Epigenetics Series: How does stress affect your genes?


Could your genes and stress be related? Is stress passed down from generation to generation?

Recent research shows that stress may alter our genes in a way that’s linked to mental and physical illnesses. These stress-induced illnesses may even be hereditary, meaning the trauma of our ancestors impacts our contemporary genetic expression. 

How is stress related to your genes? Why is stress such a problem for health?

And what can you do about it to take control of your health?   

What is stress?

What’s the first thing you think of when you think of “stress?”

Maybe you instantly think of a project you’re working on at your job or a loan you’re trying to pay off. You may even think of public speaking or skydiving.

Interestingly, when we think of “stress,” we automatically think of situations. We think of instances where our bodies are stressed. These are uncomfortable or challenging situations that push our bodies and brains to new places.

These situations cause us “stress.”

In reality, though, stress itself is a response to these situations.

When these situations occur, our bodies release stress hormones called glucocorticoids. The principal glucocorticoid is cortisol, otherwise called “the stress hormone.”

There are two types of stress: acute and chronic.

Acute stress

Acute stress occurs in the short-term. This is when you’re met with a challenging situation that you have to respond to in some way. To overcome this stressor, your body releases a burst of glucocorticoids.

Glucocorticoids prepare your body to tackle the stressor. For example, your heart might start pumping blood faster to give your body more oxygen; your eyes might dilate to see more around you, and your hands and feet might tingle because they’re receiving more blood (in case you need to fight or flee).  

These stress responses are often dubbed as symptoms of “anxiety.” But in the short-term, these hormones can actually give us a biological advantage. For example, they would allow us to fight or flee a bear we come in contact with. In more practical terms today, this response could also make us more alert and energized to give a speech or take a test.

In short spurts, glucocorticoids are manageable and healthy. They can help you tackle a situation with confidence and determination.

It’s when glucocorticoids flood our bloodstream for an extended period of time that they become an issue.

Chronic stress

Chronic stress is long-term. This is caused generally by ongoing stressful situations, like a career you hate, a debt you can’t pay, or an ongoing divorce. Chronic stress can also be the result of PTSD. Even if you aren’t currently going through the stressor, memories of that trauma can continue releasing glucocorticoids for months or years.

Chronic stress causes high levels of stress hormones for an extended period of time. This damages the endocrine system by unbalancing hormones, tiring the body, and fatiguing organ function.

In fact, chronic stress can even negatively impact your genetic expression.

Moreover, this altered gene expression can be passed down from generation-to-generation.

Before we get into how chronic stress alters epigenetic expression, let’s first take a look at why stress is bad for us.

Why is stress harmful?

Stress kills. Stress has been linked to:

Chronic stress can literally burn out your body. Your adrenal glands, which produce cortisol, get fatigued and don’t function properly. The oxidative stress caused by these stressors creates harmful free radicals that severely damage your cells. This accelerates the aging process, damages the immune system, and impacts cognitive function.

Stress is linked to just about every disease—big or small. You’re even more likely to catch a common cold if you’re stressed.

Cortisol and testosterone

Stress also has a direct impact on your sexual health.

If you’re suffering from low libido and low testosterone, it may be because you’re stressed.

Numerous studies have shown that high levels of cortisol are directly linked to low levels of testosterone. There is especially a link between stress and severe trauma with PTSD. Higher cortisol in stressful situations drastically lowers testosterone.

When your cortisol goes up, your testosterone goes down.


Why does higher cortisol mean lower testosterone?

There are likely a number of hormonal pathways that create this hormonal relationship. To simplify it, we can look at the building blocks of cortisol and testosterone synthesis.

The body uses cholesterol to produce cortisol. Cholesterol is also a necessary part of testosterone synthesis. When stress levels increase, all of your body’s cholesterol goes to produce cortisol. This leaves no cholesterol left to produce testosterone.

Testosterone is a critical hormone in healthy adult males. Low testosterone is associated with decreased sex drive, erectile dysfunction, depression, anxiety, weight gain, reduced muscle mass, cognitive impairment, arthritis, increased risk of heart disease, and more.

Low levels of testosterone kill your energy, productivity, enjoyment, and health. And low levels of T are a direct result of high cortisol and high stress.

Chronic stress not only impacts our hormones but also our genes. High levels of cortisol and low levels of testosterone can alter the way our DNA is expressed, putting us at risk for disease and illness.

