Performance anxiety is a familiar problem affecting men of all ages.
Sexual Performance Anxiety.

Sexual performance anxiety is a result of accumulated stress.

Whether the stress is rooted in self-doubt, lack of self-confidence, or fear of failure, sexual performance anxiety can be incredibly challenging for both men and women.

Read on to learn about the symptoms, causes and treatments to mitigate and ultimately eliminate sexual performance anxiety.

In this article:

Note: Read the whole article or scroll down to the KEY TAKEAWAYS section at the end of this article for a short summary.


  • There is a wide range of remedies to help you address and cure sexual performance anxiety. Effective treatment options include exploring new acts of intimacy, being open and honest with your partner, focusing on self-acceptance and actively engaging in activities that help you de-stress and get you out of your head.
  • Although viagra can help men achieve and maintain an erection during sexual intercourse, it's ineffective in targeting the underlying issues. Instead, addressing the root cause of these challenges is better to help you overcome and eliminate sexual performance anxiety.
  • Some tell-tale signs of sexual performance anxiety include stress, dread or anxiety towards intimacy, lack of interest or engagement in sexual activities, or negative or intrusive thoughts about sex. Men often experience premature ejaculation during sex or have difficulties achieving or maintaining an erection, while women experience vaginal dryness.

What Is Sexual Performance Anxiety?

Sexual performance anxiety is a fear or uncertainty in one's ability to perform sexually. Stemmed from negative or intrusive thought patterns, sexual performance anxiety heightens feelings of self-doubt and insecurity surrounding the idea of sex.

Although commonly associated with men, research has found that performance anxiety can directly contribute to developing and maintaining common sexual dysfunction issues for both men and women.

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As a flood of negative emotions consumes you, stress and anxiety begin to set in. When put into a stressful situation, our bodies react in "fight or flight" mode.

Sexual performance anxiety is a complex state of mind that is accompanied by various physical and emotional symptoms.

Even though you badly want to have sex with your partner, your negative thought patterns keep you from taking that next step.

As a flood of negative emotions consumes you, stress and anxiety begin. When put into a stressful situation, our bodies react in "fight or flight" mode.

Symptoms of sexual performance anxiety include:
  • Rapid heart rate and breathing rate
  • Dry mouth
  • Tightness in the throat or chest
  • Trembling hands, knees, lips and voice
  • Dry hands Nausea and upset stomach
  • Blurry vision Vaginal dryness in women
  • Erectile dysfunction (the most common sexual dysfunction in men)
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So what is causing sexual performance anxiety?


The stigma surrounding sexual dysfunction or sexual difficulties is extreme – especially in men.

Negative or intrusive thought patterns are common causes of sexual performance anxiety.

Often, these thoughts create a self-perpetuating cycle of anxiety, heightening feelings of self-doubt, insecurity and even sexual inadequacy.

Common causes of sexual performance anxiety include:
  • Having sex for the first time
  • Having sex with a new partner
  • Receiving negative feedback from a sexual partner who was not satisfied
  • Previous sexual experiences that were considered "unsatisfactory" or "failed" (i.e loss of erection)
  • Concern for one's ability to pleasure their partner
  • Self-doubt or lack of self-confidence
  • Body image issues
  • Low estrogen levels (affecting women primarily after pregnancy or menopause)
  • Medical or chronic health conditions (i.e. cancer treatment, medication, diabetes, cardiovascular disease, etc.)

The stigma surrounding sexual dysfunction or sexual difficulties is extreme – especially in men.

Psychotherapist and human relationship specialist Esther Perel mentions that although women can experience sexual performance anxiety, men are more susceptible to it.

Traditionally, men are pressured to be the "untiring, masterful and dominant" ones. For this reason, men's identity and self-esteem are bound to their sexuality. With this, failure in the bedroom can ultimately mean failure in themselves as a man.

If not addressed, sexual performance anxiety can take a serious toll on your mental health and well-being.

ALSO READ: Premature Ejaculation: A Man's Ultimate Guide

So, how do we break the stigma and treat sexual performance anxiety?


The goal in approaching sexuality in stages is to allow your body to guide you to do what feels right at the moment. 

Treating a psychological complication starts by tapping into your mental state to address and overcome your symptoms.

Since sexual performance anxiety is caused primarily by negative thinking patterns, targeting these thoughts will change your behaviors.

Here are some practical ways you can do this.

Approach Sexuality in Stages

When we think about sex, we must avoid thinking of the final result. Thoughts of pleasuring your partner or your ability to reach orgasm can put too much pressure on the moment.

Suppose your mental state is stopping you from enjoying intimacy altogether. In that case, it's time to take a step-by-step approach to sex.

Relationship expert Chantal Heide suggests moving through your sexual experience in baby steps. Use moments of arousal to engage in physical connection, such as with a massage or kissing, before progressing to foreplay.

The goal in approaching sexuality in stages is to allow your body to guide you to do what feels right at the moment. It can also offer you new and exciting ways to enjoy sexual activity in more ways than sex alone.

Have an Open and Honest Conversation With Your Partner

If you're struggling with symptoms of sexual anxiety in a relationship, it's essential to talk to your partner about it.

