Even though sex is supposed to be enjoyable, it is natural to worry occasionally about sexual intimacy. We wonder if we are desirable, if our appearance might be an issue, or if we will be able to “perform”. Usually people who experience these worries are able to process them and and then move past them. However, for some people, anxiety about sex is a major concern that affects every aspect of their sexual life whether they’ve been happily married for 30 years or are just beginning their journey into the world of sex.
Sexual performance anxiety is the constant worry over your appearance or your ability to perform in bed. This worry takes the pleasure out of sex, making it stressful and nerve-wracking. Ultimately, untreated sex anxiety can even lead to aversion and the avoidance of sexual activity. We often don’t consider the fact that sex is just as much about emotion as it is physical touch. If you stress too much about the various aspects of sex, it becomes harder to become aroused.
Some of the sexual worries that can arise over time include:
- Fears that you may not be able to satisfy your partner
- Having a poor body image and feeling undesirable
- Difficulties in your relationship
- Feelings of guilt
- For men there can be a fear that his penis won’t measure up or that he may ejaculate too early
- For women there can be a concern about not being able to orgasm or enjoy the sexual experience
Anxiety clearly can affect the sexual act:
- In men, the secretion of stress hormones constricts blood vessels, making it difficult to get or maintain an erection.
- In women, anxiety prevents lubrication and takes away their physical desire entirely.
- Anxiety becomes a self-fulfilling prophecy: you worry about having sex which makes you so anxious that you can’t perform sexually, which in turn increases your anxiety, which continues the vicious cycle.
There are a number of reasons these worries may develop. For example, abuse of any kind, whether from childhood or adulthood, can lead to sexual anxiety. Some health issues, such as diabetes, obesity, and hormonal imbalances can result in physical conditions that lead to sexual performance anxiety. For men, impotence or premature ejaculation can lead to sex anxiety, and in women, fear of pain or failure to orgasm can contribute to the development of the disorder.
If you or someone you know is suffering from sex anxiety, the first step to take is to see a doctor. They will perform tests to determine whether the performance issues are the result of a health condition or a medication. If a medical issue isn’t to blame a mental-health therapist may be suggested. In many aspects, any type of performance anxiety, including sexual performance anxiety, can be closely related to social anxiety disorder: both disorders share concerns about being judged or embarassed, both can result in lowered self-esteem, and both can lead to avoidance of the situation. Because they are closely related, the therapies that help with social anxiety disorders can also help with overcoming sexual performance anxiety:
- Counseling can lead to understanding intimacy anxiety.
- Cognitive behavior therapy can help change negative or inaccurate thinking and behaviors.
- Relaxation and stress relief techniques can help reduce the physical response.
For more information about sexual performance anxiety and its treatments, including cognitive behavior therapy, in the Boca Raton area, please contact Dr. Andrew Rosen at 561-496-1094 or email him today.
Dr. Andrew Rosen
Dr. Andrew Rosen PHD, ABPP, FAACP is a Board-Certified Psychologist and the Founder and Director of The Center for Treatment of Anxiety and Mood Disorders, as well as, the Founder of The Children’s Center for Psychiatry Psychology and Related Services.