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Sexual performance anxiety is when folks experience an overwhelming fear that they will be unable to facilitate a positive sexual encounter for a partner. Performance anxiety can occur before or during a sexual encounter, and it can develop from several psychological, physical, and emotional phenomena.

Performance anxiety can affect men of all ages, cultures, backgrounds, and experiences. For men, the stress is often related to their inability to maintain an erection, and therefore erectile dysfunction and performance anxiety often go hand in hand. 

Performance anxiety is hugely prevalent. Indeed, it has been found that 9-25% of men have experienced sexual performance anxiety. However, the actual numbers are likely higher

Performance anxiety is hugely prevalent. Indeed, it has been found that 9-25% of men have experienced sexual performance anxiety. However, the actual numbers are likely higher because the only way to diagnose performance anxiety is through self-reporting, and it’s challenging to get a man to admit they are anxious about anything, let alone sex! In reality, most men likely have experienced anxiety about sex before. However, it only becomes concerning if they experience unwanted and repetitive thoughts that regularly interfere with their desire or ability to sexually perform.

Symptoms of sexual performance anxiety

Although performance anxiety may involve different symptoms depending on the person, common indicators of sexual performance anxiety include: 

  • You experience racing thoughts when entering a sexual scenario that are related to your perceived inability to perform. For example, you may experience negative thoughts about your body, your erection, or your ability to successfully pleasure your partner.
  • You experience sexual dysfunction, including an inability to achieve an erection, premature ejaculation, or an inability to orgasm. As a result, you may no longer experience joy or excitement around sex and instead feel discomfort talking or thinking about it.
  • You experience the physical consequences of a fight or flight response in the body. This often includes an increased heart rate, rapid breathing, sweating, unsettled stomach, shaking, or feeling like you might faint.

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How performance anxiety happens

When folks who have anxiety around sex enter a sexual scenario, their body goes into a fight or flight response. This often becomes a self-fulling prophecy where it is their anxiety about sexually performing, which actually causes the problem. Imagine trying to get hard while dealing with the pressure of giving a presentation in public or while you’re pretty sure a lion is about to attack you - stress alone can make achieving an erection so much more difficult!

When folks who have anxiety around sex enter a sexual scenario, their body goes into a fight or flight response. This often becomes a self-fulling prophecy where it is their anxiety about sexually performing

There is a physiological reason for the association between anxiety and arousal. When you experience a stress response, hormones such as adrenaline and norepinephrine are released in the body, leading your blood vessels to constrict. When blood vessels are constricted, it is harder for blood to get anywhere, especially certain critical appendages.

The psychological impact of performance anxiety (feeling stressed out) often leads to the physical response (inability to get hard). This leads men who are physically capable, to be unable to achieve an erection or enjoy sex. Once the pairing of anxiety and perceived sexual failure happens a few times, they become connected in the mind, making the association stronger and more likely to endure. As a result of the relationship between anxiety and arousal, performance anxiety is one of the leading causes of erectile dysfunction.

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            Causes of Sexual Performance Anxiety

            Sexual performance anxiety can have several root causes. Therefore, figuring out its cause is essential to assess how to best treat it. The most common causes include:

            • You had an experience where you failed to perform sexually. Specifically, if you experienced erectile dysfunction, premature ejaculation, delayed ejaculation, or inability to achieve orgasm in the past, you may become worried that it will happen again. It is normal to have issues sexually performing occasionally, but folks who become fixated on their perceived failures are more likely to develop sexual performance anxiety when entering a new situation.
            • You experience insecurities about your body, including a lack of satisfaction with your weight, height, penis size, or other bodily attributes. If you are not confident with the way you look, you may experience anxiety about getting naked, experiencing pleasure, and using your body to facilitate pleasure with a partner.
            • You do not think you can help your partner experience pleasure or have an orgasm. If you are not confident in your ability to facilitate a positive sexual encounter, it can cause anxiety about not satisfying your partner, having them lose interest in you, and even a fear that they would tell others about your perceived inadequacies.
            • You are experiencing relationship or personal problems that are causing stress. When there is a strain in your relationship, it may be hard for you to put the issues aside and enjoy a sexual experience. Specifically, if partners are not feeling heard, if someone was unfaithful, if you are fighting, or if one of you is worried about the imminent end of their relationship, this can lead to sexual performance anxiety.
            • You have a condition or are on a medication that impacts your sexual functioning. If you know that it is more difficult for you to stay hard, you may become anxious entering a sexual situation because you are worried that as a result of your health condition, you may be unable to facilitate a satisfying encounter.

