Sexual Performance Anxiety: What It Is And How It’s Ruining Your Intimate Life

Sexual performance anxiety has nothing to do with compatibility, but it can ruin your relationships. It’s also a complex problem that deserves consideration and understanding even though it’s difficult to talk about and shrouded in stigma. Here’s what you need to know about sexual performance anxiety and how it’s harming your intimate life.

1. It can affect men and women. Sexual performance anxiety is a condition that causes people to be so nervous about sex that they either cannot engage in it at all or cannot enjoy it when they do. A lot of people think of erectile dysfunction when they think of sexual anxiety, but while this is one way that the problem can manifest, sexual performance anxiety can affect women as well as men, and present itself in more than just physical ways.
2. It’s more prevalent in men. Research suggests that sexual performance anxiety affects 9-25% of men and 6-16% of women. While this shows that men are the most impacted, it also demonstrates how common the issue is for both genders. In men, it most commonly causes psychogenic erectile dysfunction (meaning that it has a mental rather than a physical cause) and premature ejaculation, while in women it most commonly causes severely decreased sexual desire.
3. There are physical symptoms. The most obvious physical manifestation is erectile dysfunction and premature ejaculation in men, but it can also affect women physically. Severe anxiety surrounding sex can kick off a fight or flight response in the brain. This causes the release of stress hormones which in turn can make your vaginal muscles tense and prevent the production of the necessary lubrication to make sex pleasurable. The result is painful sex.
4. Some of the symptoms are mental and emotional. Along with the physical symptoms, the mental and emotional fallout from sexual performance anxiety can be crippling. Being unable to comfortably and enjoyably have sex can cause low self-esteem, anxiety about dating in general (not just the sexual aspect of it), and little to no sex drive.
5. It has a number of causes. Given that up to a quarter of men and 16% of women experience sexual performance anxiety, it’s no surprise that it has a wide range of causes. These include past trauma and bad sexual experiences, body image and self-esteem issues, lack of sexual experience, stress within the relationship, mental health conditions such as general anxiety and depression, and even excessive exposure to pornography.
6. It can be a vicious cycle. Unfortunately, sexual performance anxiety can increase over time. Your anxiety about sex causes a physical and emotional response that only reinforces your fears. If you’re a man and your anxiety causes erectile dysfunction or premature ejaculation, you will probably grow even more anxious the next time you try to have sex. For women, lack of arousal can make sex painful. Once you start associating intercourse with pain, arousal (the only thing which can make sex pleasurable) is impossible.

How it affects your intimate life

The effects of sexual performance anxiety can be difficult to distinguish from the causes, but here are a few ways that the condition strains your relationships if it goes untreated.

1. Feeling disconnected from your partner. If you can’t comfortably have sex, you will likely feel distant from your partner. This is especially true if you are embarrassed about it or avoid discussing it. Your partner may perceive that something is wrong, especially if you start avoiding sex. This may give them insecurities of their own, and push you further apart.
2. Painful sex. On an obvious level, sexual performance anxiety can make sex painful for women. Painful sex is bad for a relationship. You will likely both feel guilty and frustrated, and your overall intimacy will suffer. If you are too embarrassed or ashamed to tell your partner that you’re anxious and not aroused, sex will start to feel like an exercise in endurance, a repeated trauma that can harm your relationship with intimacy for the long term.
3. Erectile dysfunction. Erectile dysfunction is embarrassing and frustrating. While it is a common problem, it can still put stress on your relationship and exacerbate your anxieties surrounding sex. You will struggle to be intimate with your partner and may experience feelings of guilt and a sense that something is “wrong” with you. It can also cause low self-esteem in your partner. They might wonder if you’re attracted to them or if it’s their fault.
4. Fearing intimacy. Sexual performance anxiety, by definition, makes people anxious about having sex. Unless you’re in a non-sexual romantic relationship or not sexually active, this can make dating extremely difficult. You will feel cut off from your partner(s) and avoid getting close to them in the fear that it might lead to sex. This can easily be misinterpreted. If the person you’re with doesn’t know where your distance is coming from, they may assume that you aren’t interested in them.
5. Low self-esteem. Fear of engaging in intimacy can make you doubt your worth. You’ll wonder why you can’t love sex when everyone in the entire world seems to think it’s the greatest gift known to humankind. You may feel that there is something fundamentally wrong with you and that no one will ever want to be with you.
6. Difficulty forming relationships. If you can’t comfortably have sex, you may feel that you could never satisfy anyone. You’ll retreat into yourself and stop looking for relationships. If anyone tries to get to know you, you’ll cut them off or push them away. You feel like you’re hiding a dirty secret that defines you but that you can never divulge. This is a painful, lonely, and unhealthy place to be. Luckily, there are ways to address your sexual anxiety before it destroys your personal life.

Treatment options for sexual performance anxiety

Even though sexual performance anxiety affects a large portion of the population, there is still no accepted diagnosis for either gender. However, studies show there are ways of solving it. Here are the most successful methods:

1. Medication. While sexual performance anxiety is a mental condition that results in physical symptoms rather than a physical condition to begin with, men who experience it can be treated with medication if a doctor deems it necessary. Viagra and Cialis are the most common drugs used for erectile dysfunction, but it’s likely that your medical professional will suggest treating the underlying cause rather than just the symptom.
2. Therapy. Because sexual performance anxiety is a mental health condition, studies have concluded that psychotherapy can work wonders. A therapist who specializes in treating sexual issues will be able to offer insight into why the anxiety exists in the first place and provide techniques to overcome it.
3. Meditation. This may sound far-fetched if you’re skeptical of “new-agey” approaches to mental health, but a systematic review of mindfulness meditation as an intervention for sexual performance anxiety concluded that meditation is an effective method for overcoming the issue, especially for women. There are fewer studies of its effect on men, but at least one found that mindful meditation did have a positive impact on erectile dysfunction.
4. Taking things slowly. One of the main things that makes people anxious about sex is fixating on having an orgasm. This results-oriented approach puts pressure on you and your partner to get to that outcome as quickly as possible, which usually has the opposite effect. Slowing things down and enjoying foreplay will get you out of your head and remove the misconception that an orgasm is the goal. Certified clinical sexologist Megwyn White explains the benefits of shifting your focus: “Orgasm is like the cherry on top of an ice-cream sundae. It doesn’t encompass the sweetness and the delicious feelings throughout a sensual exchange. So if an orgasm doesn’t occur, it’s OK and may be more primed to happen the next time, especially as you learn to take off the pressure to top your sundae with the perfect cherry.”
5. Non-penetrative intimacy. If you want to take White’s advice a step further, forget about orgasms altogether. For men who struggle with premature ejaculation or erectile dysfunction, taking their penis out of the equation entirely can help realign their fears. Focus instead on touching, kissing, and pleasuring your partner. This will have the added benefit of spicing up your routine and giving you more ideas when you are ready to try penetrative sex again.
6. Cultivating a safe space with your partner. Sexual performance anxiety can skyrocket if you don’t feel comfortable talking about it with your partner. Trying to hide your fear of one of the most intimate things you can do with the person you’re doing it with is an incredibly vulnerable and painful place to be. Making sure that you’re with someone who you feel comfortable with and capable of talking to about this difficult issue is an essential part of overcoming it.