Erica’s work sits at an intersection many men are still reluctant to acknowledge: sexual health, confidence, intimacy, and the complicated expectations that surround masculinity. Her perspective is shaped not only by clinical experience but also by witnessing her husband navigate his own sexual health challenges, an experience that transformed what might otherwise have remained a professional subject into something deeply personal.

It taught her to question the idea of a single definition of “normal” and to recognise how closely sexual well-being can be tied to identity, relationships, and quality of life.

That understanding has also deepened through her work with veterans and injured service members, where physical change often carries emotional and relational consequences. Their experiences have reinforced her belief that resilience is not about pretending nothing has changed but finding the courage to adapt, seek support, and move forward. For Erica, listening is often the first form of care.

Much of her work challenges the quiet shame men carry around performance, comparison, and the fear of not being enough. Rather than offering confidence as something a practitioner can simply restore; she sees her role as helping people find the tools, language, and support to reclaim it for themselves.

In this conversation, we explore what happens when intimacy is treated as something worth talking about rather than enduring in silence from masculinity and vulnerability to changing desire, honest communication, and the courage to choose yourself. At its heart is a deceptively simple question: what might change if we stopped accepting “this is just how it is” as an answer?

Where Love Meets Healing 

Your journey into men’s sexual health was deeply personal. How did your husband’s experience change the way you understand confidence, intimacy, and sexual wellness? 

Erica:  My husband’s experience completely changed the way I understand confidence, intimacy, and sexual wellness because it made those things personal for me—not just clinical.

Through our own experience, I realized how easy it is to believe that our sexual health or our intimate relationships are supposed to look a certain way. We are constantly being shown what is “normal” through television, social media, culture, and even the things we were taught growing up. But the reality is that everyone’s sexual health journey is different. What is normal or fulfilling for one person or one couple does not have to define what is normal for another.

That experience has become a huge part of the philosophy behind my practice. I never want someone to feel that they have to accept something simply because they have been told, “That’s normal,” especially when they know something has changed or something does not feel right to them.

I also learned how important it is to advocate for yourself and for your partner. If you believe something is off, you deserve the opportunity to look for answers. If you do not feel heard by one provider, it is okay to seek another opinion. Sometimes that means finding another provider, another practice, or someone who is willing to look at the problem differently.

Of course, there are situations where we eventually reach the limits of what medicine can do, and I believe in being honest about that too. But there is a difference between arriving at that conclusion after truly exploring the options and being told once that nothing can be done and simply accepting it.

More than anything, my husband’s experience taught me that sexual wellness is deeply connected to confidence, intimacy, identity, and quality of life. It is not superficial, and it should not be embarrassing to talk about. You do not have to live according to someone else’s definition of normal. You deserve to understand your body, to feel heard, and to decide what confidence and intimacy look like for you.

Strength Beyond the Battlefield

Working with veterans and injured service members has played an important role in your journey. What have these men taught you about resilience and rebuilding confidence? 

Erica:  The veterans and injured service members I’ve had the privilege of working with have taught me an incredible amount about resilience. Many of these men have experienced and witnessed some of the deepest, darkest parts of this world, and yet there is still a light within them. They still want intimacy. They still want meaningful relationships. They still want to feel confident, connected, and whole.

They understand that their lives and their bodies may have changed, and what has always struck me is how willing they are to adapt and put in the work. But they need to know they are being heard, that they are not being judged, and that the person sitting across from them is genuinely on their side.

Many of them have already sacrificed so much, and unfortunately, I believe our systems are still behind when it comes to addressing both mental health and sexual health. Those two things are not separate. They are deeply interconnected, and we have to become better at treating them that way.

A person should not feel forced to sacrifice their sexual health in order to protect their mental health because of the side effects of a medication. At the same time, they should never feel that maintaining sexual function is more important than protecting their mental well-being. We have to be willing to have conversations about both and look for solutions that consider the whole person.

