How to Overcome Sexual Anxiety

How to deal with sexual anxiety in a relationship?
on October 20, 2023
Read time: 10 mins
by Moraya Seeger DeGeare

Having a healthy, fulfilling sexual relationship with your loved one is an important aspect of romantic relationships

Even though we’d like to think that love can conquer all, sexual anxiety can make physical intimacy feel impossible — no matter how much you wish it didn’t! 

Sexual anxiety can manifest in many different ways, with worries about performance, self-esteem issues, or negative past experiences haunting all of your sexual encounters. If you’re dealing with sexual performance anxiety, it can be difficult to overcome your fears in order to tackle the issue in a productive way. 

Take a deep breath — we’re here to help. 

What is sexual anxiety? 

Sexual anxiety, also known as sexual performance anxiety, is defined as the fear, or worry related to sexual activity. 

Feeling anxiety around sex can stem from a variety of factors such as previous trauma,  self-consciousness around body image or genitalia, or an existing anxiety disorder. These inhibitors can make it difficult to have a healthy sex life, as these issues trigger stress hormones that limit your performance potential. 

While sex anxiety is its own issue, it’s often seen as a side effect of other existing sexual problems, such as erectile dysfunction, or sexual pain. 

This kind of anxiety can exacerbate existing sexual dysfunction issues, with this dread surrounding the idea of intimacy only escalating with each failed sexual experience. These negative thoughts create a vicious cycle around all sexual encounters, with anxiety symptoms inhibiting sexual intercourse and making it difficult to maintain healthy and successful relationships. 

Sexual performance anxiety is very common amongst any gender, with 9% to 25% of cisgender males experiencing these issues — contributing to both premature ejaculation and erectile dysfunction (ED). 

SPA also affects women, with 6% to 16% of cisgender females experiencing sexual anxiety, which can inhibit sexual desire and cause low libido or sex drive. According to research, women affected by sexual anxiety can experience impairment to their mental health, as sexual function is considered to be an important aspect of life. 

Symptoms of sexual performance anxiety

Erectile dysfunction
Premature ejaculation
Loss of desire, sex drive, or lowered libido
Negative thoughts during sex that distract you from the experience
Other physical symptoms such as increased heart rate, sweating, or loss of natural lubrication

What causes sexual performance anxiety? 

While sex is a physical act, it’s also a highly emotional experience that is naturally affected by your mental state. If you’re anxious or stressed, your body naturally produces a response to these emotions — making it difficult to get sexually aroused, or to find pleasure in sexual experiences. 

There are numerous causes of sexual anxiety, with many existing physical conditions worsened by these fears or worries —- with research emphasizing this link in recent studies.

All of these worries trigger the release of stress hormones such as epinephrine and norepinephrine, which trigger the physical inhibitors to sex such as ED, or loss of natural lubrication. 

1. Feelings of inadequacy

Many people experience fears that they won’t be able to satisfy their partner sexually or live up to their previous sexual experiences. These worries only serve to limit your sexual pleasure and performance, as these negative thoughts cloud your ability to fully enjoy sex — often triggering physical side effects. 

“Porn in particular can trigger feelings of inadequacy, as some pornography can introduce unrealistic expectations into the bedroom,” says Moraya Seeger DeGeare, a licensed marriage and family therapist and In-House Expert at Paired. 

“Along with porn being performance-driven and not focused on emotional connection. If your introduction to sex and intimacy is via porn, it can take years of unlearning to find a genuine connection with yourself sexually.”

2. Self-esteem issues

If someone is self-conscious about their body, or fixated on certain aspects of their body image, it can be difficult to feel fully confident around sexual partners — especially newer sexual partners. 

For men, this usually fixates around their penis size, or their overall physical condition, with fears of being judged by their sexual partner. 

"Feeling like you are enough for your partner or worthy of love can easily manifest as anxiety and shame in your sex and intimacy life,” says Seeger DeGeare. 

“This anxiety can cause you to focus on your partner's pleasure at the detriment of your own.”

3. Relationship issues

If you’re going through a rough patch in your relationship, it’s hard to put all of those emotions on pause when you’re being sexually intimate. 

While some couples take out their frustrations during sex, this isn’t a healthy way forward! In order to unlock an equally fulfilling sex life, it’s essential to tackle your problems outside the bedroom so they don’t make any unwelcome appearances during that time. 

“It is common to have different levels of sexual desire in a relationship. When experiencing relationship disconnection, the partner who seeks sex to feel connected may struggle deeply in trying to emotionally reconnect when it is not intuitive for them to do it first,” says Seeger DeGeare. 

“This cycle is often present for cisgender men who are socialized to not require an emotional connection before sex. Once they feel reconnected, they often become more emotionally open. However, this clash can create tension for the couple, as the other partner may crave emotional connection to alleviate anxiety while their partner is not fully present due to the disagreement. As a result, the couple may feel misunderstood and experience anxiety in their sex life.”

4. Orgasm fears

While some people worry about orgasming too quickly, others worry that it will take them too long to climax. This kind of worry can detract from your sexual experiences, as you’re focused on the endpoint rather than enjoying this time with your partner. 

5. Health conditions

While sexual performance anxiety is viewed as a mental health condition, there could be other medical issues that reinforce each other — making the situation worse. 

