Performance anxiety during sex can be a dreadful experience. But there are ways to manage it.
by Stephanie A. Wright, RN, BSN and Sandra Silva Casabianca
Sex can be more than just the physical aspect. Emotions, hopes, and fears may also be involved.
Sometimes, personal challenges and insecurities can make you apprehensive about your sexual performance.
Though sexual performance anxiety isn’t a formal diagnosis, it can still be a valid reality for you. But there are a few ways you can learn to manage sexual performance anxiety.
What is performance anxiety?
Performance anxiety refers to significant worry and fear about your ability to execute a specific task. It may also involve concern about how others perceive you.
Performance anxiety is what some people call “stage fright.”
Performance anxiety isn’t a formal mental health diagnosis, but it’s part of social anxiety disorder. This disorder is characterized by fear of social situations in which an individual feels they’ll be exposed to possible scrutiny from others.
You can experience social anxiety:
- being around strangers
- having conversations
- during public speaking
Performance anxiety can manifest in many ways. Not everyone will feel and behave the same when having anxiety about performance situations, so you may not relate to every symptom listed here.
Some common symptoms may include:
- negative thoughts about oneself
- blushing and rapid heart rate
- nausea and vomiting
- excessive sweating
- difficulty speaking
- dizziness
- intense worry
- situation avoidance
Feeling anxiety from time to time is expected. But if you live with any anxiety disorder, you might have persistent symptoms that occur during different situations.
If you live with social anxiety, you might constantly worry about how others perceive you and how you navigate social situations.
Sexual performance and anxiety
Sexual performance anxiety refers to the fear of not being able to perform adequately during a sexual encounter. “Adequately” can mean different things to different people. What matters, though, is what you think that involves.
You may feel you won’t be able to meet your partner’s sexual preferences or experiences, which may cause you to have anxiety, for example.
On many occasions, particularly for men, sexual performance anxiety could impact becoming aroused and physically responding to sexual stimulation. This could confirm in your mind that you might not be able to perform well.
Sexual performance anxiety could manifest in many ways, including:
- difficulty getting or maintaining an erection
- premature ejaculation
- poor vaginal lubrication
- inability to achieve an orgasm
- disinterest in sexual activity
- low self-confidence
- low self-esteem
- depression
- panic attacks
Men and women can experience sexual performance anxiety, and some may experience orgasm anxiety as well.
Literature reviews from 2000 to 2018 found that 9% to 25% of men experience anxiety associated with their sexual performance. In many cases, this anxiety was linked to symptoms of erectile dysfunction and premature ejaculation.
The same reviews found that women with sexual performance anxiety account for an estimated 6% to 16% of the female population, and anxiety often manifests as a low sex drive. Anxiety can also prevent females from experiencing orgasm.
Causes of sexual performance anxiety
You may experience sexual performance anxiety for many reasons, including:
- past experiences
- biology
- your upbringing
- traumatic events
Living with anxiety disorders may also make it more likely that you experience symptoms related to performance.
Personal concerns and expectations may also cause you to have anxiety. But what causes you to experience anxiety may not cause others to have anxiety.
You may feel anxiety about your sexual performance during the first few times you have sex or when you’re just beginning a new partnership.
You could have questions like:
- Can I trust my partner?
- Will we become pregnant?
- Should we wear protection?
- What will my partner think if I cannot perform?
- Will they like my body?
- Do they love me?
Other contributing factors to sexual performance anxiety may include:
- low self-esteem
- orgasm anxiety or difficulty in achieving orgasm
- pain with intercourse
- decreased sexual drive
- depression
- pain chronic conditions
- changes in physical appearance
- anxiety disorders
- trauma
PSYCH CENTRAL RESOURCES
Setting better boundaries starts here
Learn more about defining boundaries in your relationships, practicing consistency, and living with intention with our limited series.
How to manage sexual performance anxiety
A mental health professional can help you explore the whys behind your symptoms of sexual performance anxiety and structure a treatment plan that works for you.
If your symptoms are linked to a specific situation, such as a new partnership, you may find that performance anxiety subsides as you become more comfortable with them.
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