Because sexual health is not simply about the act of sex. It can affect confidence, identity, connection, intimacy, relationships, and ultimately quality of life. By the time someone is sitting in front of me having these conversations, there is often a much deeper story behind what brought them there—an injury, an experience, a loss, a medication, a relationship, or something they may have carried quietly for years.

Sometimes one of the most powerful things we can do as providers is simply be willing to listen.

What these men have taught me is that resilience does not mean pretending nothing has changed. It means recognizing what has changed and still being willing to move forward. They want support. They are open to change. They are incredibly strong, and they are willing to do the work. But they also want to know that someone is standing beside them through that process.

That is what I strive to give them: a place where they can be heard without judgment, where we can have the conversations that are often avoided, and where they know I am genuinely on their side as they rebuild their confidence and redefine what intimacy and quality of life look like for them.

Men Still Afraid to Talk About Sex? 

Men are often taught to stay quiet about sexual concerns. What are some of the fears, shame, or misconceptions you hear most often from patients, and how do you help create a space where they can finally talk honestly?

Erica:  “Not being enough” is probably one of the most common fears that comes through my practice, if not daily.

It can show up in so many different ways: not being enough emotionally, not being enough physically, concerns about size or sexual performance, or simply not feeling like enough as a man or as a partner. Men also carry experiences from previous relationships into new ones, and sometimes those experiences begin affecting a relationship that had nothing to do with the original hurt.

There is still such a strong stigma surrounding masculinity and sexual performance: “I’m a man. I should be able to do this. This shouldn’t happen to me.” And when something does happen, whether it is erectile dysfunction, a change in sexual function, an insecurity about their body, or something else, it can quickly become, “If I can’t do this, then I’m not enough.”

Comparison is another significant issue. I hear men compare themselves to a partner’s previous relationship or sexual experience and ask, “How do I become more like him?” My response is often very simple: if your partner wanted to be with that person, they would probably still be with them. They chose you.

When someone becomes hyper-focused on one insecurity size—performance, erections, or stamina—they can also miss all of the other signals their partner is giving them. Intimacy is so much bigger than one measurement or one physical act. Part of my job is helping patients recognise everything else they bring into a relationship and sometimes helping them see what their partner may actually be asking for.

There is also tremendous fear around being judged for what someone wants or enjoys sexually. People worry that what they are about to tell me is taboo, strange, or something I have never heard before. The reality is that we have created a society where we often avoid honest conversations about sex and intimacy, yet we expect people to somehow know what is normal, what options exist, and when they should ask for help. That silence has consequences. Sometimes patients have lived with a concern for years simply because they had no idea there was something that could be done about it. No one had ever talked about it.

So I try to create a space where nothing has to begin with shame. Sometimes that means asking a question a patient was not expecting because they thought the subject was off-limits. Sometimes, because of the experiences I have had with other patients, I can recognize where the conversation is going before they are comfortable enough to say it themselves. When they realize they are not going to shock me and they are not going to be judged, you can almost feel the conversation change.

Ultimately, so much of it comes back to two things: rejection and the fear of not being enough. I want men to understand that they are enough.

Yes, there may be things clinically that I can help improve, treatments I can offer, or changes we can make that help them feel more confident. But I am not the person who ultimately gives them their confidence back. They do that.

Sometimes they just need someone in their corner to help them realize that change is possible, give them the tools to get there, and remind them that asking for help was never something they needed to be ashamed of in the first place.

Love, Labels & Linguistics 

What’s one thing you would ban from the modern dating dictionary: “body count,” “situationship,” “ghosting,” or something else?

Erica: If I could ban one thing from the modern dating dictionary, it actually wouldn’t be a word like “body count,” “situationship,” or “ghosting.” It would be an action: not showing up to a new relationship as your full self because you are afraid of being judged for what you want, what you enjoy, or what you might want to explore intimately.