For example, physical health conditions such as diabetes or heart disease can limit your sexual functioning, with certain medications also impacting your sexual function. If you’re worried about the side effects of medications, it’s important to speak to a medical health professional before coming off or changing any existing treatment plans. 

How to overcome sexual performance anxiety 

If you’re experiencing sexual performance anxiety, it can be difficult to break this recurring cycle, with your fears only serving to magnify your sexual problems. 

However, there are different treatment options and therapy solutions to explore in order to obtain a healthier, more fulfilling sex life. 

"Approaching anxiety with curiosity and self-compassion involves acknowledging the underlying emotions that contribute to your anxiety. It also entails creating a sense of safety within your relationship, especially if you are in a partnership,” says Seeger DeGeare. 

“To build safety within yourself, you can practice deep breathing or breath work, use affirmations, reduce overall stress, open up to a friend, or seek the help of a sex therapist. It is important to address any trauma, particularly if it is related to sexual trauma.”

To build safety in the relationship, try reducing pressure by engaging in physical intimacy without the expectation of performance or orgasm. This could include giving each other massages, spending time cuddling in bed, or simply holding hands more often throughout the day. Take it at your own pace. Talk to your partner about what you need to feel safe exploring each other’s bodies.

Lastly, create a safe environment by changing the location of your sexual encounters, considering the music you play, and paying attention to the smells. Remember to focus on romancing yourself, not just your partner.

1. Communication

It’s completely normal to feel a little nervous before having sex with a new partner for the first time, as you want it to be the best experience possible for you both! However, if these worries continuously affect your sex life, it’s important to verbalize your fears to your partner. 

Even though this can be a daunting task, a problem shared is truly a problem halved. Be honest about what is causing your anxiety, and with your partner’s understanding, things can instantly improve — as you’re both on the same page. 

Instead of bottling everything up, with things out in the open, it can be easier to tackle the issues as a team. 

2. Explore different intimacy options 

If you’re struggling with sexual intercourse, it might be time to switch things up. 

Explore different avenues of intimacy to alleviate some of the pressures around sex. For example, engage in mutual masturbation, include new sex toys, or explore different avenues of foreplay. 

Since studies show that sexual anxiety naturally impacts sexual arousal, particularly in women, these alternative modes of pleasure can help overcome these hurdles. These options can bring something new to your sexual experiences, and take off some of the pressures associated with your sexual encounters. 

3. Sex therapy 

Sexual anxiety doesn’t have to be dealt with alone, with an array of therapy options available to help you overcome these issues in a safe, professional environment. 

Speaking to a sex therapist can help couples get to the root of the problem, dealing with the causes of sexual anxiety at their core — highlighting issues that they may not have even realized were affecting their well-being. 

Depending on the issues you’re facing, Cognitive Behavioral Therapy (CBT), Sex Therapy, Brainspotting, EMDR, and Psychodynamic Therapy, can be very helpful for couples to tackle their problems in a productive and effective way. 

If you’re struggling with ED or PE, there are medicative options available such as Viagra or other natural stimulants. However, it’s important to discuss these options with your doctor or a medical health professional before considering these medications. 

4. Take the pressure off

If you’re dealing with sexual issues, it can feel all-consuming and can put a severe strain on romantic or sexual relationships. 

As things escalate and pressures mount, focusing on resolving the issue can only serve to make the situation worse — with extensive fixation only making anxiety levels rise. Take a step back from the sexual aspects of your relationship, taking the pressure off both partners. 

Focus on other aspects of your relationship, and bring back date nights, and long conversations. Taking sex out of the equation can help to relieve the anxieties and pressures associated with it — naturally reigniting this aspect of your relationship when you least expect it. 

5. Be supportive

If your partner is struggling with sexual anxiety, it can put a natural strain on the relationship. 

However, it’s important to clearly communicate your support for your partner, and advocate for open and honest communication. Creating this safe space makes it easier for your partner to feel comfortable — naturally relieving some of the anxiety and pressure around sexual performance. 

If your partner is struggling with ED or PE, or if they’re struggling with a low sex drive, it can be difficult to not take it personally — with your own self-esteem taking a hit. However, remember that these issues are not a reflection of you or your relationship, and they can be effectively handled with patience, understanding, and professional support. 

Frequently Asked Questions

  • How does sexual anxiety differ from sexual arousal?

    Sexual anxiety and sexual arousal refer to two different sexual experiences but are related under certain circumstances. Sexual arousal refers to the physiological and psychological excitement and readiness for sexual activity, but these responses can be affected by sexual anxiety. For example, if you’re struggling with sexual performance anxiety, it can limit your ability to get sexually aroused — making sexual experiences limited and difficult.
  • Is sexual anxiety ED?

    While erectile dysfunction (ED) can be a symptom of sexual anxiety, there are many other symptoms and issues under the umbrella of sexual performance anxiety. Some sufferers of sexual anxiety may experience ED, while others may have difficulty with orgasms, or experience a lower libido due to fears about sexual pain or underperformance. Overall, sexual anxiety manifests in many different ways, which is why symptoms and treatment options can vary greatly.
  • How serious is sexual performance anxiety?

    Sexual anxiety can affect people in many different ways, and in some serious cases can prevent any positive sexual experiences. If you’re suffering from sexual performance anxiety, no matter the severity, it’s important to seek help so you can work towards a positive and fulfilling sex life.
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