Although your past sexual experiences may bring about feelings of shame, uncertainty, or frustration, opening up a conversation can alleviate most of this stress and help you overcome your symptoms.

Remember to be honest, avoid blaming or becoming defensive, and disclose to your partner how your performance anxiety is affecting you inside and outside the bedroom.

Check-in With Your Current Mood or Emotional State

Daily check-ins are a beneficial strategy to help you overcome sexual performance anxiety. When you're feeling anxious, depressed, unattractive, or distracted, it's normal not to feel aroused or in the mood for sex.

Daily check-ins can help you recognize why you're feeling a certain way, help you regulate your emotions, and improve your stress management skills.

Work Towards Self-Acceptance

One of the greatest gifts you can give yourself is self-acceptance. Letting go of your need for perfection can fuel more confidence, minimize self-doubt and make you less vulnerable to self-criticism.

American Psychotherapist Alexander Lowen once said, "Change is possible, but it must start with self-acceptance".

In confronting your fears and accepting yourself for who you are, you empower yourself to overcome your sexual performance anxiety.

The Importance of Mindfulness

Now that we've covered the various foundational concepts to overcoming sexual anxiety, it's time to shift our focus towards mindfulness.

As an effective therapeutic technique, mindfulness helps bring your attention inward and focus more on the present moment. Peer-reviewed studies have shown that this can help reduce negative symptoms of anxiety and depression, among other mental health conditions.

In the case of sexual performance anxiety, the fear of future outcomes keeps you from engaging in sex altogether. Through mindful practice, you can overcome these fears and end your negative thought patterns that lead to sexual anxiety.

Here are three ways to practice mindfulness.


Meditation is the practice of training our awareness to focus inwardly and to achieve mental clarity, balance and stability along the way. Mindfulness meditation training helps us regain mind-body control by teaching us to let go of negative thoughts.

Accomplishing mindful meditation in 5 simple steps:

Step 1
  • Find a quiet, comfortable place to practice
Step 2
  • Set a timer for 5 minutes
Step 3
  • Breath in deeply through the nose for 4 seconds
  • hold for 7 seconds and
  • exhale forcefully through the mouth for 8 seconds
Step 4
  • Allow thoughts to pass by without engaging or drifting off with them
Step 5
  • Bring more awareness to yourself with each breath

Practice Mindful Focus While Masturbating

As a male, your symptoms of erectile dysfunction are likely the primary causes of sexual performance anxiety. Practicing mindful focus while masturbating can be a beneficial method of meditation to target and resolve these negative thought patterns.

Begin by lying down, breathing slowly and relaxing the muscles in your entire body. Use your vivid imagination to focus on a memory of you being sexual. Focus on this image while masturbating and as you become more aroused, allow these emotions to consume you without becoming distracted.

Don't rush and enjoy the process no matter how long it takes.


Yoga is a beneficial practice to gain strength, mobility and energy. Similar to meditation, this relaxation technique can also be used to enhance sexual function.

Healthcare professional Dr. Anita Sadaty explains that yoga can benefit men and women alike since it helps improve blood pressure levels, boost arousal and limits the production of stress hormones.

As an excellent form of sexual medicine, yoga can be performed alone or with your partner to help you build an emotional connection.


Exercise is a necessary first step in improving our physical and mental health. A 2015 research study looking at mindfulness and healthy behaviors found that individuals who participated in an exercise program for longer scored higher on measures of mindfulness and self-acceptance.

Exercise creates a positive physical response in our bodies by increasing our heart rate and blood flow, which helps heighten sexual desire and mitigate symptoms of erectile dysfunction in men.

ALSO READ: Your Handy Guide to Sexual Foreplay

When to Seek Professional Help

Based on the psychological factors that affect sexual anxiety, your negative or intrusive thought patterns can be challenging to break on your own. For this reason, it may be beneficial to seek professional medical advice.

Psychotherapy is an excellent option to help treat various anxiety disorders and other medical conditions.

Cognitive Behavioral Therapy (CBT) is a type of psychotherapy that can assess your thought patterns and work through them using role-playing, relaxation, journaling and other therapeutic techniques. CBT is an effective therapeutic approach that aid in a range of sexual dysfunctions, including erectile dysfunction and premature ejaculation.

ALSO READ: What's your best sex position? Let's find out.


  • Often causes of sexual performance anxiety are negative or intrusive thoughts that make any type of sexual activity challenging to perform.
  • Although more common in men, sexual anxiety can affect both genders similarly.
  • Common sexual performance anxiety symptoms include rapid heart rate, dry mouth, trembling, nausea, vaginal dryness and erectile dysfunction.
  • Effective sexual performance anxiety treatment includes addressing negative thought patterns and engaging in mindful techniques such as meditation, yoga and exercise.
  • Suppose your symptoms of sexual performance anxiety escalate and begin to take a toll on your mental health. In that case, it may be helpful to seek professional medical advice.
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Article sources

  1. 1.
    Psychotherapist and human relationship specialist Esther Perel
  2. 2.
    Relationship expert Chantal Heide
  3. 3.
    American Psychotherapist Alexander Lowen
  4. 4.
    Healthcare professional Dr. Anita Sadaty

Medical Disclaimer: This article is for informational purposes only and is not intended to give medical advice or substitute for the medical advice of a physician.

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