How does stress alter your epigenetic expression?

Epigenetics involves two key genetic alterations: DNA methylation and histone acetylation. DNA methylation adds a methyl group to the end of a DNA structure, and histone acetylation adds an acetyl to the end of the histone binding. These additions can either activate or deactivate certain genes.

Research has shown that stress causes both methylation and acetylation on a variety of genes, especially neurological genes (those in the brain).  

DNA methylation and stress

One study found that certain psychological stressors can cause DNA methylation of certain genes. For example, war trauma and physical abuse caused DNA methylation to occur on genes that activate damaging psychiatric disorders.

A study of Cushing’s Syndrome, which is caused by excess cortisol production, found genome-wide changes with regards to DNA methylation. They discovered that individuals with high cortisol levels had less DNA methylation compared to healthy individuals.


DNA methylation suppresses the expression of genes. In this way, certain harmful genetic expressions need DNA methylation in order to be suppressed. For example, in the study, the gene for psychiatric issues remained active because stress kept those genes “turned on;” this caused a number of CS patients to suffer from mental illness at a higher rate.

Research at Johns Hopkins found that mice given corticosterone appeared more anxious during a maze test. When testing their gene methylation levels, they found altered expressions in three of the five HPA axis genes.

They especially found higher levels of Fkbp5, which is the molecular complex that interacts with the glucocorticoid receptor. Genetic variations in Fkbp5 have previously been associated with PTSD and mood disorders.

transform-your-health-with-dna-2

Overall stress and genes

Basically, stress boosts cortisol and other glucocorticoids. These hormones impact histone coding and DNA methylation, activating genes of illness while deactivating healthy-suppressive genes.

Stress also plays an important role in those genes that control memory and cognitive function. Too much cortisol and these genes “turn off,” causing serious psychological and behavioral concerns.

Glucocorticoids, like the stress hormone cortisol, alter the genetic expression in the brain. Thus, any cortisol-boosting situation—like anxiety, PTSD, depression, and stress—can impact epigenetic chemical tags.

Thus, prolonged stress causes significant epigenetic changes that can drastically impact mental and physical wellbeing.

Stress doesn’t just alter your own genes. These epigenetic expressions and psychological concerns can be passed on for generations as well…

How does stress impact your children’s genes?

That’s right. You can pass your stress on to your children.

Studies have shown that environmental conditions of previous generations impact the expression of our current genes as well.


For example, one study found that daughters of women who experienced the Dutch famine were twice as likely to develop schizophrenia. The daughters did not go through the famine themselves, but their mother’s trauma was genetically passed down, increasing the offspring’s risk of mental illness.

Other studies have shown that extreme stress during pregnancy, like living through the 9/11 attacks, can pass the experience on to the child. These children report depression, anxiety, and poor coping mechanisms at a much higher rate than parents who did not live through extreme stress.

This is true even when the children are well cared for. A study of rats found that parents who experienced epigenetic-altering stress passed this genetic structure on to their pups and grand pups—even if they’re pups were cared for and loved in early life.

Although these altered genetic expressions are hereditary, they’re not permanent.

In fact, you can reverse stress-related DNA changes with environmental and lifestyle factors.  

A study of identical twins looked at how environment and trauma impacted epigenetic flags. Although the siblings were genetically identical, their epigenetics changed over time. One twin had depression, anxiety, and obesity while the other did not. This is likely because the latter twin was able to change his epigenetics in a way that suppressed the genes for those diseases.

We have power over our epigenetics.

You can deactivate the stress-related genetic expression that you may have inherited from your family.

And you can prevent the activation of your own stress-induced DNA methylation.

How can you reverse stress-induced genetic risk factors?

  1. Meditate.

One of the easiest and most effective ways to combat high stress is through meditation. Relaxation practices have been shown to reduce cortisol and increase testosterone. In fact, even just four months of meditation practice can help reset hormone levels and improve stress response.

I recommend taking a yoga class and learning deep breathing exercises. You should also get outside to meditate and relax. Studies show that taking a walk in nature is linked to lower cortisol levels. Fresh air helps calm the mind and body—and gets you to exercise as well.  

  1. Workout.

Working out has a direct impact on mood and cortisol. Working out releases endorphins, which makes you happier and less stressed.

