Sexual performance anxiety is one of those topics many people struggle with, but few feel comfortable discussing. Yet it's far more common than you might think, affecting millions across the UK and impacting both confidence and physical intimacy.
Understanding what it is, why it happens, and, most importantly, what you can do about it can make a real difference to your well-being and relationships. Let's break down the facts and explore practical steps you can take to overcome sexual performance anxiety.
Three key takeaways
Sexual performance anxiety is common: it affects 9-25% of men and 6-16% of women.
It's psychological, not physical: anxiety triggers stress responses that affect how your body performs in the bedroom, but addressing the mental side often resolves the physical symptoms.
Treatment requires more than just pills: medications like Viagra can help with confidence, but don't fix underlying anxiety.
What is sexual performance anxiety?
Sexual performance anxiety is exactly what it sounds like: “performance anxiety”. It’s the idea that sexual intercourse is a performance that is being scrutinised and evaluated. And that feeling leads many to become self-conscious, self-critical, tense or anxious while being sexual.
This can often lead to the very problems that the individual was worrying about in the first place, like erectile dysfunction, premature ejaculation or difficulty experiencing orgasm.
How common is sexual performance anxiety in men?
It might be more common than you think, with around 11.7 million men in the UK saying that they have struggled with sex at least once in their lifetime, and 9-25% having reported feeling the effects of sexual performance anxiety.
How common is sexual performance anxiety in women?
It’s not just men who experience sexual performance anxiety, as it also affects 6-16% of women, severely reducing sexual desire.
Does sexual performance anxiety go away?
Sexual performance anxiety is unlikely to go away on its own. Many people who suffer from it eventually consult a therapist to undergo cognitive behavioural therapy (CBT).
This helps change your attitude and outlook towards sex by reframing how you interpret signs and gives you more control over your emotional and mental responses to certain circumstances.
Symptoms of sexual performance anxiety
You might experience sexual performance anxiety either in the lead-up to sex or whilst it's happening. Just like any other kind of performance anxiety, it affects you both mentally and physically.
Some people have these symptoms all the time, others only now and then, and they can be mild or severe. These symptoms can include:
Is erectile dysfunction the same as sexual performance anxiety?
Sexual performance anxiety is psychological. It's the worry and stress about sexual performance. Erectile dysfunction, on the other hand, is a physical condition where you can't get or maintain an erection firm enough to have sex. But the two are closely connected.
“Sexual performance anxiety can actually lead to erectile dysfunction. When you're anxious, your body goes into a stress response. Your heart rate increases, muscles tense up, and blood flow is redirected away from areas like the penis.
What often happens is that a cycle develops. You experience anxiety, which leads to difficulty with erections. That experience creates more anxiety about the next time, making the problem worse.
The positive side is that when performance anxiety is the root cause, addressing the psychological aspect often resolves the physical symptoms.
For cases where there's an underlying physical cause of ED, treatments like medication can be very effective. The key is understanding what's driving your symptoms so you can tackle it in the right way.”
While sexual performance anxiety can be distressing, you don’t have to live with it forever. There are various steps you can take to help you move forward in the bedroom:
Medication
Prescription medications for erectile dysfunction, such as sildenafil (Viagra) and tadalafil (Cialis), can be helpful for some people experiencing performance anxiety. However, it's important to understand that these aren't a complete solution.
Whilst ED medications can help achieve and maintain an erection, they don't address the underlying psychological causes of performance anxiety. They work by increasing blood flow to the penis, but they won't eliminate anxious thoughts or boost confidence on their own.
Additionally, these medications come with potential common side effects like headaches, facial flushing, indigestion, and nasal congestion. Some people may experience more serious side effects, such as vision changes or prolonged erections.
Cognitive behavioural therapy (CBT)
CBT is a structured, evidence-based talking therapy that can be highly effective for performance anxiety. It works by helping you identify and challenge the negative thoughts that make anxiety worse.
CBT typically involves regular sessions over several weeks or months. Many people find that the skills they learn in CBT continue to benefit them long after therapy has ended.
How to help your partner with performance anxiety
One of the most powerful and often overlooked ways to address sexual performance anxiety is through honest, open communication with your partner. Anxiety thrives in silence, whilst openness and connection can help to break it down.
Here are two ways you may want to approach this:
Discuss expectations
Performance anxiety often stems from perceived pressure to perform a certain way. Having an honest conversation about what you both want and need from your intimate life can help reduce this pressure.
Talk about their feelings
Let them share what they’re experiencing with you. See if there are ways that you can be more understanding and supportive. Many people report feeling immediate relief simply from opening up about their concerns.
If you find it difficult to start these conversations on your own, couples therapy or sex therapy can provide a safe, structured environment to improve communication and work through issues together.
FAQs
Can Viagra help with performance anxiety?
Erectile dysfunction can be brought about by performance anxiety, and so sometimes using a medication for erectile dysfunction can help by giving added confidence going into sexual activity.
How to get hard with sexual anxiety?
Working with your partner to reduce the feeling of sexual activity being a performance and instead focus on being more in the moment can help.
It is better to develop your skills of being present outside of your intimate moments with a regular meditation practice giving you the skills to apply this in the bedroom.
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