Sexual performance anxiety is a type of anxiety that leads to intense worry or fear of performance before or during sex. Many people feel pangs of nervousness before having sex. The root cause could be anything. It might get triggered because you may be having sex for the first time, have body image issues, fear the pain, or worry about being unable to meet sexual expectations. If sexual performance anxiety persists for long, it may become hard for you to engage with your partner sexually, and lack of sexual activity may eventually strain your emotional relationship.

Fortunately, there are some ways to address this concern to help you outgrow sexual performance anxiety.

What is sexual performance anxiety?

Sexual desire should occur naturally, much like feeling hungry and eating food or feeling thirsty and quenching that thirst with water. Similarly, engaging in sex is a natural act, and one should not doubt their performance level. However, if someone feels less confident and stressed, they may worry about their sexual performance and feel anxious while engaging in sexual activity. This can affect their performance as their mind gets diverted, says psychiatrist and sexologist Dr Sanjay Kumawat.

Wondering how stressful or anxious thoughts affect your sexual performance? When you feel anxious, in response, your body starts producing more of its stress hormone, cortisol. When there is a spike in cortisol levels, there is a dip in levels of the sex hormone testosterone, thereby lowering your sex drive or libido. Sometimes, the medications you consume to treat anxiety or depression can also harm your libido.

Symptoms of sexual performance anxiety

Just like performance anxiety, this type of anxiety can affect you mentally and physically. People battling with sexual performance anxiety often get overwhelmed by sex-related thoughts and get engulfed in a loop of negative thinking or fears that they face issues engaging in sexual activity. This can happen before or during sex.

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The outcome? Men may find it hard to maintain an erection (erectile dysfunction), climax, or ejaculation. Some people, irrespective of gender, can even completely lose interest in having sex. Sometimes, grave anxiety can also show up physically in the form of palpitations, upset stomach, and shaking. Some of the common sexual performance anxiety symptoms include:

• Inability to orgasm during sex
• Dryness of vagina
• Painful sex

What causes sexual performance anxiety?

People could have limiting beliefs about their sexual performance or have different fears, and experiences that could affect their sex life. Causes of sexual performance anxiety include:

• Feeling anxious about your partner’s sexual expectations or satisfaction.
• Feeling worried about how your masculine or feminine energy would come across during sex.
• Low self-esteem or body image issues.
• Lack of physical or emotional attraction towards your partner.
• Past negative sexual experiences can leave you feeling anxious.
• Fear or anxiety about sexual trauma.

The effect of sexual performance anxiety on relationships

Lack of sex owing to sexual performance anxiety can negatively impact romantic relationships. This Sage Journal study indicates that couples who engage in more sexual activity tend to deepen intimacy and have a lower divorce rate.

The inability to have or enjoy sex can make your partner feel less connected and intimate. This can lead to tension in the relationship with the partners left questioning the care they have for you. People suffering from this anxiety also become cautious of their partners, which ruins trust and intimacy.

How to cope with sexual performance anxiety?

Anxiety stems from negative thought patterns or worries about an event that is about to happen. The best way to deal with sexual performance anxiety, just like any other form of anxiety, is by learning to identify your triggers and finding ways to destress to manage those negative thoughts and feelings that are impacting your sex life. Some of the coping mechanisms include:

• You can try mindfulness meditation to become aware of your thoughts and desires related to sex.
• Yoga can also aid in curbing stress and help enhance your mind-body relationship.
• Indulging in masturbation to learn better about what you enjoy or do not enjoy during sex.
• Seeking professional help from a sex therapist can help identify your thoughts and feelings that give birth to sexual performance anxiety.
• Open communication with your partner can help manage performance anxiety by better understanding their feelings and struggles related to sex. This might help prick your bubble that keeps you from enjoying sex like body image issues or performance concerns.
• Indulge in more foreplay to help improve intimacy.
• Most of the time, it’s a body image issue that comes in the way of sexual performance and self-doubts. It’s important to understand sexual physiology and anatomy from your counselor if not already known. This includes understanding the timings of both male and female arousal and orgasm, which helps dispel any myths about sexual performance, says the expert.
• Any earlier traumatic experience can be addressed with counseling. However, if difficulties persist, medical intervention for anxiety symptoms may be necessary. If issues of premature ejaculation persist, intervention with behavioral therapy and medication is necessary. For partial erection, a physical examination and certain investigations will be necessary with the consultation of doctors, tells the expert.

Accept that sex is not perfect always. Sometimes, females take longer to reach orgasms. That is how their body is made.

Other ways to spark up your sex life can be:

• Cuddling
• Kissing
• Hugging
• Holding hands
• Having quality time with each other

Treatment for sexual performance anxiety

The intensity of sexual performance anxiety heavily relies on the root causes. There is limited scientific research on the success of these treatments. However, a combination of therapy and treatment can be helpful.

1. Cognitive behavioural therapy (CBT)

CBT is a type of talk therapy where you get a chance to give vent to your emotions and concerns regarding performance during sex. Voicing your concerns to your therapist can help reach a common approach to treating sexual performance anxiety.

CBT helps people reframe their negative thoughts surrounding sex which makes it difficult to perform or enjoy good sex. This helps identify triggers while directing your energy towards dismantling old beliefs.

2. Couples therapy

Seeking couples therapy aids people in improving their sexual performace by helping them communicate their feelings with their partner and get to the root cause of the feelings that may affect sexual performance. This type of therapy focuses on the couple as a whole, not just on the partner suffering from sexual performance anxiety.

This approach can help eradicate feelings of shame, fear, and miscommunication that exists between couples. It makes room for an open dialogue pertaining to sources of emotional distress or negativity while coming up with solutions to solve the underlying issues.

3. Medications

Some kind of medications may help curb issues in males like erectile dysfunction. Some anxiety medications, unlike the others that decrease the sex drive, can be suggested to improve sexual arousal and sex drive.