High-intensity interval training boosts testosterone and decreases cortisol. Learn more about using HIIT to lower cortisol and increase T here.

This decrease in cortisol has actually been shown to boost cognitive function and improve behavior and mood.  

However, if you have high levels of stress, an intense workout might worsen the problem by boosting cortisol in the short-term. This cortisol increase isn’t harmful to your genes, but it can increase levels of anxiety and tension in individuals already experiencing high levels of stress.

Plus, losing weight and fat can help reduce stress. Moreover, body fat increases estrogen, which decreases T levels. This causes lower testosterone, and low T, in turn, leads to increased body fat and reduced muscle mass—which further impacts stress. It becomes an unhealthy cycle of weight gain, low T, and stress!

  1. Eat more carbs.

People tend to shy away from carbs because they “make you gain weight.” However, a diet that’s too low in carbs can actually make you gain weight by increasing cortisol levels.

Carbohydrates actually help reduce cortisol levels, especially post-workout.

However, don’t go guzzling carbs when you’re stressed, as too many carbs will cause weight gain and this can further increase cortisol and lower testosterone.

It simply means you want to maintain a balance of macronutrients: proteins, fats, and carbs. Studies have shown that higher protein diets lead to high cortisol levels, while a strong ratio of protein to carbs creates the most balanced hormones.

Click to learn more about the dangers of an all-protein diet—and why you need carbs.

  1. Get more vitamin C.


Vitamin C has been linked to reduced cortisol production, especially after an intense workout. Vitamin C is also a great testosterone booster.

One study found that vitamin C actually regenerated 58% of damaged testosterone molecules. It also helps with sperm quality, motility, and volume for improved sexual health. Boost your testosterone and you can help reduce your cortisol and stress.  

You can find vitamin C in a number of healthy foods, like citrus, guava, red peppers, strawberries, and papaya.

  1. Sleep more.

Sleep helps reset your hormone levels, reducing cortisol and increasing testosterone.

In fact, if you don’t sleep enough, your cortisol levels rise astronomically.

Cortisol levels naturally rise slightly in the morning to help us wake up and prepare for the day. In reverse, cortisol drops at night to help us sleep.

However, if your body doesn’t drop cortisol at night, you’ll deal with insomnia and late-night anxiety. You’ll also have increased levels of cortisol in the morning that can cause severe, chronic stress whenever you’re awake.  

Sleep is critical to balance hormones, reduce stress, and restore your body’s natural health.

Learn more about how sleep impacts your epigenetics here.

  1. Stand in power poses.

Studies have shown that you can increase testosterone by 20% and reduce cortisol by 25% simply by standing in a “power pose” for two minutes. The researchers concluded that you can change your brain and hormonal chemistry through body language and behavior.

Simply pretending to be powerful and stress-free will make you powerful and stress-free!  

Conclusion

Stress impacts our behavioral epigenetics. Traumatic experiences in our past—and in our ancestors’ past—can scar our DNA. Although we can inherit stress-induced genetic expressions, we can also reverse this process as well. With certain lifestyle and environmental changes, you can reduce your stress and reset your genetics for a healthier expression.

Are you ready to change your genes?

Work With Me

You’ll learn how to change your environment and lifestyle to reduce your risk of major diseases… and finally, have the energy and health you crave!

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You’ll get access to a genetic-based report and analysis, along with a private consultation that will put you on track to your ultimate health.

With the Male 2.0 Method, I test your DNA, interpret the results, and create a customized strategy just for you. This plan is specific to YOUR individual genes and lifestyle.  It will improve every area of your life, from your health and professional productivity to your overall longevity and total wellbeing. Male 2.0 gives you the actionable tools you need right now.  It reveals what you need to customize and design your future limitless self.

Click here to learn more about the lifelong benefits of a personalized genetics consultation and epigenetic coaching program.

Want more tips to optimize your health?  Listen to the latest podcasts. Click HERE 

I look forward to working with you to take your health goals to the next level.

COMING SOON TO AMAZON

In Male 2.0, Dr. Tracy Gapin has turned everything we once thought we knew about men’s health and performance upside down. The old model of how to be “a man” is broken. A man who works himself to death. A man who tries to NOT get sick but isn’t really healthy either. A man who takes a pill for every ill but is never really cured. That was Male 1.0. Now, imagine being THE MAN ─ owning your performance in the bedroom, the weight room, and the boardroom. Living a fully optimized life. Becoming limitless. This is Male 2.0!

