Sexual Performance Anxiety and How to Treat It

9 min read

Sexual Performance Anxiety and How to Treat It

Public speaking is an irrational fear that many people around the world regardless of gender have. When brought up, many people will agree that it is something that they are afraid of.  If asked to do it, they would turn it down. It stems from a fear of humiliation – especially in front of an audience who may or may not judge you for your ‘performance’. Sexual performance anxiety roots form the same fear of humiliation and fear of judgment.

What is Sexual Performance Anxiety?

Performance anxiety is not a novel concept.

In fact, it is an anxiety or fear that is prevalent in many fields where there is an element of performance involved. That means stage actors, theatre performers, athletes in sports all have levels of anxiety. Which directly affect, inhibit, or halt their ability to perform when it is required of them.


Simply because they are afraid to mess up.


This sort of anxiety is an interpersonal one, meaning it originates from internal fears.


Toning down the scale a notch, many people can see reflections of similar fears in their lives. Particularly when it comes to their romantic or sexual partners.

Sexual performance anxiety, commonly referred to as SPA is the fear, anxiety, and stress of being unable to sexually perform with a partner during sex. These feelings can occur before, during, and even after sex.

In men, it can result in a number of issues that may result in symptoms that cause premature ejaculation or even erectile dysfunction. This can then turn into a nasty circle of self-doubt which then in itself becomes a self-perpetuating cloud of anxiety.


Sexual performance anxiety in men manifests in ways where it can start hurting other aspects of their life. Premature ejaculation has been known to cause all kinds of self-image issues in men. So it is better to get on the path to treating it before it causes further harm in men.


Where Sexual Performance Anxiety comes from

To understand where SPA comes from, we must first understand what anxiety itself is. Then how it manifests itself in different ways in multiple aspects of our life.

Anxiety is a natural, basic, and necessary emotion that is found in both humans and animals. It has been a pivotal emotion in our development and evolution as a species. It is the emotion that made early man wary of threats and dangers that might come their way.

Humans have had two very basic functions in our evolution:

Anxiety is the emotion that has helped humans come as far as we have with regard to survival.


But we are no longer the hunter-gatherer species we once were. Our threats and our survivability have taken on other shapes and as a result, so have our anxieties. Our survival, particularly in society is linked to our careers, our

relationships, and our sexual prowess.


This is where the reproduction-survival Venn diagrams begun to overlap and it culminates in one of the most common complaints people have with sex: sexual performance anxiety.

Biological Factors that Influence Sexual Performance Anxiety

Anxiety is caused by several physiological factors in your body. It affects sexual performance when they come in clash with the responses your body generates when it is sexually aroused.


Typically, anxiety triggers a ‘fight or flight’ response within your brain. This is a normal reaction which humans have evolved to have with situations deemed as dangerous. This is what is known as a sympathetic nervous response in humans.


In order to receive and then maintain an erection, human men have what is called a parasympathetic response, also referred to as the ‘rest and digest’ response.


When these two occur together, they cancel one or the other out.


So as one could imagine, these two types of responses in men can then muffle the natural response required for an erection and result in either premature ejaculation or erectile dysfunction.


SPA is one of the biggest contributing factors towards PE and ED.

How to overcome sexual performance anxiety

One of the main hallmark feelings of men dealing with premature ejaculation has been anxiety during sexual encounters. This then of course results in them ejaculating too quickly. In other men, this anxiety can even result in erectile dysfunction triggered by mental duress.


So what are some ways or overcoming sexual performance anxiety?


Anxiety is a tough nut to crack but is ultimately treatable. Treatment of anxiety can result in a huge quality of life boost which can help with PE and ED.

Sexual Performance Anxiety Treatment

Treatments for anxiety should be hyper-personalized to the individual. Most anxiety disorders are ultimately treatable, but it takes time and effort to identify which specific treatment should be used for any individual person. Both therapy and medication have been recommended to tackle anxiety. Though it should be noted, only one form of therapy should be done at a time.


