ERECTILE DYSFUNCTION AND PERFORMANCE ANXIETY THERAPIST
JON PREZANT, LCSW, MA, CST — AASECT-CERTIFIED SEX AND COUPLES THERAPIST
Therapy for the part of erectile problems that medication doesn’t reach. I’m a licensed clinical social worker and an AASECT-certified sex therapist, and I’ve been featured as an expert on men’s sexuality in Men’s Health. I work online with men across New York, New Jersey, New Hampshire, and Florida.
It happened once, maybe twice. Now you’re thinking about it before anything starts, partway through, and afterward, and that monitoring is what keeps the problem going. Most men I see have already read everything available online and understand how erections work. What reading can’t touch is the belief, often years old, that losing an erection means something is wrong with them.
What I treat: erections that are unreliable with a partner or fade partway through, performance anxiety, early or delayed ejaculation, anxiety that began after a single difficult night, and erectile changes related to illness, medication, or age. When a medical evaluation makes sense, I refer to sexual medicine urologists I work with, so the physical and psychological sides are treated together.
I hold an MSW from Yeshiva University, an MA in Trauma and Crisis Studies from Tel Aviv University, and certification in sex therapy through AASECT and the Modern Sex Therapy Institutes. I live in Brooklyn with my husband and our dog, Bernie.
WHAT MEN BRING IN:
FINE ALONE, NOT WITH SOMEONE
If erections are reliable when you're alone or when you wake up, the physiology is usually intact. The difficulty shows up with a partner, and that's where we focus.
THE PILL HELPS, KIND OF
Medication can help the body respond, but it does nothing for the dread underneath. Some men find they need higher doses, or stop trusting it altogether. Therapy addresses what medication leaves untouched.
ONE BAD NIGHT THAT BECAME A PATTERN
It happened once. You started watching for it, and the watching made it happen again. Treatment focuses on interrupting that loop between anticipation and response.
WITH A NEW PARTNER
Everything works in a long relationship and falls apart with someone new, or the reverse. Novelty and pressure affect arousal in ways most men were never told about, and this pattern is very common.
Your Questions, Answered.
What to expect when you start working on this.
HOW THERAPY WORKS
How do I know if it's physical or psychological?
One useful clue: if you have erections on your own or wake up with them, the physical mechanism is usually working. I still often recommend a urology evaluation to rule out hormonal and cardiovascular factors, and I can refer you to specialists.
How long does it take?
Performance anxiety often improves noticeably within eight to twelve sessions. Longer-standing patterns take more time, and we’ll review progress together as we go.
What happens in a session?
We talk; there’s no physical contact or examination. You’ll learn how arousal actually works, and we’ll address the thoughts and attention patterns that interrupt it. I often assign structured exercises between sessions, such as sensate focus.
Is This For Me?
Should my partner come?
It isn’t required, and many men start alone. A partner can be helpful later, particularly since their response is often part of what keeps the pressure on.
I'm gay. Does this apply to me?
Yes. Gay men face their own versions of this, around topping and bottoming, hookups, and body expectations. As a gay man and a sex therapist, I know that territory well.
Do you take insurance?
No. I’m out-of-network. Sessions are $200, and I provide a monthly superbill you can submit to your insurer for reimbursement. Check your benefits in about a minute.
Where I work
NYC and all of New York State, New Jersey, New Hampshire, Florida. All sessions online.
Work With Me
Jon Prezant, LCSW, MA
AASECT-CERTIFIED SEX THERAPIST · NY, NJ, NH, FL
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My Blogs
Gay Men and Porn: When It Becomes a Problem (And When It Doesn’t)
Almost everything written about gay men and porn...
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Most people asking whether they’re ready for a...
Read MoreCouples Therapy and the Growth Edge: Rethinking Low Desire, Erectile Dysfunction, and Sexual Boredom
Most couples who come in for couples therapy...
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