Sexual Performance Anxiety

Sex is supposed to be enjoyable, but it's tough to have fun if you're constantly worrying about how well you're doing. If you want to put the sparkle back in your love life, learn why sexual performance anxiety might be happening to you and get some tips to put yourself at ease.

Causes of Sexual Performance Anxiety

Sex is more than just a physical response. Your emotions have something to do with it, too. When your mind is too stressed out to focus on sex, your body can't get excited either.

Lots of different worries can lead to the problem:

  • Fear that you won't perform well in bed and satisfy your partner sexually
  • Poor body image, including concern over your weight
  • Problems in your relationship
  • Worry that your penis won't "measure up"
  • Concern about ejaculating too early or taking too long to reach orgasm
  • Anxiety about not being able to have an orgasm or enjoy the sexual experience

These things may lead your body to release stress hormones like epinephrine and norepinephrine.

Symptoms

Your state of mind can have a big impact on your ability to get aroused. Even if you're with someone who you find sexually appealing, worrying about whether you'll be able to please your partner can make it impossible for you to do just that.

One of the effects of the stress hormones is to narrow blood vessels. When less blood flows into your penis, it's more difficult to have an erection. Even guys who normally don't have any trouble getting excited might not be able to get an erection when they're overcome by sexual performance anxiety.

Sexual performance anxiety isn't diagnosed as often in women as it is in men, but it can affect arousal in women, too. Anxiety can prevent women from getting lubricated enough to have sex, and it can take away the physical desire to make love.

Anxiety can take you out of the right mind-set for sex. When you're focused on whether you'll perform well, you can't concentrate on what you're doing in bed. Even if you are able to get aroused, you may be too distracted to reach orgasm.

Sexual performance anxiety leads to a cycle of troubles. You might become so anxious about sex that you can't perform, which leads to even more sexual performance anxiety.

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Overcoming Sexual Performance Anxiety

If you've got sexual performance anxiety, see a doctor -- someone you're comfortable enough with to discuss your sex life. The doctor will examine you and do some tests to make sure a health condition or medication isn't the cause of your problems.

During the exam your doctor will ask about your sexual history to find out how long you've had sexual performance anxiety and what kinds of thoughts are interfering with your sex life.

Medications and other therapies can help treat erectile dysfunction and other sexual problems that have physical causes. If a medical issue isn't to blame, your doctor might suggest you try one of these approaches:

Talk to a therapist. Make an appointment with a counselor or therapist who has experience in treating sexual problems. Therapy can help you understand and then reduce or get rid of the issues that are causing your sexual performance anxiety. If you worry about premature ejaculation, for example, you can try some techniques that help you gain more control. 

Be open with your partner. Talking with your partner about your anxiety can help ease some of your worries. When you try to reach a solution together, you may draw closer as a couple and improve your sexual relationship. 

Get intimate in other ways. Learn how to be intimate without sexual intercourse. Give your partner a sensual massage or take a warm bath together. Take turns pleasing each other with masturbation so you don't always have to feel pressured to perform sexually.

Exercise . Not only does working out make you feel better about your body, it also improves your stamina in bed. 

Distract yourself. Put on some romantic music or a sexy movie while you make love. Think about something that turns you on. Taking your mind off your sexual performance can remove the worries that stop you from getting excited.

Finally, take it easy on yourself. Don't beat yourself up about your appearance or ability in bed. Get help for sexual performance anxiety so you can get back to having a healthy and enjoyable sex life.

WebMD Medical Reference Reviewed by Neha Pathak, MD on November 25, 2017

Sources

SOURCES:

McCabe, M.P. International Journal of Stress Management, November 2005.

Hale, V.E. Archives of Sexual Behavior, 1990.

Kandeel, F.R. Male Sexual Dysfunction: Pathophysiology and Treatment, CRC Press, 2007.

Porst, H. Standard Practice in Sexual Medicine, Wiley-Blackwell, 2006.

Corretti, G. Psychiatric Times, August 2007.

Phillips, N.A. American Family Physician, July 2010.

Jacobsen, J.L. Psychiatric Secrets, 2nd ed., Hanley & Belfus, 2001.

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