Sexual Performance Anxiety: Causes, Symptoms and Treatment

sexual performance anxiety

Sexual performance anxiety is related to the worries a man has before an intimate session with the partner. The worries are about oneself and one’s ability to please the partner. It has been observed that sexual performance anxiety is one of the many causes behind erectile dysfunction in males.

Sexual performance anxiety is nothing but negative thoughts. Negative thoughts can be about body image , imagined weakness in erection , belief that my erection is not hard enough to please my partner , and fear that one may get early ejaculation , or fear of loss of erection or low stamina . The combination of these fears produces stress hormones, which contract the blood vessels to reduce blood flow and cause erectile dysfunction.


Causes of sexual performance anxiety

The basic cause is to dominate fear in mind that one is not good or fit to perform well in the bed with the partner. The constant stress, or anxiety regarding the poor body image is the root of other causes which manifest in the form of sexual performance anxiety.

The other cause is fear of loss of erection during intimacy. It may be a side effect of a previous failed erection. Such males often fail to get the erection that they perceive is the right measure for a successful intimate moment.

Relationship issues or lack of intimacy between partners also makes it difficult to involve the mind in the intimacy. The mind has a big role to play in the erection process. It triggers the release of neurotransmitters, which stimulate the central nervous system. The central nervous system releases cGMP to relax blood vessels. Relaxed blood vessels draw in blood to create an erection in the male organ. So, any thought or negative feeling which disturbs the mind can lead to sexual performance anxiety.

Premature ejaculation is a major cause of sexual performance anxiety. It is a condition, in which a male cannot hold the ejaculation till the completion of the intimate act. The ejaculation happens within a few seconds of ejaculation. The fear of ejaculation before the start of the intimate session is a major worry of males with the problem.  Premature ejaculation should be treated to avoid erectile dysfunction. Both these issues are major sexual performance anxiety causes of males.

Erectile dysfunction is a male erection issue. Any male who has experienced some kind of erection issue in any previous intimate session will fear the same in the next session. This fear leads to sexual performance anxiety.


Symptoms of sexual performance anxiety

The biggest symptom is lack of erection due to constant fear and anxiety. Worry or fear never allow the mind to relax. Without a relaxed mind and body, the erection cannot take place.

The tense body and mind release stress hormones. These hormones constrict the blood vessels to reduce the blood flow towards the male organ. Lack of sufficient blood flow reduces the ability to have an erection.

Lack of response to partner touches is another symptom of sexual performance anxiety. Normally, a male is stimulated by the touches of the partner. In heightened state of stress, a male fails to respond to the touches of the partner.

Lack of stimulation is a major symptom of sexual performance anxiety. Stimulation is required for an erection. Doctors prescribing sildenafil 200mg for severe cases of erectile dysfunction also mention the need for stimulation for an erection. The stress and high anxiety makes it difficult for a man to get an erection with stimulation. Stimulation needs a relaxed body and mind, which a man with anxiety finds hard to get.

Treatment to cure sexual performance anxiety

There is no medication or drugs which can curb the anxiety and fear about intimate sessions with the partner. The first line of treatment is talking with the partner and discussing all fear. Most of the fears are imagined by the male. These fears may not be actually present in the intimate session with the partner.

Once a partner is aware of the fears and anxieties of the male, she may try to go slow during the intimate session. Going slow means that both partners will take time before starting the intercourse.

Focus on activities other than intercourse. One of the basic treatment methods is focusing on activities that are done before the intimate session. The foreplay will reduce the need for an erection, which may lead to some relaxation.

  • Counselling sessions

Counselling sessions are basically talk therapy sessions to remove negative thoughts. The talk therapy is non medication therapy done at the clinic of a professional psychologist. The professional discusses the innermost fears and anxiety without any inhibitions with the patient.

Cognitive behaviour therapy is applied by the professional. It is a positive thought that is fed in the mind of the patient. The therapy helps a male to deal with negative thoughts. It also enables the patient to change the response towards the same thoughts and feelings which earlier created depressive thoughts.  There is strong evidence that patients have emerged from the therapy with strong positive results within a couple of sessions.

The counselling sessions with the partner are also conducted. These joint sessions enable the partner to understand the fear of the male. The understanding makes a female respond in such a manner that a male is able to approach her without any fear.

  • Medication

There is no such medication to treat sexual performance anxiety. But males who are suffering from premature ejaculation, which generates fears and anxiety about the performance, are prescribed some medicines to delay the ejaculation.

Doctors may prescribe Cialis 60mg or lower dose to delay ejaculation. This dose is for a severe case of erectile dysfunction. The dose has an impact period of 36 hours, which ensures that there are more than one erections. The dose will allow a male with premature ejaculation to have another erection soon after first ejaculation.

The confidence that there will be no loss of erection helps a man to overcome stress and anxiety of underperformance.

  • Non- medication therapy

Experts recommend using essential oils, and creating a soothing ambience before an intimate session. Essential oils comes in various fragrances. Picking a favourite fragrance and using it with diluter helps calm nerves and relax mind. Herbal massage done by experts loosen the body parts and relaxes the mind.

  • Overcoming psychological hesitation by using herbs and herbal products

There are some herbs used for centuries to improve male health and promote physical and sexual wellbeing. These herbs improve libido, relax tense muscles, improve confidence by enhancing sexual prowess of males and encourage male to seek intimacy. Ginseng, Ashwagandha, and white musli are some of these herbs.

A healthy meal with exercises also improves confidence by improving physical stamina, creating energy, and enhancing libido. There are various yoga poses that are especially helpful to overcome sexual performance anxiety. The combination of all these measures improves the physical and mental aspect of intimacy.


Negative feelings and thoughts are at the core of sexual performance anxiety. The only way to deal with sexual performance anxiety is to change lifestyle and have positive feelings. A healthy diet will overcome low libido or stamina problems and changing lifestyle will remove negative feelings.



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