Tracy Gapin, MD, FACS  is a board-certified Urologist, Men’s Health Expert, Author, and Professional Speaker. Using state-of-the-art biometric monitoring, nutrition and lifestyle intervention, Dr. Gapin coaches Fortune 500 executives and evolutionary leaders of business, sports medicine, and high performance. He specializes in cutting-edge precision medicine with an emphasis on epigenetics, providing men with a personalized path to optimizing health & performance. www.SmartMensHealth.com 

11 Ways To Conquer Performance Anxiety TODAY

Performance anxiety is one of the biggest opponents against a healthy and happy sex life. It can become a physical and emotional obstacle that can drastically impact your quality of life—both inside and outside the bedroom.

What is performance anxiety and how can you overcome it to achieve an exciting sex life once again?

What is performance anxiety?

Performance anxiety is literally anxiety about being able to perform sexually.

It can manifest in a number of ways:

  • Premature ejaculation (PE): ejaculating before or immediately after penetration
  • Delayed ejaculation (DE): a prolonged period and/or overstimulation is necessary in order to ejaculate
  • Erectile dysfunction (ED): inability to get or maintain an erection long enough for intercourse
  • Psychological stress in and out of the bathroom
  • Low libido or lack of interest in sex
  • Obsessive negative thoughts

Performance Anxiety | Gapin Institute
Even cheating on a partner or having multiple partners can be a sign of performance anxiety. In some cases, men may seek sexual satisfaction elsewhere if they find they are having performance anxiety with their partner. This is generally the cause of some sort of previous negative sexual experience with that particular partner, often exacerbated by a lack of communication.

Note: Experiencing one of the above instances once or twice doesn’t necessarily mean you have performance anxiety. However, as we’ll discuss below, even one instance of the above can actually make you talk yourself into having performance anxiety in the long-term!  

What happens to your body with performance anxiety?

Performance anxiety isn’t all in your head—although it usually stems from the head. Anxiety is not only an emotional or psychological problem but also a physical concern with serious associated health implications. Anxiety is part of the body’s natural fight or flight response. It’s actually a warning sign meant to help protect us from danger.

Performance anxiety can actually make you feel like you’re in a hostile situation when you’re about to sex. That’s not very sexy.

When you feel anxious or stressed, your body releases cortisol. Cortisol, the “stress hormone,” actually stops the production of testosterone. You need a high level of testosterone in order to feel sexy. Testosterone is the libido-boosting hormone in both men and women. Lowered testosterone can cause a decreased sex drive, depressed mood, weight gain, and erectile dysfunction—all of which worsen or cause performance anxiety.

Learn more about how to naturally raise your testosterone levels and reduce cortisol levels.

Moreover, anxiety can actually cause your blood pressure to rise. This can lead to hypertension and cardiovascular concerns, which inhibit blood flow throughout the body. This means that blood can’t flow to the penis for an erection. In fact, anxiety is often a major contributor and cause of erectile dysfunction because the penis literally isn’t getting the blood it needs to get hard.

These physical manifestations of stress can worsen your ability to perform sexually, causing a negative feedback cycle of performance anxiety.

Where does performance anxiety come from?

Sexual Performance Anxiety | Gapin Institute
Performance anxiety often starts small and grows. It’s generally psychological, where you start to overthink your sexual experiences.

Did I last long enough?

Did I make my partner happy?

What did my partner think about that one thing that I did?

Was I good?

The more you ask yourself these questions, the more anxiety you’ll get. These constant thoughts can affect your ability to have enjoyable sex in the future. You’re too busy thinking about what could go wrong or your partner’s “judgment” than focusing on the fun and pleasure of the moment.

But these thoughts are coming from somewhere… so what can spur these anxieties?

Society’s views of sex

Consider the term “performance anxiety.” Even the wording of that is stressful!

Socially, we’ve started to think of sex as a “performance.” This puts a lot of pressure on the act. It reminds us of public speaking or playing in the Super Bowl; we feel like we’re expected to have grand performances in the bedroom.

Moreover, masculinity standards can put a lot of pressure on sex. When boys start entering “adulthood,” they’re quickly taught that having sex makes them cool. We continue to watch movies and TV where the “cool” guys get the girls and have amazing sex. This starts to condition the brain that sex equates to masculinity.

