When Sexual Struggles Aren’t “Just Physical”
Many men come to therapy believing something is “wrong” with their body — when in reality, their sexual difficulties are deeply connected to stress, anxiety, shame, trauma, or relationship patterns.
Men’s sexual health therapy can help if you’re experiencing:
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Performance anxiety or fear of “losing” an erection
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Erectile dysfunction without a clear medical cause
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Difficulty staying present during sex
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Avoidance of intimacy or dating
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Shame, self-criticism, or pressure to perform
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Mismatch between desire, arousal, and emotional connection
Gay Men & Sexual Health
Many gay men feel confident in most areas of life — but struggle when it comes to sex or intimacy.
Concerns around performance, desire, shame, or connection often remain unspoken.
This work focuses on helping you develop a healthier relationship with sexuality and emotional closeness.
A Psychological Approach to Men’s Sexual Health
I don’t treat sexual difficulties as mechanical problems to “fix.” I help men understand why their nervous system, mind, and body are reacting the way they are — and how to change that pattern safely and sustainably.
My work integrates:
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Anxiety and trauma-informed therapy
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Attachment-based psychology
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Cognitive and somatic approaches
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Real-world relational insight
This is therapy for men who want lasting confidence, not temporary reassurance.
What to Expect in Men’s Sexual Health Therapy
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A calm, non-judgmental space to talk openly about sex
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Understanding the emotional and psychological roots of your symptoms
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Learning how anxiety and pressure impact arousal
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Tools to regulate your nervous system during intimacy
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Rebuilding trust in your body and sexual response
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Moving toward sex that feels connected, confident, and present
Common Sexual Health Concerns I Work With:
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Sexual performance anxiety
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Erectile dysfunction with psychological roots
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Compulsive sexual behaviors
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Low sexual desire
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Intimacy avoidance
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Shame around sex or arousal
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Relationship-based sexual difficulties
Men’s Sexual Health Therapy: FAQs
1. What kinds of issues can sex therapy help with?
Sex therapy for men can address concerns like erectile dysfunction, low libido, premature ejaculation, performance anxiety, sexual shame, relationship disconnection, and more. Whether the issue is physical, emotional, or relational, therapy can help untangle what’s really going on and support you in moving forward.
2. Is erectile dysfunction all in my head?
Not entirely — but the mind plays a powerful role. While there can be medical factors involved, many men experience ED due to stress, anxiety, self-doubt, or unresolved emotional dynamics. Therapy can help you understand those factors, reduce pressure, and reconnect with your body in a healthier way.
3. What happens during sex therapy?
Sex therapy is talk-based and focused on understanding what’s affecting your sexual wellbeing. We’ll explore your personal history, thought patterns, emotional blocks, and relationship dynamics. No physical exams, no awkward exercises — just honest conversation and practical strategies tailored to your goals.
4. Is it embarrassing to talk about this stuff?
It’s normal to feel hesitant — most men weren’t taught how to talk about sex openly. But in therapy, this becomes a safe, confidential space to drop the shame and speak honestly. You’ll likely find that simply naming the issue is a huge first step toward healing it.
5. Can therapy actually improve my sex life?
Yes — when you're no longer weighed down by anxiety, shame, or pressure, everything changes. Therapy can help you feel more confident, present, and connected — not only during sex, but in how you relate to yourself and your partner.
Learn more about these patterns:
If you'd like to explore how intimacy, confidence, and desire can become connected to emotional experiences, the following articles may be helpful.
Going Deeper:
If you'd like to explore how sexual patterns develop — and why they sometimes feel difficult to shift — this video looks at the psychology behind what are often called “sexual templates” in gay men.
Related Support:
Concerns around intimacy or confidence often intersect with both personal growth and relationship dynamics.
Some clients explore these areas through:
About Your Therapist
I'm Michael Pezzullo, LMFT — a Los Angeles-based therapist specializing in men’s mental and sexual health. I work with men who are successful on the outside but struggling internally with anxiety, intimacy, and sexual confidence.
My approach is direct, thoughtful, and grounded in both clinical training and real-world experience.
Ready to Feel More Confident and Present?
You don’t need to force your body to cooperate — you need to understand it.
If you’re ready to address the root of what’s happening, I offer a free 15-minute consultation to see if this work is right for you. Book a free call now.
