Performance anxiety during sex can be a dreadful experience. But there are ways to manage it.

Sex can be more than just the physical aspect. Emotions, hopes, and fears may also be involved.

Sometimes, personal challenges and insecurities can make you apprehensive about your sexual performance.

Though sexual performance anxiety isn’t a formal diagnosis, it can still be a valid reality for you. But there are a few ways you can learn to manage sexual performance anxiety.

Performance anxiety refers to significant worry and fear about your ability to execute a specific task. It may also involve concern about how others perceive you.

Performance anxiety is what some people call “stage fright.”

Performance anxiety isn’t a formal mental health diagnosis, but it’s part of social anxiety disorder. This disorder is characterized by fear of social situations in which an individual feels they’ll be exposed to possible scrutiny from others.

You can experience social anxiety:

  • being around strangers
  • having conversations
  • during public speaking

Performance anxiety can manifest in many ways. Not everyone will feel and behave the same when having anxiety about performance situations, so you may not relate to every symptom listed here.

Some common symptoms may include:

  • negative thoughts about oneself
  • blushing and rapid heart rate
  • nausea and vomiting
  • excessive sweating
  • difficulty speaking
  • dizziness
  • intense worry
  • situation avoidance

Feeling anxiety from time to time is expected. But if you live with any anxiety disorder, you might have persistent symptoms that occur during different situations.

If you live with social anxiety, you might constantly worry about how others perceive you and how you navigate social situations.

Sexual performance anxiety refers to the fear of not being able to perform adequately during a sexual encounter. “Adequately” can mean different things to different people. What matters, though, is what you think that involves.

You may feel you won’t be able to meet your partner’s sexual preferences or experiences, which may cause you to have anxiety, for example.

On many occasions, particularly for men, sexual performance anxiety could impact becoming aroused and physically responding to sexual stimulation. This could confirm in your mind that you might not be able to perform well.

Sexual performance anxiety could manifest in many ways, including:

Men and women can experience sexual performance anxiety, and some may experience orgasm anxiety as well.

Literature reviews from 2000 to 2018 found that 9% to 25% of men experience anxiety associated with their sexual performance. In many cases, this anxiety was linked to symptoms of erectile dysfunction and premature ejaculation.

The same reviews found that women with sexual performance anxiety account for an estimated 6% to 16% of the female population, and anxiety often manifests as a low sex drive. Anxiety can also prevent females from experiencing orgasm.

You may experience sexual performance anxiety for many reasons, including:

  • past experiences
  • biology
  • your upbringing
  • traumatic events

Living with anxiety disorders may also make it more likely that you experience symptoms related to performance.

Personal concerns and expectations may also cause you to have anxiety. But what causes you to experience anxiety may not cause others to have anxiety.

You may feel anxiety about your sexual performance during the first few times you have sex or when you’re just beginning a new partnership.

You could have questions like:

  • Can I trust my partner?
  • Will we become pregnant?
  • Should we wear protection?
  • What will my partner think if I cannot perform?
  • Will they like my body?
  • Do they love me?

Other contributing factors to sexual performance anxiety may include:

  • low self-esteem
  • orgasm anxiety or difficulty in achieving orgasm
  • pain with intercourse
  • decreased sexual drive
  • depression
  • pain chronic conditions
  • changes in physical appearance
  • anxiety disorders
  • trauma

A mental health professional can help you explore the whys behind your symptoms of sexual performance anxiety and structure a treatment plan that works for you.

If your symptoms are linked to a specific situation, such as a new partnership, you may find that performance anxiety subsides as you become more comfortable with them.

If chronic stress is a contributing factor, developing stress management skills could be helpful.

Professional treatment for anxiety

Standard treatment for anxiety disorders includes psychotherapy, particularly cognitive behavioral therapy (CBT). CBT aims to help you rework some of your thoughts and support you in developing skills to manage your symptoms.

In some cases, your health professional may also recommend medications to relieve some of your anxiety symptoms.

If erectile dysfunction (ED) is causing your sexual performance anxiety, a sexual health expert could recommend a treatment plan. The plan could be complemented with psychotherapy sessions, too.

Some of the medications commonly used for ED include:

Treating your ED symptoms could help ease performance anxiety.

Self-care strategies

Some self-care strategies and natural options to relieve anxiety may also help you with sexual performance anxiety.

Breathing and mindful exercises can help you calm down quickly just before your sexual encounter, for example. Somatic techniques may also contribute to a sense of grounding whenever you feel your anxiety levels rising.

Other self-care tips to consider include:

  • Journaling. Writing about how you feel and exploring possible reasons for your feelings might get you closer to understanding the root cause of your performance anxiety.
  • Exercising. Moving your body can boost your mood and self-confidence.
  • Lifestyle choices. Limiting the use of alcohol and avoiding substance use could help you in managing anxiety symptoms.
  • Stengthening your bond. Working on improving your relationship by opening communication could help you safer and more secure when intimacy time arrives.
  • Changing attachment styles. If you have an anxious or insecure attachment style, you may be more likely to experience anxiety.

Living with anxiety can affect many aspects of your life, including sexual intimacy. This may stem from personal worries, past experiences, or physical conditions.

Anxiety can be managed, and a mental health professional can help you with the treatment plan that will work best for you.