Health Care
July 16, 2021

Sexual Performance Anxiety: What Is It And How To Overcome It

Pressure to perform in bed can stop you from having a good time, but there are ways to work through the fear.
Written by
Ella Dorval Hall
Published on
July 16, 2021
Updated on
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Sex is supposed to be fun. It can be a time to explore yourself and your partner in new, intimate ways. Or it can simply be a good, connecting time. But if you feel your anxiety always gets in the way of your enjoyment, you might be experiencing sexual performance anxiety. Such anxiety can pose challenges in the bedroom and it can manifest for a number of reasons. Whatever is causing it, you aren’t alone in the feeling. According to a 2010 study published in the Sex Med Review Journal, sexual performance anxiety is actually one of the most common sexual complaints. While it can be difficult to deal with, there are ways to overcome your performance anxiety. First, it can be helpful to simply understand what it is and some of the reasons that may cause it. 

What is sexual performance anxiety?

“Sexual performance anxiety is the experience of severe anxiety that overtakes you as you have sex with a partner” sex therapist Dr. Bat Sheva tells These anxieties are usually about someone’s sexual performance, their ability to satisfy their partner, or how their body is functioning. 

According to a 2005 study published in the International Journal of Stress Management, “performance anxiety is related to an excessive need to perform or to satisfy the partner in a sexual interaction. The focus is on performance rather than the individual’s own pleasure and satisfaction.” This causes someone with performance anxiety to be so fixated on their partner’s experience that they can’t pay attention to their own pleasure. It can be a vicious cycle “As one ‘failure’ follows another, the level of performance anxiety increases and further impedes the sexual functioning.“ In other words, if you’re having a hard time getting it up and you start to get anxious about that, it can make it even harder to get it up, which then only makes you more anxious. 

What’s the difference between sexual performance anxiety and sex avoidance? 

As with most things, a person can experience sexual performance anxiety on a spectrum. In a less severe situation, a person may feel worried about their ability to orgasm and it might make them a bit distracted during sex, for example. Some may experience sexual performance anxiety situationally: They may have anxiety with a new partner, but not so much in a longer term relationship where they feel more comfortable. Others may experience it on a more extreme end of the spectrum and become sex avoidant. 

Sex avoidance is when someone has a general aversion toward sex. This person may “[shun] intimacy and the enjoyment that comes with having a sincere connection to a loving partner.” according to the Center for Treatment of Anxiety and Mood Disorders. They may find they can’t initiate sex, but might enjoy sex after a partner has initiated it. 

Sexual Aversion Disorder tends to be even more intense than general sexual avoidance. “With this disorder, the individual actively seeks to avoid genital sexual contact with a partner. Often, the person will even avoid genital contact related to a gynecological exam or procedure. Sexual aversion disorder can be so traumatic that the person won’t allow any physical touch or kissing” according to the Center for Treatment of Anxiety and Mood Disorders. 

Why do people experience sexual performance anxiety?

People experience sexual performance anxiety for a number of reasons. Perhaps you fear finishing too quickly or not being able to orgasm at all. You might feel so insecure about the size of your penis, how your vagina or boobs look, or some other body part, that it causes you to feel too distracted or anxious to enjoy yourself with a partner. Maybe you’re not sure if your sex drive is normal or you are comparing yourself with your partner’s previous partners and worry you won’t match up. Another reason you may experience performance anxiety is because you have some form of sexual dysfunction or issue. For example, you might experience erectile dysfunction, premature ejaculation, vaginal dryness, or pain during sex

“Oftentimes, we have false expectations of what sex should be like based on what we see in porn or the movies. This can result in unwanted pressure to perform and create anxiety” Dr. Shemeka Thorpe, a sexuality researcher and educator, tells “Performance anxiety can also be triggered by the fear of disappointing our partners during sex, experiences of sexual trauma, religious shame, and the anticipation of sexual pain due to chronic pain disorders."

Symptoms of sexual performance anxiety 

The symptoms of sexual performance anxiety can also be the cause of the anxiety itself. For example, if you experience vaginal dryness, it might make you feel worried about your ability to get wet and then this worry can actually make it harder to get wet. The same can be said for maintaining an erection, or other sexual issues you may experience. While anxiety can certainly contribute to the issue, some of these symptoms can also be medically treated. 

Other symptoms depend on the severity of your anxiety. Some people experience panic attacks, tense muscles — including the muscles surrounding the vagina which can lead to vaginal pain, or nausea — according to the Center for Treatment of Anxiety and Mood Disorders. It’s also possible that people with performance anxiety will experience guilt, shame, or low self-esteem when they turn down their partner. While all these symptoms may sound daunting, it is possible to overcome them. 

How to overcome sexual performance anxiety

While there’s no one-size-fits-all solution, there are a few helpful things you can try. If your anxiety has caused you to lose interest in sex completely and you are not interested in exploring how to work through it, that’s okay too! Not everyone feels the need to improve their sex life right now or ever. For those who are looking for some tips, though, we’ve got you covered. Some tips may be right for you and others may. Do whatever feels good to you.

Here are a few ways to work through performance anxiety and potentially overcome it completely. 