            Is there any treatment for sexual performance anxiety?

            Fortunately, there are several proven methods to help folks conquer their performance anxiety.  

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            Treat Underlying Health Issues

            For many, there may be an underlying health condition contributing to their issue. If this is the case, ED would likely have come first and led to the development of sexual performance anxiety. If you notice that you are having erectile dysfunction, even when you are not experiencing stress or when you are without a partner, you should get an exam to see if a health condition or medication is the cause of the problem.

            If it feels like you have a lower libido that may be causing ED, you can take a supplement to help boost testosterone and increase desire. As well, a cock ring could help increase the power of your erection. Once you treat the physical cause of your ED and see that you can sexually perform again, you should experience less anxiety. 

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            Performance anxiety involves experiencing thoughts that often impact one’s ability to perform. As a result, the best way to treat this is to put the focus back on the body and away from the mind. Mindfulness involves exploring ways to stay in the moment and think about your body and what you are doing instead of what you are thinking. One way to do this is to take long, deep synchronous breaths either alone or with your partner.  When you notice yourself getting anxious, focus back on your breath. Take it slowly and explore each other’s bodies without focusing on your erection. You can also engage in deep breathing during masturbation. Work on becoming more in touch with your body to quiet negative self-judgments, and help the brain shut up so you can enjoy the physical pleasure.

            Prove that it works 

            Spend some one-on-one time with your member to work on feeling more confident about your mind-penis relationship. If you pleasure yourself and your penis cooperates, that is evidence that there is nothing wrong with you on a physical level. Masturbating and gaining control of your erection can be a significant step towards building confidence so that you and your penis are on the same page when you invite a sexual partner to join.

            Train with a Sex Toy 

            When treating people with have phobias, a strategy called systematic desensitization is often utilized.  In this technique, folks are exposed to successively more anxiety-provoking stimuli to work their way towards confronting their fears.  If you are currently experiencing fear or anxiety around sex, you can use a sex toy and imagine you are having sex with someone while engaging in mindfulness to remain calm. 

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            You can use a thrusting pocket pussy, a male masturbator a tube stroker, or just your hands, and envision yourself sexually engaging with someone. Notice the thoughts you are experiencing, and work on focusing on your breathing instead of your anxiety.  This exploration may allow you to feel more confident when entering a sexual situation IRL, because you have proved you can do it!

            Do some Unlearning

            When you watch porn, there is an unrealistic standard set where men are always shown as wanting sex and being ready to perform. In reality, it is normal for sex to be awkward, for each position not to work perfectly, for somebody not to orgasm, and for your penis to not always fully listen to your demands. Get educated about sex and work on normalizing the inherent awkwardness and imperfection.

            We are taught that a man’s penis is the primary way to pleasure a partner. If it isn’t functioning, this can feel like a failure of your masculinity and sexuality. In reality,  less than 20 percent of women can orgasm from penetration, without clitoral stimulation. As a result, you can likely produce more pleasure for your partner by using your tongue and finger than your penis.

            Focus away from your Penis During Sex

            If your performance anxiety is related to erectile dysfunction, try shifting the focus away from your member. Put on a timer and create a space where there will be no penetration or penis-related activities. Spend a long time kissing, touching each other, and giving your partner oral sex. If your partner wants penetration, use a dildo. This should allow your brain to stop experiencing anxious thoughts about performance because it is off the table, and instead, it will help you get back in touch with your body in a pressure-free environment.

            Challenge Irrational Thoughts

            Anxiety often consists of experiencing irrational thoughts that are not helpful or logical. Do you honestly think your cock will never work again? Do you really think she will not call you to hang out again if you give her a fantastic orgasm but don’t have penetrative sex right away? Is it logical that all he cares about is your hard cock? Challenge some of your thoughts! You can engage in self-therapy by noticing which irrational thoughts you are experiencing and seeing if you can replace them with more positive thoughts. You can even go all out and write some mantras, “My worth is not connected to my penis,” “I can still facilitate pleasure without my dick!”, “I will get over this anxiety and pound pussy again!”

            When should you see a specialist?

            If you experience sexual anxiety or erectile dysfunction from time to time, there is no cause for concern. It only becomes a problem when it interferes with your desire or ability to enjoy sex. This is a widespread concern, and there are many treatment options to explore. For many folks, getting connected to their body during sex, working on confidence, and reframing any irrational beliefs you may hold can be a significant step in getting over performance anxiety. If you have tried some of the suggestions above and it still feels like it is an issue, I recommend you speak to a specialist in the field regarding treatment options. Good luck out there!

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