
“Relationship is not a test but a connection. When the brain is busy controlling, the body will lose its natural state. Treating overthinkers is not just with medicine, but helping them learn how to relax their mind,” said Dr. Duy.
Besides, it is necessary to pay attention to the overall health of the brain. Lack of sleep, alcohol, tobacco, and excessive caffeine all cause the hippocampus – the emotional regulation center – to function poorly, increasing stress. In addition, physical inactivity reduces endorphins (happy hormones), making it more difficult for the body to achieve natural pleasure. A rested brain, a cared for body and an understood relationship are the three core elements of healthy sexuality. Overthinking not only saps pleasure, it also erodes emotional connection, making sex more of a burden than a joy.