What is Sexual Performance Anxiety?
Sexual performance anxiety [SPA] is a type of anxiety that is related to sexual activity. While it is a common sexual issue, it is still not recognized as a diagnosis and can have a significant impact on women’s health. SPA usually occurs alongside or before other sexual dysfunctions.
When a person suffers from severe SPA, they may worry about their performance, fear failing, and experience difficulties sexually. Recent large-scale studies have shown that 6-16% of women and 9-25% of men reported feeling anxious about sexual performance for at least one month over the past year, and SPA can severely inhibit sexual desire.
Causes of Sexual Performance Anxiety
Various reasons can cause sexual performance anxiety, and oftentimes it stems from a combination of psychological, emotional, and interpersonal factors. Some of the common causes:
- Fear of Failure: The fear of not meeting personal or societal expectations during sexual encounters can contribute to performance anxiety. Concerns about one’s ability to satisfy a partner or perform up to a certain standard can lead to pressure and anxiety.
- Past Negative Experiences: Previous negative sexual experiences, such as sexual trauma, rejection, or performance issues, can lead to anxiety in future sexual encounters. These experiences may create a fear of repeating past difficulties or being judged negatively.
- Body Image and Self-esteem Issues: Insecurities about one’s physical appearance or self-esteem can also impact sexual performance. Worries about body image, feeling unattractive, or low self-confidence can all contribute to anxiety during sexual activities.
- Relationship Issues: Relationship issues, such as unresolved conflicts, communication issues, or lack of emotional intimacy, can affect sexual performance as well. Tensions or disconnection with the partner can create anxiety and pressure in the sexual context.
- Pressure to Perform: External pressures, including societal expectations, cultural beliefs, or media portrayals of idealized sexual performance, can contribute to anxiety. The feeling of needing to meet certain standards or perform in a certain way can lead to performance anxiety.
- Lack of Sexual Education: Insufficient knowledge or understanding of sexual functioning and anatomy can lead to anxiety. Inadequate sexual education or a lack of information about sexual pleasure and satisfaction may result in uncertainty and performance-related worries.
- Psychological Factors: Psychological conditions like generalized anxiety disorder, depression, or other mental health issues can contribute to sexual performance anxiety. Moreover, factors such as overthinking, excessive self-criticism, or high levels of stress can negatively impact sexual performance.
Symptoms of SPA
Sexual performance anxiety can be seen in various ways, and therefore the symptoms vary from person to person. Here are some common symptoms associated with performance anxiety during sex:
- Difficulty Achieving or Maintaining Erection [in males]: Anxiety can interfere with the physiological processes involved in an erection, thus leading to difficulties in achieving or sustaining an erection during sexual activity.
- Premature Ejaculation [in males]: Anxiety and heightened arousal levels can contribute to premature ejaculation, where ejaculation occurs sooner than desired, often before reaching climax.
- Inhibited or Delayed Orgasm [in both genders]: Anxiety can delay or stop orgasm, making it challenging to reach climax or experience sexual pleasure.
- Loss of Sexual Desire or Arousal: Performance anxiety can reduce sexual desire or arousal, leading to a lowered interest or motivation for sexual activity.
- Excessive Self-consciousness: Individuals with sexual performance anxiety may also experience intense self-consciousness or self-confidence issues during sexual experiences. They may excessively worry about their appearance, performance, or the judgment of their partner.
- Negative Thought Patterns: Anxious thoughts, such as fear of failure, concerns about satisfying a partner, or worries about sexual performance, can dominate one’s mind and interfere with sexual enjoyment and contributing to performance anxiety.
- Physical Symptoms: Anxiety can trigger physical manifestations such as increased heart rate, sweating, trembling, dry mouth, or gastrointestinal discomfort. These physical symptoms may further contribute to the overall worry experienced during sex.
- Avoidance or Disinterest in Sexual Activities: Sexual performance anxiety can lead to a hesitation to engage in sexual activities or a desire to avoid them altogether due to the fear of performance-related issues.
Treatment for SPA
Currently, due to the lack of in-depth studies on SPA, there are no proven methods for it yet. However, the studies addressing non-sexual performance anxiety, social anxiety, and ED treatments may provide a good starting point. An effective manage to manage performance anxiety is to be present during sexual experiences, eliminate distractions, and focus on sensations rather than the function of sexual performance.
- Cognitive-Behavioral Therapy [CBT]
Cognitive-behavioral therapy [CBT] is a type of psychotherapy that effectively treats non-sexual performance anxiety and social anxiety. Although there is a lack of studies on the subject, it is recommended for sexual performance anxiety. CBT aims to change patterns of thinking and behavior that negatively impact a person’s life or well-being. - Mindfulness & Meditation
Mindfulness meditation training is another technique that is useful for treating non-sexual performance anxiety and social anxiety. When a person practices mindfulness, the goal is to focus on sensations occurring in the present moment without passing judgment. Mindfulness-based interventions help individuals regulate their emotions, manage their anxiety, and positively impact their sexual performance anxiety. - Medications
Phosphodiesterase 5 inhibitors are FDA-approved effective treatments for ED and premature ejaculation, both of which include sexual performance anxiety as a major element.
Natural anti-anxiety supplements such as sage, passionflower, l-theanine, and bitter orange are also available. Nitric acid boosters like l-citrulline, l-arginine, and Panax ginseng can increase congestion and lubrication. Additionally, plant-derived alpha-adrenergic antagonist compounds such as yohimbine/Yohimbe and Citrus aurantium/p-synephrine are believed to contribute to sexual arousal.
Getting Help with Dr. Mozhgan for Sexual Performance Anxiety
Dr. Mozhgan Sayyad is a prolific doctor with over 25 years of invaluable experience and a proud member of prestigious organizations like the European Society of Aesthetic Gynecology [ESAG], the International Society of Sexual Medicine [ISSM], and the European Society of Sexual Medicine [ESSM]. Dr. Mozhgan is well known for her tremendous service in aesthetic surgeries & non-surgeries, female sexual dysfunction, and other gynecology & obstetrics issues [including STD, Menopause treatment, HPV, and more]. With over two decades of exceptional service, Dr. Mozhgan has wonderfully assisted thousands of women on their journey.
Book an appointment with Dr. Mozhgan and say goodbye to your worries.
