How to Overcome Sexual Performance Anxiety

Phi Atratus
  • Apr 14, 2022
  • 4 min read
healthy sex life

Sexually active men and women encounter various problems that affect their performance. Although it’s easy to think these problems happen only to you, the fact is that millions of people deal with the same issues. For example, sexual dysfunctions are common in both genders and happen in 10–52% of men and 25–63% of women.

The most common problems that affect sexual function include low libido, premature ejaculation, erectile dysfunction, and sexual performance anxiety (SPA). The latter isn’t discussed as much as it should, considering that many people have to deal with it.

Experiencing difficulties with sexual function has a major impact on a person’s confidence, relationships, and so much more. While it may seem things are never going to get better, the reality is that these dysfunctions are manageable. Various treatment and management options are available to people with sexual dysfunctions. Psychotherapy is one of them.

In this article, we’re going to discuss how to overcome sexual performance anxiety, why it happens, and what makes therapy so important.

What Is Sexual Performance Anxiety?

Sexual performance anxiety is defined as fear, worry, or anxiety associated with sexual activity. As you can conclude by the name, it’s a type of performance anxiety, i.e., apprehension and fear of the consequences of being unable to perform at the expected level.

While feeling anxious before sex is normal, especially among inexperienced individuals, people with SPA are so nervous, they can’t perform or enjoy sexual intercourse. 

Today, SPA is usually discussed in the context of male sexual function. Men aren’t the only ones who can experience this problem, however. Sexual performance anxiety affects 9–25% of men and 6–16% of women. In men, SPA contributes to psychogenic erectile dysfunction and premature ejaculation, whereas in women, it severely inhibits sexual desire.

Causes of Sexual Performance Anxiety

A single cause of sexual performance anxiety doesn't exist. Various factors play a role here, such as:

Symptoms of Sexual Performance Anxiety

The most common symptoms of sexual performance anxiety in men are the following:

  • Difficulty achieving orgasm during sexual intercourse
  • Little to no interest in having sex
  • Premature ejaculation during sexual intercourse
  • Inability to achieve or sustain an erection long enough for pleasurable intercourse (erectile dysfunction)

As mentioned above, women also deal with sexual performance anxiety. Symptoms they experience are:

  • Difficulty getting aroused
  • Vaginal dryness
  • Pain during sexual intercourse

It’s also useful to mention that individual differences apply. Sexual performance anxiety can affect people differently.

Since SPA is more likely to affect men, it’s important to address the link with erectile dysfunction. Men with sex-related anxiety often can’t achieve an erection at all, or they can’t maintain it long enough to have satisfactory sex.

Men have sexual performance anxiety due to negative thoughts telling them their penis is not big enough or that they aren’t good in bed. Problems with relationships and other issues in life can also affect your thinking and cause SPA. On the other hand, erectile dysfunction can have physical causes as well, such as old age.

How to Treat Sexual Performance Anxiety

Treatment of sexual performance anxiety depends greatly on its cause. The most common treatment options are medication and psychotherapy. In many cases, a combination of the two approaches works best.

There’s a lot you can do in addition to the recommended treatment approaches. For example, some tricks include having an open and honest conversation with your significant other, focusing on intimacy and passion, and making lifestyle adjustments that can boost your confidence. Regular exercise is a good way to make it happen. Exercises help you get (or stay) in shape, improve blood flow, support erectile function, and increase your confidence.


When it comes to medication, a doctor may prescribe drugs formulated for the treatment of erectile dysfunction. These medications can improve erectile function and thereby increase a man’s confidence. Keep in mind that you can only get these drugs with a prescription. That means you should consult a health care provider regarding sexual performance anxiety and erectile dysfunction.


If you’re wondering, “can I overcome sexual performance anxiety with therapy?” the answer is yes, you can. This is because SPA is primarily caused by negative thoughts, stress, and anxiety. In other words, your mental health plays a major role here.

For that reason, a therapist creates a safe place where you can talk about your problem without feeling judged. The role of therapy is to help you understand the inner mechanisms that lead to SPA so you can control them more effectively, thereby improving your sexual performance. 

As you work on your mental health, you get to overcome negative thoughts that contribute to the development of SPA and sexual dysfunctions, such as erectile dysfunction and premature ejaculation.

The exact therapy approach depends on the therapist and the severity of your condition. The most common type of therapy for SPA treatment is cognitive behavioral therapy (CBT).

CBT is a form of psychotherapy where you identify negative behavior patterns and thoughts in order to influence them for the better. Evidence shows that it can help with non-organic erectile dysfunction. Basically, non-organic erectile dysfunction occurs due to psychological causes, and SPA fits into that category. Studies reveal CBT can also help women improve sexual function and their sexual relationships.

The best thing about CBT is that it allows you to take progressive steps in managing your sexual performance anxiety. With regular therapy sessions, you learn to overcome or manage your fear, insecurities, and negative thoughts.

The therapist helps you identify specific negative thoughts that come across your mind before SPA occurs. You and your therapist then analyze these specific thoughts, thus making it easier to diffuse them in the future. In other words, you gradually train your mind on how to stop sexual performance anxiety.

Is Online Therapy Helpful?

Therapy helps clients learn how to overcome sexual performance anxiety in a healthy manner. It arms you with skills and coping mechanisms you can use to decrease the impact of negative thoughts, fears, and other emotions.

Many people, especially men, are reluctant to discuss their sexual function with other people, including therapists. You may feel uncomfortable sitting in front of a therapist and talking about performance anxiety in bed.

That’s why online therapy is so helpful here.

Online therapy works just like face-to-face counseling, with internet-based CBT being successful in the treatment of various mental health problems, primarily different kinds of anxiety.

Just like face-to-face therapy, online counseling revolves around regular sessions with a therapist. The only difference here is the setting. You can take part in online counseling via text or voice messages from your bedroom, office, car, or any other place. 

Additionally, your therapist is the most suitable professional for your specific needs since you aren’t limited to the selection of therapists near you. This isn’t always that easy to achieve in face-to-face therapy; their location matters a lot.

Since men aren’t eager to discuss their sexual performance with others, you can always choose to be anonymous online. That way, you have the freedom to talk about your mental health and sexual dysfunction and work on their management.

Yet another outstanding advantage of online therapy is that it's more affordable. Working on your mental health shouldn't cost a fortune.

The Bottom Line

Sexual performance anxiety is a common problem that affects men and women. Men are more likely to have this issue, though. The good thing is that SPA is treatable. Therapy is an effective approach for managing SPA, and evidence shows that CBT can help improve sexual function in men and women alike.

Online counseling is equally beneficial, and it offers a lot to clients. Online therapy sessions are easy to attend, affordable, and you also get to be anonymous if you want.

Sexual performance anxiety isn’t the end of your sex life. Things can get better. Be proactive and start with your online counseling sessions today on DoMental.

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