Which pathway addresses sexual performance anxiety?
Performance anxiety with intact desire often routes to the Sexual Wellness pathway (PDE5) to interrupt the anxiety-vascular loop. Confirmed low testosterone routes to TRT in parallel. Psychological care is encouraged.
Full answer
Sexual performance anxiety is a feedback loop: anxiety drives sympathetic tone, which impairs erectile response, which reinforces anxiety. The Sexual Wellness pathway (tadalafil/sildenafil) can interrupt the loop in candidates with intact libido and acceptable cardiovascular candidacy. Men with confirmed low testosterone are evaluated for TRT in parallel. Psychological care (CBT, sex therapy) is encouraged when the primary driver is psychological. Every route is synchronous-video reviewed.
Educational. Not a substitute for individualized provider review.
- Sexual Wellness pathway — Primary source · oMeds
- Reviewed by Dr. Laura Purdy, MD, MBA · Clinical Director, oMeds · Last reviewed 2026-05-29