As a society, we’ve transformed sex from something intimate and pleasurable to something competitive and goal-oriented. Thus, if something “goes wrong,” we can start to feel emasculated or anxious about ourselves.

Porn

Porn adds another layer to this idea of “performance.” Pornstars are literally putting on a sexual performance. Everything has to look perfect in porn. That can make us normal folks—without special lighting and editing equipment—feel a little anxious.

Watching a lot of porn can actually even cause erectile dysfunction due to insufficient real-life sexual arousal, issues of low self-esteem and confidence, and less visual and auditory stimulation. Learn more about porn-induced erectile dysfunction here.

Past negative experience

Negative Experience Performance Anxiety
Like any sort of “trauma,” our minds can build negative associations. If something happened in a previous sexual experience, you might consciously or subconsciously take this event with you into your other experiences.

For example, you had one instance of premature ejaculation with your partner for some reason. Or you had a week where you couldn’t seem to get an erection. You might be embarrassed by your “inability to perform.” You can then start convincing yourself that you have a “problem” and that you’ll never be able to please your partner again.

This is especially exacerbated if a negative experience happens and the partners don’t communicate about it. This can cause men to start overthinking the experience, often undermining their own masculinity and confidence in tandem.

Confidence or self-esteem issues

Specific sexual instances can cause men to lose confidence in the bedroom. Other confidence or self-esteem issues can make a man feel anxious to get naked or please his partner. For example, a man may have body issues because he’s slightly overweight or he’s insecure because he has a large mole near his penis.

Again, these confidence concerns often stem from a lack of communication with the partner. More often than not, these are perceived self-esteem issues not based in reality.

Medical concerns

While performance anxiety is often psychological, these psych concerns can stem from physical problems as well. There are some unrelated medical problems that inhibit your ability to have sex. For example, a man may have diabetes, which shows a secondary symptom of erectile dysfunction.

When a man has these physical concerns, he might start thinking something is “wrong” with him—rather than thinking of his ED as a medical concern. This can then lead to negative self-talk and confidence concerns, ultimately lending itself to performance anxiety.

Desire to please

Sometimes performance anxiety can come from a positive place but have a negative impact. You might worry about pleasing your partner so much that it actually becomes debilitating. You start overthinking about how to “perform” in a way that will excite them, and you end up not having any fun or pleasure yourself. If you don’t feel that excitement yourself, your brain won’t signal your body to physically prepare to have sex. If you aren’t feeling sexy, your body won’t be able to have sex.

Negative feedback loop

All of these physical and psychological concerns can mix to create a negative feedback loop, potentially causing a man to spiral down into severe performance anxiety.

The cycle looks something like this:

  1. Something happens that causes you to feel you didn’t perform “at your peak” during a sexual experience.
  2. You start thinking about that sexual experience and wondering what happened.
  3. This overthinking begins to cause you to wonder if you have some sort of “problem.” This can make you feel emasculated and unconfident.
  4. Thinking about this “problem” causes the problem to manifest itself. You can literally talk yourself into not being able to perform.
  5. This causes further problematic sexual encounters.
  6. This causes even more anxiety, which can push your body into a physically unhealthy state of high stress, low testosterone, and high blood pressure.
  7. In turn, these concerns create a physical performance issue.
  8. So you can’t perform again because of a physical problem.
  9. And then the negative self-talk starts again.

It causes a vicious cycle of psychological and physical concerns.

This cycle can be hard to break when you’re in it.

But you can break it…

And you can start breaking it right now!

 

How do you overcome performance anxiety?

Stop thinking of sex as goal-oriented

Sex performance anxiety
Sex is not about putting on a performance. Sex is not even about having an orgasm. It’s about pleasure and intimacy. It’s about connecting with your partner in an intimate—and very enjoyable—way.

Try having sex without worrying about an orgasm. Tell your partner that you want to focus solely on foreplay. This can relieve some of the pressure and give you time to better explore one another. This can help overcome some mental hurdles moving forward.

Stop judging yourself.

Masculinity does not mean you are perfect at sex. Sex is an important part of life—but it’s not an important part of your identity.

If something happens, don’t start telling yourself you have a “problem.” Realize the event for what it is. Maybe you’d had too much to drink. Perhaps you were stressed from work. Maybe you have an underlying medical concern to chat with your doctor about. Stop overthinking or misplacing meaning to a sexual event.