I would love to see people enter relationships being able to say, “I’ve never experienced this before, but I’d like to try it.” And maybe you try it and discover you don’t like it. Great—then you don’t have to do it again. But now you’ve created a relationship where intimacy can be discussed rather than assumed.

How do we compromise? How do we meet in the middle? How do we create an intimate relationship where both people feel safe enough to talk about what they want, try new things together, discuss what worked and what didn’t, and continue evolving?

Because relationships change. People change. Bodies change. Desire changes. What intimacy looks like at the beginning of a relationship may not be what it looks like five, ten, or twenty years later. We have to give ourselves and our partners permission to evolve with it.

Otherwise, you can find yourself ten years into a marriage thinking, “I am so sick of the same position for six minutes in the dark,” while your partner is lying next to you with absolutely no idea you ever wanted anything different—because you never told them.

We cannot expect our partners to know what we have never been willing to communicate.

I think there is something incredibly powerful about showing up from day one as who you truly are and creating a relationship where both people can talk openly about intimacy without shame. That does not mean your partner has to want everything you want or agree to everything you suggest. Consent, boundaries, and compromise still matter. But there should be enough safety in the relationship to have the conversation.

And if being honest about who you are and what you desire is immediately met with judgment or an unwillingness to even communicate, then maybe that person simply is not the right person for you.

I would rather see people discover that through an honest conversation early on than spend years becoming a version of themselves they thought they needed to be in order to be loved.

You Don’t Have to Live With It

For the man reading this who has quietly lost confidence in himself, his body, or his sex life, what would you want him to know before he decides that this is simply something he has to live with? 

Erica:  If you are the man sitting on the couch, looking around at your life and quietly wondering, “How did I get here?” I want you to know that you do not have to stay there.

And that does not mean you have to blow up your entire life and start over. For some people, maybe it does mean making a significant change. But for others, it may begin with one very simple decision: choosing yourself.

Maybe that means finding a practice like mine that can help you address your sexual health, body image, or confidence. Maybe it means walking into a gym, joining a recreational sports league, finding a sexologist, talking to a therapist, or working with a coach. Maybe it is as simple as hiring a babysitter once a week and taking your wife out to dinner because somewhere along the way you stopped making time to be a couple.

There is almost always something you can do. Sometimes it is a big action. Sometimes it is a small change. Sometimes it is simply changing the way you think about yourself and deciding that where you are today does not have to be where you remain.

But that first decision has to be yours.

I also want men to know that I never take that first step lightly. When someone walks through my door and asks for help with something as personal as his confidence, his body, his sexual health, or his relationship, I understand what it may have taken for him to get there. There may have been months or even years of insecurity, frustration, embarrassment, or conversations he was afraid to have before he finally decided to ask for help.

And if my practice is not the right place for you, find the place that is. Find the provider, therapist, coach, community, or person who hears you and is willing to help you move forward. Sometimes finding the right support takes work. Sometimes it is discouraging. Keep looking.

The phrase I use in my practice for men is “Dominate Your Life,” and to me, that has never meant being the biggest, strongest, loudest, or most dominant person in the room. It means taking ownership of your own life. It means showing up for yourself and saying, “What I am experiencing right now is not acceptable to me, and I am willing to find out what I can do.”about it.”

Maybe there is a treatment. Maybe there is a solution. Maybe there is an entirely different path you have not considered yet. You will never know if you decide from the beginning that this is simply something you have to live with.

Editor Note 

How quietly the idea of “enough” shapes so much of our intimate lives. We measure ourselves against expectations, past partners, bodies, performance, and versions of masculinity we were never asked whether we actually wanted. And somewhere in that measuring, we can lose sight of the person we are trying so hard to prove.

Erica’s perspective offers a gentler, but no less challenging, alternative: confidence is not something someone else can hand back to you. It begins with the willingness to question what no longer feels right, speak honestly about what you need, and accept that intimacy is allowed to evolve.

Because feeling enough begins when you stop asking whether you measure up.