Sexual Performance Anxiety: Symptoms, Causes, and Treatment

Sexual performance anxiety is a type of anxiety in which an individual shows extreme fear and gets worried related to sexual activities or performance. It can be also called as performance anxiety and can either happen before the sex or during the sex. Sometimes It may lead to erectile dysfunction, but one should not confuse sexual performance anxiety as erectile dysfunction, Since both are two separate conditions.

It takes place due to multiple reasons like when an individual is not able to satisfy the partner’s sexual needs or when they are unable to get or keep the erection. Occurrence of sexual performance anxiety may or may not ruin the relationship with the sexual partner, however it may ruin the moments during sexual Intercourse, impacting the person’s intimate and sexual life. It is the most common condition these days and is seen to be occur mostly in men than in women. Because of sexual performance anxiety, an individual may lost their interest in having any sexual activities.

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Symptoms of sexual performance anxiety

There are both physical as well as mental symptoms associated with occurrence of sexual performance anxiety. Physical symptoms includes erectile dysfunction, premature ejaculation or delayed ejaculation in men and vaginal dryness in women. Other symptoms could be inability to get orgasm or being in pain during sex. People having sexual performance anxiety have increased heart rate, unsettled stomach and sweats often while having sex or thinking about having sex with someone in future.

Decreased interest in sexual activities, negative thoughts and feelings about oneselves and ones own capabilities associated with sexual performances, worrying excessively or fearful feeling when thinking of having sex are some of the mental symptoms of sexual performance anxiety.

Causes of sexual performance anxiety

Sexual performance anxiety, as the main cause of anxiety is in the name itself, people consider or see sexual activities as some kind of performance that needs to be done right in order to seek pleasure. It establishes a mindset that insists on perfection in sex, even when it is being done for the very first time. People worry that their sexual partners or society will judge them based on their sexual performances, leading to self-consciousness and self-critical thoughts. It reduces their capabilities and makes them consider sex to be a performance instead of an activity that gives feeling of pleasure and intimacy.

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1) Critical thoughts about oneselves:

It takes place when the person thinks or feels negatively about oneself during or after sex. It may goes like “what if my sexual partner doesn’t enjoy the sex” or “what if I do something wrong in between sexual activity”. Performance anxiety occurs when person worries or predict that something bad is going to happen during sexual activity. It may include thinking of inability to get erection, premature or delayed ejaculation (in case of men) or vaginal dryness (in case of women).

Thinking about the pain during or after sex may also be associated with performance anxiety. People also have concerns or insecurities regarding their self body image such as body weight and postures which leads to having performance anxiety.

2) Prior negative sexual experiences:

Often previously occurred negative sexual experiences in which one failed to provide sexual satisfaction to others or was unable to experience satisfaction and pleasure themselves while having sex with someone may create different perspectives associated with sex that causes performance anxiety. People fears of experiencing previous negative events again.

3) Societal expectations or pressures:

Society’s unrealistic expectations and the intense pressure exerted by others to perform perfectly for the partner’s pleasure can cause sexual performance anxiety.

4) Other mental illnesses:

Depression and general anxiety disorder may lead to sexual performance anxiety or vice versa.

Treatment for sexual performance anxiety

Either Medications and therapies or the combination of both can help in treating the condition of sexual performance anxiety.

Medications to treat performance anxiety

Medications, commonly used to treat erectile dysfunction, can also address sexual performance anxiety. Some other medicines that are found to be effective in case of sexual performance anxiety are trazodone, buspirone and bupropion.

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Therapeutic approach to treat performance anxiety

1) Cognitive behavioural therapy (CBT):

Cognitive behavioural therapy is the most common and effective treatment for treating any kind of anxiety, including sexual performance anxiety. Cognitive behavior therapy is a type of psychotherapy and can also be called as talk therapy. All people can use it, and it is most effective when combined with medications.

2) Exposure therapy:

In exposure therapy, therapists expose individuals to situations that cause worry and anxiety. It allows them to face their fears regarding sexual performances in a safe and controlled setting, thereby allowing an individual to overcome their fear of sexual performances.

3) Desensitization:

systematic desensitization may also help the person to overcome their fear of getting physical or having negative thoughts before or during sexual activity. It involves both relaxation and gradual exposure. Systematic desensitization occurs in three steps which includes learning ways to relax muscles, then making the list of fears, ranking them based on the frequency and the intensity and lastly exposing oneselves to each fear one by one in order to get comfortable facing the fear.

Other coping strategies that could help with sexual performance anxiety may include masturbation, spending time with oneself to understand better, getting out of the head and concentrating and enjoying the moment instead of thinking if the other person is liking it or not. Accepting that sex isn’t perfect and it needs not be perfect is a way a person could change their thinking and confidence regarding sex thereby reducing sexual performance anxiety.

Take it easy and go at ones own pace and the most important is to think positively of oneself. Meditation could also help with the performance anxiety by making an individual stay in the moment, to be able to relax without worrying about the consequences or anything, it also helps in reducing stress and helps lead a satisfactory sexual life.

It is a mental health condition and affects mind and body the same way any other anxiety or stress can. However, if one is able to change their thoughts, considers sex as an activity that is to be done to provide pleasure rather than a performance that needs to be done perfectly and by taking appropriate therapy and Medications, one will be able to reduce or overcome the anxiety better.