Remind yourself how awesome you are.

Stay positive performance anxiety
There is power in positive thinking. Stand in front of the mirror and tell yourself you’re amazing in bed. Tell yourself that you’re a sex god. Whatever phrases work to get you excited, happy, and goofy. Just like you can talk yourself into having performance anxiety, you can talk yourself into having sexy confidence!

Moreover, think of all the sensual moments in your life. These moments can be during sexual or romantic. They should remind you of your sexual prowess and the amazing feelings you had during those exciting moments. This reminder can instantly renew your sexuality and help remind you of your abilities.

Eliminate external stressors.

Performance anxiety can stem from other anxieties and stresses as well. If you’re feeling stressed, your cortisol levels will rise, which increases blood pressure and inhibits testosterone production. You may not even feel stressed, but it could manifest itself in the bedroom and impact your sexual health.

Consider what stresses you have in your life. Find ways to manage the anxiety and environment around you. Take proactive steps to reduce stressful triggers around you.

Take time to relax.

relax performance anxiety | Gapin Institute
Sometimes you can’t avoid stress. But you can mitigate or reduce it. Take time to calm your overall body, and your sexual health will calm in tandem. Try yoga and meditation. Try mindfulness techniques. Do breathing exercises, which help regulate heart rate, reduce blood pressure, and decrease muscle tension—which all put your body in a better state for sex.

Working out is a great way to relax and release nervous energy. It also increases your testosterone levels and lowers your cortisol, which can help overcome erectile dysfunction. Exercise can also make you happier and healthier overall, so you’re less likely to fall into stressful situations like sex-related anxiety.

Check out: 9 Exercises To Beat ED And Have Better Sex

Communicate with your partner.

Communication is key to overcoming performance anxiety. No matter the cause of your anxiety, talking about it with your partner can release some of the tension. Often, your partner can help reduce some of your concerns by telling you how they view the situation. Honesty allows you to work together to manage and overcome the situation.

Plus, opening the lines of communication can allow you to try new things with your partner. For example, you might want to tell your partner that you’re feeling anxious about performing, so you want to try having sex without orgasm. There will be no expectations for you to finish because you talked about it ahead of time.

Get a little kinky.

Get Kinky, Performance Anxiety | Gapin Institute
Now that you’ve opened the lines of communication, try new things. If you don’t have erectile dysfunction and can still ejaculate in other situations, it likely means you’re in some sort of anxiety-ridden “rut” with your partner. Share your fantasies or try out new moves.

Breaking a routine with new experiences can help overcome anxiety. You’re not “repeating patterns” so there is less pressure.

And remember- if you tried something new and it didn’t work, that’s okay! At least you tried it. You’ll have less stress moving forward with other experiences.

I recommend trying tantric sex. Tantric sex focuses on breathing and mindfulness rather than on the actual physical act of sex. In fact, it’s not uncommon for men and women to orgasm without penetration! This is a great way to get intimate with your partner without worrying about the “performance” aspect.

P.S. Practice makes perfect. The more you have sex, the more confident you’ll be in your abilities.

Avoid drugs and alcohol.

Drugs and alcohol can actually worsen anxiety and lower sexual desire and arousal. Moreover, drugs and alcohol actually unbalance your hormones, which can lower libido and make it harder to obtain an erection.

Reduce your porn watching.

Porn sets unrealistic expectations about sex, which can lead to severe anxiety and performance concerns. It can even cause erectile dysfunction in high doses.

Remember: Porn is edited. You can’t compare yourself to the special effects used in porn filmmaking.

Seek professional help.

Talking to a sex therapist is a discreet and effective way to help you understand where your performance anxiety stems from. They will look at your relationship and sexual history to get at the root of your sexual stressors.

It is not embarrassing to seek professional help. You deserve to have an exciting and vivacious sex life, and a professional will help get you to that point.

You can find quality sex therapists through the American Association of Sexuality Educators, Counselors, and Therapists.

Change your lifestyle.


Performance anxiety and general anxiety often stems from lifestyle. Diet, exercise, supplements, and health choices all impact your stress levels inside and outside the bedroom.

If you want to overcome anxiety, you need to change your lifestyle.

You can kiss performance anxiety goodbye…

And say hello to the best sex of your life!