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Performance Anxiety
How pressure to perform can affect your sex life
Anxiety can have a strong impact on how we have sex. For as many as 25% of people, anxiety around sex can get in the way of erections or orgasms.
Luckily, there’s a few different ways you can overcome sexual performance anxiety and get back to enjoying sex.
Last reviewed: 18/11/2020 by Dr Babak Ashrafi
Contents
What is sexual performance anxiety?
Sexual performance anxiety is when you feel fear or worry about your ability to have sex. These feelings can make it difficult to enjoy sex, and in some cases can make you unable to perform. This can happen before having sex, or during.
‘Performance anxiety’ is when doing something in front of another person or a group of people gives you anxiety (also known as ‘stage fright’) and is related to social anxiety. It can happen when you need to do things that can cause you to feel anxious such as taking an exam, visiting the doctor, having a job interview, or speaking in public.
Whether sexual or non-sexual, it can be completely normal to experience a small amount of performance anxiety, including performing in bed. However, performance anxiety can affect people differently, and for some, it can cause panic attacks or affect their day-to-day life.
A study published in 2019 showed that sexual performance anxiety affects between 9% to 25% of men and 6% to 25% of women.
Does performance anxiety only happen with a new partner?
Being in a new relationship can be exciting, but it can also be a reason for getting sexual performance anxiety. You might be worried about pleasing your new partner and even worried the relationship will end if you can’t.
Lots of people in new relationships feel this way so it’s completely normal. Remember that your new partner probably feels the same way. After you’ve been partners for long enough to feel more secure, and you’ve had sex more often, the sexual anxiety should get better. There are also some tips listed below that could help you through any early rough patches around sex with a new partner.
While anxiety with a new sexual partner is a common cause for performance anxiety, it’s not the only reason for it.
Some other common triggers of performance anxiety can include:
- Not feeling great about the way your genitals look or feel, or poor body image in general
- Work-related stress
- Problems in your personal relationships
- Financial stress
- Problems with your love life
- Worrying about coming too early (premature ejaculation), taking too long to come (delayed ejaculation), not being able to get or stay hard (erectile dysfunction), or getting pain during sex
Check out our research on what fears people have around sex:
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Can performance anxiety make you lose your erection?
Yes. Many men find they can’t get or keep erections because of anxieties around sex, known as psychological erectile dysfunction. This is actually the leading cause of erectile dysfunction in younger men and doesn’t mean there’s necessarily something physically wrong with you.
Even if your erectile dysfunction is psychology and not physical, you might still be able to get treatment. Erectile dysfunction medication is effective and safe when approved by a doctor and it can help even with anxiety-related erectile dysfunction.
If your erectile dysfunction is new or sudden, you should speak to a doctor to rule out physical causes for it, regardless of whether it is mainly psychological or not.
Can performance anxiety make it hard to orgasm?
Yes. Some people find they can get hard enough to have sex, but can’t reach orgasm because of the pressure they feel during sex. Not being able to orgasm (anorgasmia) is a common side effect of performance anxiety.
If you have an anxiety disorder and you’re using medication to treat it, you may be getting anorgasmia as a side effect from your treatment.
Can anxiety make you orgasm too quickly?
Yes. While some men find the pressure to perform in the bedroom stops them from orgasming, others find the increased anxiety causes them to orgasm faster than they want. If this is the case for you, as well as getting treatment for your anxiety, you could try premature ejaculation treatment.
How can you get over performance anxiety?
Like other forms of anxiety, you can get counselling or therapy to help manage it. You can get cognitive behavioural therapy (CBT), or other types of therapy on the NHS.
As well as counselling or therapy, there are some other lifestyle changes or techniques you could try to improve your performance anxiety, including:
- Use meditation and mindfulness exercises
- Get rid of stress factors in your work and life
- Change your negative thought patterns with cognitive behavioural therapy
- Avoid rushing sex
- Discuss your worries and anxiety concerns with your partner
- Try sex therapy to work through performance and intimacy issues
- Learn more about sex and sexual behaviours
- Go to couples counselling to help with relationship problems
- Try talking therapy to manage stress and other life challenges
If you need help or someone to talk to, Relate are an organisation the NHS recommend to help you handle sex and relationship issues.
How to get and keep erections with performance anxiety:
You can treat erectile dysfunction caused by performance anxiety the same way as other types of erectile dysfunction. Counselling and lifestyle changes can help, but you also get medications to help you get and keep erections, even with sexual performance anxiety, including:
Other medications for performance anxiety:
As well as helping you get and keep erections, there are other medications that can help you manage sexual performance anxiety, including:
- SSRIs – these are antidepressants that can help you manage your anxiety, but side effects can include no being able to get or keep erections, and not being able to orgasm
- Beta blockers, like propranolol – in some cases, doctors can prescribe propranolol for performance anxiety to help keep your heart rate steady before a performance
- Priligy or EMLA – if your anxiety is making you orgasm too quickly, these medications could help you last longer in bed
Sources
Can Performance Anxiety Cause Erectile Dysfunction? Healthline (2017) [accessed 3 June 2019]
Generalised anxiety disorder (2018) NHS [accessed 3 June 2019]
Performance anxiety (2019) Good Therapy [accessed 3 June 2019]
Sexual performance anxiety (2020) WebMD [accessed 3 November 2020]
Make sexual performance anxiety (2020) National Anxiety Center [accessed 3 November 2020]
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