Sexual Performance Anxiety Therapy

Cognitive-behavioral therapy is one of the most recommended sexual performance anxiety treatments. The clinical efficacy of this type of therapy has been huge, mostly because therapists can craft a personalized therapy for each individual.


Common treatment methods include having individuals who deal with sexual performance anxiety come to terms with the fact that there is no imminent danger or threat. In a way, individuals face their fears and realize that the anxieties and dangers are unfounded.


Therapists may expose the individual to similar fears and try and establish the ‘safety’ of the situation. This would help the individual realize the absence of danger. Thus helping suppress the ‘fight-or-flight response and enable the ‘rest and digest’ response which helps achieve an erection.


In a sexual setting, there is no imminent danger! In fact, it is quite the opposite. The ‘danger’ might arise from the fear of humiliation – which is understandable. But, you’re there to enjoy yourself and pleasure your partner too. The whole point of it is to have fun.


Sexual performance anxiety medication and medication for anxiety, in general, have been proven to help with the condition. Although as a disclaimer, it is highly recommended that you consult your doctor or physician before you start taking any form of medication.


While one may assume that both cognitive behavioral therapy and medication would go hand in hand, evidence suggests that a monotherapy technique is more effective at resolving the problem.


Medication such as selective serotonin reuptake inhibitors(SSRI) and serotonin and norepinephrine reuptake inhibitors(SNRI) have shown to be most effective along with the calcium-channel modulator pregabalin. However, any and all medication cannot be taken without the proper guidance and supervision of doctors.


Some medications have known side effects and can worsen anxiety-related symptoms if the dosage is not correctly advised. This is why self-medicating is highly advised against. Most physicians will not even give you these medications without a prescription from a doctor.

Mindfulness-based techniques

Mindfulness-based techniques(MBT) are becoming a more common answer when asked how to fix sexual performance anxiety.

MBTs entail an individual paying attention to every thought and/or feeling that they may have without judgment. In this case. an individual may pay attention to every thought related to why it is they have such anxiety in sex.


This way, finding the root of the problem becomes easier. The therapy may be as easy as performing gentle yoga poses, walking, or running – but all the while being mindful about one’s feelings.


MBTs have shown to have an effective result in treating sexual dysfunction and anxiety in general. This technique has led to improvements in arousal, reduction of fears and anxieties, and overall increased satisfaction.

Exercise and Physical Activity

Regular physical activity is a help for many ailments that the body has and has shown to have great results in treating anxiety. It releases serotonin in the body, which is a hormone that helps regulate moods and is commonly referred to as the ‘happy hormone’


Exercise can help treat premature ejaculation, so it is natural to assume that it can even help with its root cause. Indeed, there have been countless studies that show the efficacy of a normal exercise routine in treating anxiety. Exercise releases hormones in the body that combat the feelings associated with anxiety and help regulate blood flow which can go a long way in helping with premature ejaculation and erectile dysfunction.


Regular aerobic exercise is effective at treating raised anxiety levels – while more high intensive exercise regimens have shown even greater results in treating sexual performance anxiety.


Anxiety can take shape and form in many different ways. Many forms manifest in our daily lives and inhibit regular, everyday functions.


The biological roots of anxiety and sexual performance anxiety are a mish-mash of chemicals cancelling each other out. Which usually result in outcomes that hinder your daily lives. Fortunately, there is a multitude of ways you can start treatment for sexual performance anxiety.


One of these ways is cognitive behavioral therapy(CBT). Therapists will guide patients to help them realize that there is no imminent threat or danger. Another form of CBT is mindfulness behavioral therapy. As the name implies, it is a technique to remain mindful of one’s feelings.


Good old exercise was discussed as a way to combat therapy, both in the long and short terms.


Whatever the technique, one must realize that their anxiety is ultimately treatable and its treatment will result in a better quality of life!


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