Feeling nervous about sexual performance, known as Sexual Performance Anxiety (SPA), is pretty common. But interestingly, SPA is a bit different or unusual compared to other sexual concerns.

What is Sexual Performance Anxiety?

Sexual performance anxiety is a specific kind of performance anxiety that specifically impacts sexual activities. Individuals experiencing this may worry about their ability to perform before or during sexual activities. 

This concern is more common in men and can even contribute to the development of sexual issues like erectile dysfunction.

Effect of SPA

SPA shows up differently depending on whether it happens before or during sex. 

If it occurs before, it can make having sex nearly impossible as you might struggle to get or maintain an erection. On the other hand, if it happens during sex, you may find it difficult to enjoy the experience or reach climax.

If you don’t address SPA, it might lead to other sexual issues and a loss of interest in sex. A study revealed that performance anxiety significantly contributes to the development of sexual dysfunction in both men and women. Taking steps to manage this anxiety is crucial for maintaining a healthy and satisfying sexual life.

Signs of Sexual Performance Anxiety

Signs of SPA can manifest in various ways. For men, these signs may include a lack of interest in sexual activities, premature ejaculation, difficulty getting or maintaining an erection, and challenges reaching orgasm during sex.

In women, symptoms might present as vaginal dryness, difficulty getting aroused, and experiencing pain during sex. Recognizing these signs is essential for addressing and managing SPA.

Diagnosis of SPA

Even though there’s no official diagnosis for SPA in current or upcoming diagnostic frameworks, many in the field of sexual medicine are well aware of it. It’s often seen as just one of several factors linked to sexual issues.

It’s common for SPA to be mistaken for erectile dysfunction, even though they’re distinct issues. While SPA can contribute to erectile dysfunction, they involve different aspects of sexual health. It’s important to recognize the difference to ensure accurate diagnosis and appropriate treatment.

To diagnose SPA, a psychotherapist usually conducts an evaluation to rule out other potential causes for diminished sexual performance, such as underlying medical conditions. This thorough assessment helps ensure an accurate understanding of the situation and allows for appropriate diagnosis and treatment.

Causes of Sexual Performance Anxiety 

When you’re anxious, your body undergoes changes that can impact sexual performance. Anxiety often leads to an increase in hormones like norepinephrine and cortisol, elevating blood pressure and potentially impeding blood flow to the penis, making it challenging to achieve or maintain an erection.

SPA is multi-faceted, stemming from a mix of biological and psychological factors:

Body Image Concerns

Feeling overly concerned about height, weight, or specific body parts can trigger anxiety during sexual activities.

Emotional Disconnect

Issues in emotional connection with your partner may contribute to SPA.

Mental Health Conditions

Conditions like depression or generalized anxiety disorder can play a role in SPA.

Lack of Sexual Experience

Those with less sexual experience might feel anxious about performance initially.

Stress

Stress from work or other situations can affect sexual performance and lead to anxiety.

Previous Negative Experiences

Past negative sexual encounters, whether with current or former partners, can contribute to anxiety.

Excessive Porn Consumption

Overconsuming pornographic content may create unrealistic expectations about sex, linked to the development of sexual dysfunction.

This anxiety can create a harmful cycle: initial anxiety affects performance, leading to increased anxiety in subsequent sexual encounters. Breaking this cycle often involves addressing both the physical and psychological aspects of SPA.

Treatment for SPA

The treatment for sexual performance anxiety depends on its underlying causes, often involving a combination of medication and psychotherapy:

Psychotherapy

Cognitive-behavioral therapy is a common recommendation to address sexual performance anxiety.

Medication

Erectile dysfunction medications like Viagra and Cialis may be suggested for those dealing with SPA.

While cognitive-behavioral therapy and medication, especially for erectile dysfunction, have shown effectiveness in treating SPA, ongoing research is needed. Some medications like Buspirone, bupropion, and trazodone also exhibit potential in managing symptoms of this type of performance anxiety.

It’s essential to consult with a healthcare professional to determine the most suitable treatment approach based on individual circumstances.

Coping With Sexual Performance Anxiety

Coping with SPA begins with shedding any shame associated with not having an ideal sex life. In many cases, this anxiety lessens over time, especially when linked to new relationships or resolved partner issues.

Individuals with SPA often wrongly believe they’re inadequate, focusing on their partner’s satisfaction rather than their own. Shifting the focus to mutual enjoyment can alleviate anxiety. Here are additional tips:

Meditate

Incorporating meditation helps manage performance anxiety.

Masturbate

Spend time understanding your own needs.

Get out of your head

Focus on enjoying the moment rather than worrying about potential issues.

Accept imperfections

Recognize that sex isn’t always flawless, and there are days when you may not feel up to it.

Slow down

Ensure adequate foreplay for both you and your partner.

Manage stress

Eliminate stressors from your life through techniques like meditation, exercise, and sufficient sleep.

Seek therapy

Consulting a sex therapist can help identify the root causes of sexual performance anxiety.

Remember, overcoming sexual performance anxiety often involves a combination of self-reflection, communication, and seeking professional guidance.

Supporting a Partner With Performance Anxiety

Supporting your partner through SPA involves taking a considerate approach. Here are some ways to help:

Be Supportive

Offer understanding and patience, taking things at a comfortable pace without applying undue pressure.

Positive Feedback

Share encouraging, non-critical comments about what you enjoy. Focus on the positive aspects of your experiences.

Pleasurable Activities

Shift the focus towards activities that bring pleasure to both of you, fostering a sense of enjoyment in the moment.

Effective Communication

Keep communication open and honest. Discuss feelings, concerns, and desires openly, creating a safe space for both partners.

Reframe Focus

Instead of emphasizing sexual performance, concentrate on building physical intimacy. Redefining the expectations can alleviate pressure and reduce performance anxiety.

Remember, creating a supportive and understanding environment contributes significantly to overcoming sexual performance anxiety in a relationship.

References

1. Ohwovoriole, T. (2024, January 12). What to know about sexual performance anxiety. Verywell Mind. https://www.verywellmind.com/sexual-performance-anxiety-symptoms-causes-treatments-5207955 
2. Pyke, R. E. (2020). Sexual performance anxiety. Sexual Medicine Reviews, 8(2), 183–190. https://doi.org/10.1016/j.sxmr.2019.07.001