 1. Recognize what you’re anxious about

“Think about the following questions: Are you only experiencing anxiety with a specific partner? Is it because you plan to try something new? Is it because of the way you view your body?” Dr. Thorpe suggests to 

First identifying what is making you feel anxious can make the concerns feel less powerful and allow you to take the next steps to address the concerns.

2. Communicate your anxieties to a partner

Communicating with a partner about your anxieties can take some of the pressure off and allow you to ask for support. It can be helpful to have a more in-depth discussion outside of a sexual situation and really delve into what the anxieties are, where they stem from, and potential solutions. For example, if you experience pain during penetration, you might say, “penetration is painful for me, but I really like doing X, Y, and Z things.” 

During a sexual encounter, it’s important to continuously check in with yourself and a partner. You might say something like, “During sex, I feel anxious about [x]. And often, it makes it ever harder for me to [X]. It would help me if you could [x]. How does that sound to you?” 

It can be difficult to communicate the specifics of your anxiety if you don’t know your partner well or if you’re having a one night stand. In these cases, try communicating broader topics first, like your boundaries or what you do and don’t like during sex. If you don’t feel comfortable bringing up a specific issue, like vaginal dryness, consider bringing lube with you or saying something along the lines of, “I think using lube is hot.” While not every anxiety can be resolved with communication and you might find it difficult to speak openly with a partner, learning to express your wants and needs is an important first step.

3. Practice mindfulness 

In the past few years there has been a growing body of research on the positive effects of mindfulness on sexual pleasure. In Come As You Are, Emily Nagoski, Ph.D., says mindfulness is “the key to managing any form of performance anxiety.” To practice mindfulness during sex, try and “notice what you’re paying attention to, and then shift your attention to the thing you want to pay attention to.” 

For example, if you find yourself preoccupied with how long you’re taking to orgasm, try to shift your attention to something you find sexy, like the way your partner’s touch feels or the sound of kissing. You may need to refocus your attention over and over again throughout sex, and this is normal.

4. Don’t think of orgasm as a goal

When you put pressure on yourself to orgasm, it can make it even more difficult to finish. While it can be hard to take the focus off orgasming — especially when you’ve learned that sex must end in orgasm or that it’s a sign of how good you are in bed — removing orgasm as the end goal will help you find pleasure in other ways. Instead, focus your attention on finding pleasure in other ways and what connects you to a partner during sex. 

5. Incorporate more foreplay 

“Foreplay and touch are great ways to overcome anxiety, this includes touching yourself and your partner in sexual ways to increase arousal” Dr. Thorpe tells Because performance anxiety can be rooted in expectations about how you should perform during sex, foreplay and mutual masturbation can be great ways to drop expectations about what you think you should be doing and allow you to get in touch with what you actually want to be doing. This will help you focus on the sensations and pleasure in your body, instead of the thoughts about how you think you should be performing. 

6. Focus on what you like instead of what you think your partner likes

People with performance anxiety are often caught up in pleasing their partner, so much so that it keeps them from being immersed in their own sexual experience. Dr. Bat Sheva tells that “the more you practice focusing on what feels good to you and what you want to do, the easier it all gets… Assure yourself that you deserve to feel good and keep encouraging yourself to feel what you are feeling and choose what to do next.” As you check in with your partner, remember that your pleasure is just as important as theirs. If you’re not sure what you like and don’t like, masturbating on your own can be a great way to experiment with various touch and movement. 

7. Remember that you can stop at any time 

Dr. Thorpe suggest to that you should “check in, communicate with your partner(s), and decide if having sex is what’s best for you in that moment.” You might find you’re feeling really anxious, nervous or are experiencing vaginal pain and having sex is not enjoyable right now. Remember you can stop having sex at any time and that you don’t need to apologize or feel bad about it. This is especially true if you’re experiencing pain — you never need to push through unwanted pain to continue having sex in order to please your partner. 

8. Seek help from a professional 

Sex therapists, sex coaches, and some sex educators are trained to give you tools and information to help with challenges like performance anxiety and sexual dysfunction. A sex therapist may be able to help you understand if there is something underlying your performance anxiety that may not have to do with sex at all. 

If your anxiety is rooted in what might be a medical issue, such as vaginal pain, dryness, or erectile dysfunction, seek help from a doctor, sex therapist, pelvic floor therapist, or practitioner. There are medical treatments available that might be right for you.

The bottom line

While experiencing sexual performance anxiety may be difficult, it is possible to overcome. Be sure to pay attention to what you feel anxious about and talk with your partner about it. You might try strategies like mindfulness, focusing on foreplay or mutual masturbation, or working with a professional. Remember that sex is not a performance and that your pleasure is equally as important as your partner’s.

Reviewed for Medical Accuracy

Ella Dorval Hall (she/they) is a white, eating disorder recover-er, sex and pleasure educator. She's worked at a national sexual health organization, Healthy Teen Network, training educators how to teach evidence-based sex education curriculums. Ella now hosts workshops, writes, and does 1:1 education that brings people the information and skills they need to actually enjoy sex. You can find more of Ella’s work on Instagram @unlearnings3x.

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