How To Overcome Sexual Performance Anxiety

The lights are low. The music is soft. The mood is (seemingly) right for the fireworks to fly.

Except it’s all wrong.

You worry. Your mind races. You just can’t get into it.

What’s happening?

It could be sexual performance anxiety. And it can take a toll on your interest in having sex. On your sexual pleasure. And on your relationship(s).

Studies show that sexual performance anxiety is more common than you might expect. It’s estimated that up to 25% of men and 16% of women are affected.

What causes it? And what can you do about it? Certified sex therapist Theresa Callard-Moore, PhD, shares advice.

What is sexual performance anxiety?

Sexual performance anxiety happens when feelings of anxiety — like fear, embarrassment and worry — affect your sexual interest, performance or pleasure. It can happen to anyone, regardless of your sex assigned at birth, gender identity or sexual orientation.

Like other kinds of performance anxiety — say, anxiety that creeps up when you’re talking in front of a crowd or parallel parking — sexual performance anxiety isn’t a diagnosis itself. But it can be related to other anxiety disorders, like social anxiety or generalized anxiety disorder.

The trouble with sexual performance anxiety is that sexual satisfaction is both an emotional and physical response. So, when you’re feeling anxious, chances are, the sparks aren’t going to happen.

“We all want connection and attachment. And sexual connection is one way to feel that,” Dr. Callard-Moore points out. “So, we can put a lot of pressure on ourselves in those moments. And with pressure can come disappointment.”

That can mean issues like: 

• Erectile dysfunction.
• Premature ejaculation. 
• Anorgasmia (not having an orgasm).
• Low libido.

“If, instead of being in the moment, we’re in our heads thinking about whether we’re going to please our partner or if we’re going to be able to sustain an erection or whether that person finds our bodies attractive, it’s going to be harder to enjoy sex. And that leads to a less-than-fulfilling encounter,” she illustrates.

And it’s a vicious cycle: The next go, you’re now thinking about that last time. So, again, you’re not relaxed and you’re not in the moment. And on and on.

Eventually, you can lose interest in having sex. Because it’s just not worth the emotional toll.

It’s a domino effect that extends far beyond the bedroom. Your partner or partners blame themselves. Or they become resentful. Or they may think you must not want them anymore. Your connection begins to erode.

What causes sexual performance anxiety?

Sexual performance anxiety can happen for all kinds of reasons, like:

• New encounters. While some people may enjoy that butterflies-in-the-stomach effect of getting to know a new partner, others may find themselves riddled with anxiety as they navigate new territory.
• Past sexual disappointments. If you have a history of sexual performance issues or lingering memories of a lackluster performance in your sexual past, it can be tough to put your sexiest self out there. Worrying about the past and fearing a similarly anticlimactic performance can cause anxiety.
• Concerns about your body image. Sex can make you feel vulnerable. And if you’re concerned about your body’s size, shape, wrinkles or sags, anxiety can take over. 
• Worries about your relationship. Concern about the health of your relationship can take a toll on your sex life. If you’re concerned about whether your partner is hiding something from you or you’re resentful that they aren’t pulling their weight on the household chores, those concerns can affect your sexual interest and performance.
• Past trauma. A history of trauma or abuse can significantly affect your sexual interest and pleasure.
• Other stresses and anxieties. When you have countless thoughts and a long to-do list racing through your mind, it can be tough to let loose and get in the mood. Knocking boots can feel like just one more thing to do that day.

How to overcome sexual performance anxiety

Sexual performance anxiety can put a real kink in your sex life (and not in the fun way).

The good news? You don’t have to resign yourself to a sexless existence if that’s not what you want.

Dr. Callard-Moore offers this advice to help get your groove back.

Communicate with your partner(s)

It may seem obvious, but your partner can’t read your mind. (Really, they can’t.)

So, if you have needs that are unfulfilled or worries that are keeping you from enjoying a roll in the hay, speaking up can be the first step on the road to satisfaction. And it can keep your partner from assuming that your sexual performance anxiety is somehow their fault.

“If we’re feeling connected, and we know our partner has good intentions — that they also want pleasure and connection — it becomes easier to find your way together,” Dr. Callard-Moore reassures.

Understand both of your needs

If you think back to your sex education, whether in school or through media, like movies and magazines, what did you really learn?

You probably learned about pregnancy, sexually transmitted disease and a couple dozen euphemisms for genitalia.

But did anyone explain the biological reactions that are needed to sustain an erection? Or tell you how clitoral stimulation can be more pleasurable than penetration? Probably not.

“For most people, the sexual education we receive is dismal,” Dr. Callard-Moore reflects. “We fill in the gaps with music, movies, magazines, porn and our own sexual experiences. But we often don’t truly understand our bodies and our needs, let alone our partner’s.”

Take, for example, a person whose sexual performance anxiety hinges on concerns about premature ejaculation. Trying out ways to please your partner with other means (say, fingers, toys or your mouth) can lessen your anxiety. (And it may be even more pleasurable for them.)

“There are a lot of ways to find sexual pleasure without even taking off your pants,” she says.

Or if you’re concerned that you’re not as well-endowed as porn has led you to believe you should be, consider this fact: The average penis size is five inches.

If you’re concerned that your partner will be turned off by your cellulite or your less-than-perky breasts?

Dr. Callard-Moore shares this report, “What we see in the media are all these ‘perfect bodies.’ It’s a cultural problem. But in interviews with real people, when they’re asked about things like, Do you notice your partner’s belly pooch? Or Do you care if they have freshly shaven legs? The answer is, almost unanimously, Nope. They don’t see it. They don’t care.”

In short, knowledge is power. And the more you can learn about how sexual pleasure and arousal work, the less mysterious it all becomes. And the less anxiety-provoking it can be.

Seek professional advice

You deserve as robust and active a sex life as you want. And if sexual performance anxiety is getting in the way, help is available.

For example, medication and medical devices can help with issues related to erectile dysfunction. That can be especially useful for people who have health concerns, like low T or diabetes that can affect your ability to sustain an erection.

For other people, just knowing those options are available can be the confidence boost you need to overcome anxiety.

“Having a bottle of Viagra® or a penile pump in the drawer could give you some peace of mind,” Dr. Callard-Moore notes. “And sometimes, that’s all you need.” 

If your anxieties stem more from concerns within your relationship or trauma in your past, talk therapy can help explore those concerns and determine a path forward. Resources like Psychology Today’s Find a Therapist tool can be a good place to start. Or ask a healthcare provider for a referral.

Dr. Callard-Moore also suggests working with a trustworthy sex therapist to help overcome sexual performance anxiety. Find a directory of certified sex therapists and counselors on the American Association of Sexuality Educators, Counselors and Therapists website.

Your sexual health is part of your overall well-being. And if sexual performance anxiety is getting in the way, know that you can overcome it. And you deserve to.