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Understanding and Overcoming Sexual Performance Anxiety


couple struggling with sexual performance anxiety

Sexual performance anxiety is a sense of anxiety or nervousness a person can feel before or during sex. When there is adrenaline pumping through your body and revving up your nervous system, it can be extremely difficult to relax and feel pleasure. While performance anxiety can get in the way of gratifying sexual experiences, there are strategies and education that can help you and your sexual partner(s) navigate and manage the side effects.


Sexual Performance Anxiety & Orgasm Challenges


If you experience delayed ejaculation or find it difficult to reach orgasm during sex and don’t know what to do, you aren’t alone. Nearly 75% of individuals with a vagina don’t experience vaginal orgasms. Though less common, 3% of people with penises encounter delayed ejaculation, a medical condition in which a person can maintain an erection, but needs an extended amount of time to ejaculate. Additional barriers to orgasm for people with penises might be due to Erectile Dysfunction (ED), or the inability to maintain and erection during intimacy.


Not achieving orgasms may have nothing to do with your genitalia and everything to do with an unskilled partner or an uncomfortability with your own sexuality. You might try practicing with yourself first so you know what feels good to you and what doesn’t. You might also talk with your doctor to rule out any health conditions or medications that could be hindering your orgasm.


Sexual complaints are one of the most common reasons for seeking help in people with anxiety. If you have never experienced an orgasm (with a partner or solo) you may be experiencing preorgasmic primary. A more common condition, preograsmic secondary, means you can’t climax with a partner.


Sexual performance anxiety can play a part in keeping you from orgasm by worrying about your performance and ability to please your partner, worrying about the relationship, worrying about having an orgasm, or anxiety about receiving pleasure.


Start by giving yourself permission to receive pleasure and check in on your mental health. Increasing self-awareness and learning to control your mind goes a long way in supporting your sexuality. Mental health has been referred to as one of the strongest influencing factors on sexual satisfaction.


Next, assess your relationship. Try thinking about the following questions:


“Is this relationship working or is it time to let it go?”


“What am I afraid of feeling or not feeling?”


“Is there a resentment I’m holding onto that needs to be discussed?”


“I Want To Have Sex, But I’m Not Lubricated”


The desire is there but you’re not primed at the pump. You may be experiencing arousal non-concordance, meaning, the body is aroused and the mind isn’t or vice versa. When this happens there’s a lack of connectedness often related to anxiety. Note, there is a difference between mental and physiological arousal.


Performance anxiety leads to many people getting stuck in their head and feeling out of their body. Work through the anxiety and learn to manage your ruminating mind. Focus less on what you are thinking and more on what you are feeling.


Many individuals with vaginas, particularly in long term relationships, experience less spontaneous arousal. Many don’t see an attractive individual and feel turned on, instead they experience responsive arousal. Responsive arousal requires more work, aka foreplay.


Anxiety may be pushing on your brakes. The dual control model suggests an excitatory and inhibitory responses to arousal. Maybe you were in a fight early in the day, your boss sent you an email you haven’t checked, or you’re worried about your prickly legs. All of these scenarios represent an inhibitive response (brakes) and detract from your present moment awareness in sex.


Slow down, engage in some deep breathing, and explore other erogenous zones. Pay attention to the sensations in your body and focus on enhancing the dialogue inside your head. If you find yourself thinking: “Why am I not wet?” try asking, “what would make this feel better?”


Friendly reminder that lube is your friend! Anyone who comments otherwise may be buying into misinformed sexual beliefs about vulvas.


If you are someone who has experienced sexual abuse or sexual assualt you may be coping with the after effects of trauma. Seeking therapy may help address your concerns on a deeper level and get you back to a hot and healthy sex life!


“I Want To Have Better Sex With My Partner, But They Don’t Seem Interested”


Levels of desire can change overtime. Men’s hormones tend to change slowly over time, whereas women’s fluctuate more rapidly (i.e. each month). Hormones play a role in sexual behavior and some researchers believe an increase in estrogen during the menstrual cycle can lead to a higher sex drive.


Hormones aren’t the end all and be all; other systems individuals interact with play a part as well. Don’t let your anxiety rush to conclusions about sexual dysfunction in yourself or your partner.


If you want to have more enjoyable sex, you might start by thinking about what sex means to you.


What do you enjoy about sex?


What do you get from sex?


How are you communicating these thoughts and feelings to your partner?


Talking to your partner about sex can seem taboo and it might feel like it takes away the spontaneity. In reality, openly expressing sexual desires and fantasies and communicating sexual concerns is associated with greater sexual satisfaction. The anticipation of sex can be just as enjoyable as the act.


You and your partner may want to eat dinner at different times and that likely won’t start a fight or prompt feelings of rejection. Neither should wanting sex at different times. When you feel you’ve exhausted communicating and exploring, perhaps the next conversation is about monogamy. This might feel scary, but that’s in part because society has labeled monogamous relationships as the epitome of relational success.


Remember, talking about sex can bring novelty all on its own. If you are looking for more information check out these 13 sex therapy books that will possibly change your sex life.


Good luck and happy sexing!


Modern Intimacy is a group therapy practice, founded by renowned Psychologist and Sex Therapist, Dr. Kate Balestrieri. This inclusive blog is designed to provide a wealth of information and resources for mental health, relationships, and sexuality. Subscribe today to get the latest information from our expert contributors from all around the world.


Author Bio

Heather "Lulu" Mazzei is a Clinical Associate at Modern Intimacy, in Los Angeles, an Associate Clinical Social Worker, supervised by Dr. Kate Balestrieri, Heather is passionate about healthy relationships and helping the people she works with to develop relationships that thrive.



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