How to overcome sexual performance anxiety by Beaonca Ward

Common Causes and Prevalence of Performance Anxiety

Sexual performance anxiety affects roughly 25% of men worldwide. Furthermore, this common occurrence has been shown to contribute to both premature ejaculation and erectile dysfunction. Performance anxiety can be the result of the overwhelming pressure sometimes society often places on men to perform well during sex which usually involves getting and maintaining an erection.

Our physical bodies are fluid and sometimes can be inconsistent. This does not mean there is a particular failing that is experienced in the body. Stress can also affect one’s ability to maintain an erection. These hard demands and expectations placed on men to perform well can lead to fears that they are inadequate or will have to deal with a disappointed partner. Other issues such as medication and health concerns can also be contributing factors to experience performance anxiety.

Reframing Common Beliefs About the Body

Another common experience that can sometimes come as a surprising cause of performance anxiety is deep emotional reactions. Sometimes having intense feelings of love for someone can bring up associated fears about the relationship’s progression. It is not uncommon for men to question if the person that they are with is a good fit or will stay with them long term. These strong emotions can actually trigger a response in the body that can contribute to experiencing performance anxiety. When we place pressure on ourselves to “do everything right”, our minds and body may learn to enter fight or flight mode and take the enjoyment out of our sexual experiences.

To further complicate matters, when we do recognize we are in fulfilling relationships that excite us, the body may respond by making it more difficult to maintain an erection. This belief does tend to directly conflict with common ideals that men who are interested in someone should always be able to have an erection with them. The truth is that our bodies can’t always correctly differentiate between excitement and fear because both emotions trigger similar physiological responses.

Both emotions activate the sympathetic nervous system and prepare the body for action. In both cases, you might notice that your heart rate has increased. To make matters worse, both excitement and fear can be expressed in the body through a release of cortisol and adrenaline, both of which can increase a state of heightened awareness. When we become more aware, we may actually start to feel anxious because our minds are responding to the release of cortisol and adrenaline by spending more time thinking in our minds rather than focusing on the physical sensations we are feeling in our bodies during a sexual experience. In such cases, you are not just battling your mind, you are battling a normal physiological reaction that may be naturally responding to how excited you are to spend time with someone that you care about. The way that we can tell the difference between fear and excitement requires us to change how we interpret what we physically feel and experience in our bodies in the moment. 

If your typical reaction to strong emotional experiences involve muscle tension or discomfort in your abdominal region, you are also likely to experience difficulty staying in the moment and recognizing the difference between excitement and fear.

Another potential obstacle that can further exacerbate issues associated with sexual performance anxiety is confusion about how to confront your partner about what you’re experiencing. It is not uncommon for women to have fed into cultural ideas about what is expected for men to do or in this case not do during sexual experiences. It is likely that your partner may have never experienced having sex with someone who struggles with performance anxiety. In such cases, it is important to extend compassion to yourself and to your partner. Having a direct and honest conversation about what you’re experiencing might be particularly difficult if you and your partner have a history of not handling conflict as well as you would like to. In such cases, it can be a good practice to first have one conversation with you partner focused on the fact that you are experiencing a little bit of anxiety. It may be worth mentioning to your partner that you are in fact excited to be with them but recognize there just may be a bit of a disconnect between your body and mind in certain moments due to how you feel emotionally.

Make it clear to your partner that you are attracted to them and happy to be with them if that is the case. A healthy partner that you have built an adequate foundation of trust with will seek to understand more about your experience and approach the conversation with a level of empathy even if they are a bit hurt or confused.

After confronting the initial challenge, you can bring up a second conversation focused on non sexual activities you want to engage in with your partner. In some cases, someone might notice that they experience performance anxiety more often when they lack adequate non-sexual experiences that fulfill their needs. Someone who has a deep need for emotional closeness might experience performance anxiety as the result of placing intense pressure on themselves to make their sexual experience count because it’s the only way they have lately been able to experience emotional closeness with their partner.

Unfortunately, there is a lack of well proven treatments to completely get rid of this condition. However, mindfulness based exercises have been shown to create significant improvements.

3 Non Sexual Practices That Can Enhance Sexual Experiences

Prolonged Cuddling

Take some time to cuddle your partner for a set period of time. 25 minutes can be a great start. Make it a priority that you two will engage in this practice without the expectation of having sex or engaging in sexual behaviors. Focus your time and energy on staying present in the moment with your partner and prioritizing cuddling positions that feel good to you both. Not only will this release an influx of feel good hormones, but you’ll also condition yourselves to enjoy physical experiences that can bring up similar physiological reactions that you experience during sex, without the performance anxiety. This might make it a little easier for you to practice refocusing your mind the next time you do experience the same physiological reactions during sex. 

Eye Gazing

During this exercise, you’ll spend about 7 minutes gazing into the eyes of your partner. This practice has been helpful for some couples to deepen their emotional connection by practicing mindfulness techniques without the pressure of having to perform. There truly is no right or wrong way to complete this exercise. Eye Gazing gives you another opportunity to practice being seen and vulnerable both of which can bring up fears that contribute to performance anxiety when having sex.

Special Dates With Your Partner

Schedule a few minutes each week for a special date night with your partner. Take some time to discuss with your partner what new experiences you want to cultivate together as a couple to enhance your relationship. This exercise has been proven to help couples deepen their relationship and better understand one another. In some cases, this special hour you spend together can foster a sense of closeness and trust that makes it easier for you to lean on your partner in moments of performance anxiety.

References:

Brooks A. W. (2014). Get excited: reappraising pre-performance anxiety as excitement. Journal of experimental psychology. General, 143(3), 1144–1158.  https://doi.org/10.1037/a0035325

David L Rowland, Paraskevi-Sofia Kirana. (2025). A theoretical model for sexual performance anxiety (SPA) and a clinical approach for its remediation (SPA-R), Sexual Medicine Reviews, Volume 13, Issue 2, April 2025, Pages 184–201,  https://doi.org/10.1093/sxmrev/qeaf012

Pyke R. E. (2020). Sexual Performance Anxiety. Sexual medicine reviews, 8(2), 183–190.  https://doi.org/10.1016/j.sxmr.2019.07.001