Have sexual performance anxiety? What both men and women need to know

Nervousness and stress are common causes of sexual performance anxiety, experts say. dolgachov/GettyImages

Sex is supposed to be an enjoyable experience, but for some, it can evoke feelings of major anxiety, making the act of sex a dreaded deed rather than something to look forward to.

These feelings are part of what is known as performance anxiety, and it’s a common issue that happens to both men and women of any age.

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“It’s to feel so fearful [of sex] that is has a physical manifestation and it affects your behaviour towards sex,” relationship expert Chantal Heide explains. “There are performance issues, which are the mechanics of it, which for women is they don’t become lubricated or for men, they experience erectile dysfunction. But the anxiety is what would happen after that.”
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There are several reasons as to why one might experience sexual dysfunction, which could then lead to performance anxiety in the bedroom, Heide says.

Nervousness of first-time encounters is common, and may cause sexual dysfunction in men in particular, Heide points out, as well as stress. In these cases, it’s not a physical issue, but rather something that has manifested mentally and/or emotionally.

Being overweight and/or having high cholesterol can also be a cause of dysfunction – again, especially in men. In this case, dysfunction can be a result of a health and physical issue.

“Both of these have the effect of narrowing your arteries,” Heide says. “And the vascular system going into your penis is the smallest veins you’re going to find in a man’s body. So if you’re narrowing the vascular system, the penis is going to be affected.”

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According to Medical News Today, other causes may include low testosterone levels, smoking, alcohol or drug abuse, nerve damage from diabetes, injury or recent surgery.

For women, body issues can contribute to sexual dysfunction and performance anxiety, as well as painful sex, Heide says.

The Mayo Clinic adds that low estrogen levels after menopause can also be a cause.

Men and women’s performance can also be impacted by cancer treatments, chronic illnesses, disorders, certain medications and depression.

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Dealing with performance anxiety doesn’t only impact individuals, but it can have an effect on a relationship should one or both partners be affected.

“The relationship can become asexual,” Heide says. “It can become a relationship where it feels like sex isn’t something you want to tackle because it causes more issues than – sometimes – anything else.”

But should dysfunction and/or performance anxiety be something you or your partner is dealing with, Heide offers some tips on how to navigate and cope.

If the dysfunction is coming from a state of mind, Heide says not to make a big deal out of it with your partner. Instead, be patient, understanding and supportive of your partner.

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If this mental state continues to be an issue, then approach sexuality in stages, Heide suggests. Engage in sexual activity in stages and work around it. You don’t have to go from zero to 100 right away. Again, be patient and take baby steps. There are other ways to enjoy each other sexually, Heide says, that doesn’t involve intercourse.

Lastly, sexual counselling may be a good thing to try, Heide says. This way, a professional can help you navigate the sensitive issues while keeping the peace between both partners and helping to control any anxiety that may arise.

Should this be a physical issue due to illness or medications, it is then best to consult with your primary physician.

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