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Sexual Performance Anxiety: Symptoms, Causes, and How to Deal With It

Sexual Performance Anxiety: Symptoms, Causes, and How to Deal With It

Sexual Performance Anxiety: Symptoms, Causes, and How to Deal With It

Sexual performance anxiety is categorized under performance anxiety. Although it is not yet officially recognized by the Diagnostic and Statistical Manual of Mental Disorders, (DSM-5), it is still a noteworthy concern. 

Sexual performance anxiety is a common psychological condition that affects both men and women. However, it is generally believed to be more prevalent among men. A review article revealed that 9% to 25% of men experience sexual performance anxiety, compared to 6% to 16% of women. This condition has far-reaching consequences, affecting overall well-being and casting a shadow on relationships. Read on to gain a deeper understanding of this complex issue.

Sexual Anxiety Symptoms

Recognizing the signs of performance anxiety is crucial for early intervention and support. Men experiencing this condition may display a variety of emotional, psychological, and physical symptoms, including the following: 

  • Diminished arousal.
  • Disruptive thoughts or the stress of meeting expectations.
  • Being nervous and expecting unfavorable results.
  • Lack of interest and avoidance of intimate situations.
  • Failing to reach the climax or climaxing too soon.
  • Erection difficulties.
  • Fear of sex or of being unable to perform.
  • Feelings of inferiority, uneasiness, and frustration. 
  • Physical symptoms such as increased heart rate, sweating, trembling, and muscle tension.

What are the Causes of Sexual Anxiety?

Either a singular reason or a complex interplay of various factors may lead to emergence of performance anxiety in men. These include the following:

  • Relationship challenges: Unresolved disputes, communication problems, or a lack of emotional bonds can increase anxiety in marriage or relationships. 
  • Previous negative experiences: Past experiences of sexual failure or trauma, including instances of rejection, criticism, or perceived inadequacy can have a lasting impact on self-esteem rendering them more susceptible to sexual performance anxiety. 
  • Unrealistic performance expectations: The weight of expectations can exert pressure to meet certain standards of manliness and endurance creating a sense of inadequacy and triggering anxiety. Especially in today’s age, where social media perpetuates unrealistic images of sexuality, exacerbating pressures and expectations.
  • Negative body image: Feelings of insecurity about one’s body can significantly lower self-esteem and lead to fear of judgment during intimate moments. Anxiety rooted in this negative self-perception can profoundly affect sexual performance.
  • Underlying sexual conditions: There are certain disorders that affect sexual function in men such as erectile dysfunction. These conditions can be both a source and consequence of sexual anxiety.
  • Pre-existing anxiety disorders: Social anxiety disorder and panic disorder rank among the most prevalent anxiety disorders that may contribute to anxiety in bed.

Identifying the root cause with the help of a healthcare professional can help choose the most effective solutions for male performance anxiety.

How to Overcome Sexual Anxiety Related to Performance?

A range of treatment options are available for sexual performance anxiety which can help regain confidence. Professional help for anxiety includes two elements:

  • Psychotherapy: Consulting a mental health professional regarding sexual performance anxiety can help you deal with it on a thinking level. Cognitive-behavioral therapy (CBT) and mindfulness-based interventions are common approaches that help in reducing sexual anxiety:
    • CBT begins by helping you identify negative thought patterns underlying sexual performance anxiety. The next step is to challenge these thoughts and replace them with more realistic and positive perspectives. In the long run, CBT assists in recognizing your potential triggers and developing tailored strategies to prevent the recurrence of sexual anxiety. 
    • Mindfulness-based interventions help in focusing on the present moment during times of intimacy, preventing distraction and overpowering thoughts. By developing a calm awareness, you learn to observe your thoughts without judgment. Regular practice of mindfulness-based interventions can empower you to navigate sexual performance anxiety with greater resilience and a more open, accepting mindset.
  • Medications: In cases where the severity warrants it, anti-anxiety medications may be prescribed to alleviate symptoms. Some medicines that can be helpful include buspirone, trazodone, and bupropion.

A healthcare professional can determine the most suitable course of action based on a detailed assessment. Then, to improve the effectiveness of professional help, it’s important to consider self-help approaches too:

  • Use relaxation techniques: Incorporating relaxation techniques, such as deep breathing, meditation, or mindfulness, can promote a sense of calm and help manage anxiety symptoms.
  • Sensate focus exercises: Gradually increase comfort with touch through sensate focus exercises, enhancing intimacy without performance pressure.
  • Limit explicit content consumption: It may contribute to anxiety so one should consider reducing or eliminating its consumption to create a healthier mental space.
  • Adapt healthy lifestyle choices: Adopt a healthy lifestyle that incorporates regular exercise, balanced nutrition, and sufficient sleep, as research indicates their positive impact on enhancing sexual function, reducing anxiety, and promoting overall well-being.
  • Cut down on detrimental practices: Smoking, alcohol consumption, and substance abuse have a profound impact on both physical and mental well being, exacerbating sexual performance anxiety.
  • Educate yourself: Learn more about sexuality, anatomy, and the varied aspects of sexual experiences through healthy and positive ways to empower yourself and alleviate anxiety. 
  • Communicate with your partner: Talk openly and honestly with your partner about any fears and expectations to create a supportive and understanding environment between you two.


Sexual performance anxiety is a common occurrence; there is no need to feel shy or let it diminish your self-worth. Also, remember that it is a manageable concern. If you notice any disturbing symptoms, consider taking proactive steps and consult a healthcare professional right away. They will help you identify the causes of the condition and identify what treatment options can be effective based on a thorough assessment.

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