You’ve probably already been to the doctor. Maybe you’ve tried medication. And maybe it helped with the mechanics — or maybe it didn’t — but something still doesn’t feel right.
What most men describe isn’t really about erections. It’s about the dread that comes before — the worry that it’ll happen again, the pulling away from a partner because the risk of failure feels too high. The avoiding. The excuses. The quiet shame that seeps into everything.
That’s not a medical problem. That’s anxiety wearing a very convincing disguise.
This page is about sex therapy for erectile difficulties — a talk-based, confidential approach that addresses the psychological and relational side of what’s happening. I offer this work in Pittsburgh and online across Pennsylvania, New Jersey, New Mexico, and Rhode Island.
If this sounds familiar, I’d be glad to talk it through.
Schedule a free consultation →What’s Actually Happening
Erectile difficulties almost always start with something real — stress, a health issue, a medication side effect, a relationship that’s been tense for a while. But then the anxiety takes over.
You start watching yourself during sex. Monitoring your body instead of being present with your partner. That self-monitoring — sometimes called spectatoring — is one of the most reliable ways to shut down arousal.
The more you watch, the less you feel. The less you feel, the more you watch. It becomes a loop — and the original cause stops mattering because the loop itself is now the problem.
For many men, this also starts to affect the relationship. You might be avoiding intimacy altogether, making excuses, or going through the motions while being somewhere else entirely. Your partner feels the distance — and now there are two problems: the ED and the growing disconnect between you.
How This Work Helps
I work with erectile difficulties from the inside out — not by giving you techniques to perform better, but by helping you understand what’s actually driving the difficulty.
That usually means addressing performance anxiety directly — learning to notice when the monitoring starts and how to shift back into your body. It often involves sensate focus exercises you do at home, designed to rebuild comfort and pleasure without the pressure of “performing.”
If you’re in a relationship, we’ll likely look at how the ED has affected things between you and your partner — the conversations you’re not having, the distance that’s grown, the assumptions each of you is making about what the other thinks.
This is talk-based therapy. Nothing physical happens in session. The work is about understanding the patterns, reducing the anxiety, and rebuilding your relationship with your own sexuality.
Ready to start working on this? A free 15-minute consultation is the simplest way to see if this approach fits.
Schedule a free consult →What Therapy Looks Like
Sessions are 53 minutes, either in person at my Pittsburgh office or online via secure video. I work with individuals and couples — sometimes the most effective approach includes both.
We’ll start by understanding your specific situation: when the difficulty started, what makes it better or worse, how it’s affecting your life and relationships. From there, we build a plan that’s specific to you — not a generic protocol.
As an AASECT Certified Sex Therapist, I bring specialized training in sexual health that most general therapists don’t have. This isn’t something you need to explain from scratch — I’ve worked with this extensively.
Practical Details
I offer ED therapy in person at my office in Pittsburgh’s East End (East Liberty/Shadyside area) and online across Pennsylvania, New Jersey, New Mexico, and Rhode Island.
This is a private-pay practice. That means no insurance company deciding how many sessions you get or what we’re allowed to work on. The depth and pace of the work are determined by you, not a managed-care algorithm.
Evening and Sunday appointments are available — because this isn’t the kind of thing most people want to squeeze in during a lunch break.
Frequently Asked Questions
What does erectile dysfunction therapy actually involve?
ED therapy with me involves understanding what’s happening for you physically, emotionally, and relationally. We’ll explore your medical history, stress levels, relationship dynamics, and performance anxiety. I use a combination of education about the physiology of erections, cognitive techniques to reduce performance pressure, communication strategies with your partner, and sometimes specific behavioral exercises. It’s not about forcing anything—it’s about removing the obstacles that are getting in the way.
Is erectile dysfunction just a physical problem, or is it psychological?
It’s almost always both, which is why therapy is so effective. Your mind and body are connected—anxiety about your erection directly affects your ability to have one. Even if ED starts with something physical like diabetes or medication side effects, the psychological response creates a cycle that makes things worse. That’s where therapy comes in. We address both the medical components and the anxiety, shame, and relationship stress that often develop alongside ED. Many men find that even with medication, therapy helps them regain confidence and enjoy sex again.
How is therapy different from just taking medication for ED?
Medication can be very helpful, but it doesn’t address the performance anxiety or the relationship patterns that often develop with ED. A man might take medication and still experience anxiety about whether it will work, or feel disconnected from his partner. Therapy gives you tools to manage that anxiety, improve intimacy and communication with your partner, and often reduces your dependence on medication over time. Many of my clients find that combining therapy with medication—or eventually just using therapy alone—gives them the most sustainable results and the deepest sense of sexual confidence.
What should I expect in a typical session for ED therapy?
Sessions are confidential and judgment-free. We’ll start by understanding your specific situation—when the ED started, what you’ve noticed about it, and how it’s affecting you emotionally and in your relationship. From there, we might discuss relationship communication, work through anxiety reduction techniques, address any myths you’re holding about sex or performance, and I may suggest some behavioral exercises to practice between sessions. I’m here to answer questions, normalize what you’re experiencing, and help you build a plan that works for your specific situation.
Does my partner need to come to sessions with me?
Not necessarily, though partner involvement can be really helpful—especially if relationship dynamics are contributing to the ED. I usually start with individual sessions to create a safe space for you to be fully honest. As we work together, we can discuss whether bringing your partner in for some sessions would be beneficial. If you’re in a relationship and your partner is open to it, couples sessions can help with communication, reduce your partner’s worries, and make the whole experience less isolating. But the choice is yours, and many men work through ED successfully in individual therapy first.
Ready to Get Started?
Schedule a free consultation to discuss how therapy can help.
Schedule a Free ConsultationFurther Reading
Erectile Dysfunction: When It’s More Than Physical – A Sex Therapist’s Perspective for Men
Spectatoring: Why Watching Yourself Have Sex Kills Desire (And How to Stop)
Beyond Technique: A Man’s Guide to Authentic Sexual Performance & Fulfillment.
Reduce Performance Anxiety & Enhance Pleasure: A Guide to Sensate Focus for Men