The Very Real Threat of Sexual Performance Anxiety

Unfortunately, many people struggle with a lack of sexual confidence or loss of confidence in their sexual abilities. Often sex becomes tied to the idea of “performance” instead of pleasure and anxiety takes hold. I treat many individuals who experience “ sexual performance anxiety.” However, this term often gets tied mainly to men.

Men often tie much of their worth to the idea of being able to “get it up” or “lasting really long” during sex. It is amazing that even after one experience of being unable to gain an erection or a sexual encounter where they ejaculate faster than they want to, it can instill a sense of extreme anxiety that carries over to their next sexual encounter. So much rides on that next encounter, but if it happens again, the cycle of stress, anxiety, and sense of sexual confidence plummets to the floor. Then unfortunately there is a major increase to Premature Ejaculation (PE) and Erectile Dysfunction (ED).

Is Erectile Dysfunction or Premature Ejaculation really in your head?

This is a very complicated answer and various components can come into play, but the short answer is that yes, anxiety and self-doubt can absolutely play a large role in erectile issues and premature ejaculation.

That is not to say that medical issues, life history, or age don’t play a role, but often when a man is healthy and does not have a history of these issues throughout his whole life, anxiety and lack of sexual confidence are playing a large role.

How Your Partner Responds Matters

While I hate the term “sexual dysfunction” it’s worth noting that when sexual issues or challenges occur it can often be made worse by how a partner responds. When sexual challenges are not normalized but commented on negatively like, “What’s wrong with you?” “Are you not attracted to me?” or “That was disappointing” sexual anxiety is often going to become a central issue for the person experiencing the sexual challenge.

Further, many times after a man has a long period of experiencing sexual challenges, his partner also starts experiencing sexual challenges and feels anxious and stressed during sex.

How to Start Getting Help for Sexual Performance Anxiety

The good news is that when there is an anxiety component causing sexual challenges therapy can be an effective tool to start working through it. It can often be helpful for not just the person experiencing the challenge, but for their partner to also come to therapy with them.

This can start the process of normalizing the issues, finding methods to help both the PE and ED, as well as start using therapeutic methods like Cognitive-Behavioral Therapy to start addressing and tackling the anxiety.

There are methods, toys, and exercises that can be implemented to help with ED and PE. But a large component is also learning how to rebuild self-esteem, develop distress tolerance, take time for self-reflection, and learn how to “turn off” the negative voice in your head destroying your self-esteem and confidence.

Through patience, understanding, and a reframing of thinking, healing from performance anxiety is very possible, and it can allow individuals to start having sex with a new healthy mindset where pleasure is the priority, not performance.