Sexual Performance Anxiety: 3 Things You Need to Know & Signs, Causes and Treatment

By Tatenda


Last Updated: July 7, 2022

Discussing sexual dysfunction is one of the biggest taboos in our society.

This is concerning considering the fact that about half of all men between the ages of 40-70 experience these problems.

Thankfully, we are slowly moving towards creating an environment where we can openly discuss such issues without any shame.

Occasionally feeling anxious is quite normal, however, when anxiety gets in the way of your sexual performance, that might be a problem known as sexual performance anxiety (SPA). 

Read on and learn more about the signs, causes and treatment options for sexual performance anxiety (SPA). 



Signs and Symptoms of Sexual Performance Anxiety

SPA is usually a result of being very self-conscious and concerned about how your partner perceives you sexually.

Insecurities might be a result of how your body looks, fear that you’re unable to satisfy your partner or subconsciously comparing yourself to their previous partners. 

Although common in men, the condition can also affect women. 

The wave of anxiety can come before or during the sexual act and in both instances, it hinders one’s ability to sexually perform. When one gets anxious before sex, it becomes impossible for them to even have an erection and when it happens during, they don’t enjoy sex and often can’t climax. 

This creates a self-perpetuating cycle where one thinks of the time they were not able to perform. This triggers anxiety, which later on continues to get in the way of their sexual performance. 

Without a supportive partner who understands the condition, it might continue going on until sexual intercourse becomes a thing of the past in a relationship. 

Some common signs include: 

  • Premature/delayed ejaculation
  • Having negative thoughts concerning sex
  • Inability to orgasm/climax
  • Pain during sex
  • Erectile dysfunction
  • Feeling worried before/during sex
  • Increased heart rate
  • Loss of interest in sex
  • Difficulties getting aroused



Causes of Sexual Performance Anxiety

There is no one-size-fits-all when it comes to the causes of sexual performance anxiety. Experiences are different for each person and so are the causes.

Moreover, SPA can’t be attributed to one cause. Rather, it is a result of the interaction of several factors. 

Some of the common causes include: 

Relationship stress

When there is a lot of stress and conflicts in a relationship, one can develop a low self-esteem. This will be even worse when there is any form of abuse present. Consequently, one gets anxious and becomes unable to fully enjoy sex. 

Psychological conditions

Experiencing other conditions such as stress, anxiety and depression can also impact one’s ability to perform sexually. 

Orgasm fixation

Sex is so much more than just the orgasm.

Once you or your partner become fixated on orgasms and use that as a determinant of good sex, SPA might develop. You become worried about your ability to orgasm and/or get your partner to orgasm. That becomes your focus and induces anxiety around sex. 

Genital fixation

We live in an unfortunate world where we have certain standards regarding what genitals should look like for one to enjoy sex.

Being grounded in the overemphasis on genital appearance exposes one to the possibility of constantly being worried that theirs aren’t good enough to satisfy the other person. 

Overconsuming pornographic content

Studies have found a relationship between sexual dysfunctions and pornography. Watching pornographic material fosters a false perception of how one should engage in sex. One ends up feeling pressured to comply with the unrealistic standards, resulting in SPA.  

Lack of exercise

This can lead to low stamina and result in one being unable to perform as they used to. The change in physical ability can result in one feeling inadequate and having a negative self image. 

Body image issues

As we get older, our bodies change and sometimes we find it difficult to accept those changes.

Being concerned about your body image, especially regarding weight or aging can impact your sexual performance. You end up feeling less attractive and and anxious about your sexual performance.



Treatment and Coping Options for Sexual Performance Anxiety

The best way to treat sexual performance anxiety is to address the root cause. As a result, it is important to identify the cause so that you can adopt the most effective treatment option. 

Some of the common treatments include: 


This can be done either in person or online. A sex therapist can help you get to the root of the problem and work with you to go past the sexual dysfunction. Psychotherapy can also effectively help in treating anxiety. 


You can talk to your physician about performance sexual anxiety and when they see fit, they can prescribe some medication such as Benzodiazepines, Anti-Anxiety Medications, Viagra, Selective Serotonin Reuptake Inhibitors and Cialis. These will help with the sexual dysfunction as well as the anxiety. 

To cope with Sexual performance anxiety you can consider: 

  • Quitting smoking
  • Meditating
  • Engaging in physical exercise
  • Self-exploring
  • Reducing distractions
  • Improving your diet
  • Reducing alcohol intake
  • Moving away from the idea of ‘perfect’ sex
  • Being present during sex



You Don’t Have to Be Embarrassed About Sexual Performance Anxiety

Many people would rather suffer in silence than talk about any form of sexual dysfunction.

We all have to do our part to deal with this stigma. Be open and create a non-judgmental environment that allows your partner or friends to talk about their sexual experiences openly.

Photo by Lisa



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