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Anxiety is a psychological condition in which a person feels worried or nervous about something going wrong. Sexual performance anxiety is a type of anxiety which can affect both men and women. It’s the fear that you won’t be able to perform sexually or enjoy sex. This worry can take over and make you unable to perform or enjoy sex. 


If you’re concerned about your anxiety or feel like it’s affecting your day to day life, you should see your GP. 


What are the causes of sexual performance anxiety?


Sexual performance anxiety is a term that can be used to describe several different worries that may affect a person’s sexual performance. Certain anxieties might only affect men although there are more general sexual performance related issues that may be common in both men and women.


A common cause of sexual performance anxiety in women is the fear of not being able to orgasm. For men, erectile dysfunction, which is the term used to describe the difficulty of getting and maintaining an erection hard enough for sexual activity, may cause sexual performance anxiety. Premature ejaculation, which is the term used to describe when men reach sexual climax too early, could also lead to performance anxiety in men. 


Stress


Another important factor that can impact sexual performance is stress. While external causes of stress such as work-related matters, family issues or financial problems might not be related to sex, the worry they cause can affect a person’s ability to focus on and enjoy sex.


Other causes


While certain causes of sexual performance anxiety might only affect either a man or a woman, such as a man’s ability to get an erection, there are certain issues that are common in both men and women.


Examples of these include: 


• Low confidence or self-esteem
• Body image issues 
• Previous negative sexual experiences
• Fear of rejection 
• Fear of an underwhelming sexual performance
• Concern that they won’t be able to satisfy their partner


How can sexual performance anxiety affect sex?


Unfortunately, one of the most negative effects of sexual performance anxiety is that mental issues can end up becoming physical issues. Worrying about sex or other things you might be stressed about can affect your ability to become sexually aroused, enjoy sex or reach orgasm.


An example of how mental symptoms of sexual performance anxiety can become physical in men is that stress hormones cause blood vessels to narrow. This can affect blood flow to the penis, making it more difficult to get an erection. Men that are sexually attracted to their partner, or who have not had difficulty with becoming aroused in the past, may struggle to become erect due to performance anxiety. Even if you are able to get an erection, you might find that you’re unable to orgasm due to your mind not being fully focused.


Sexual performance anxiety can affect women’s ability to become aroused, too. Not being able to fully focus on sex can result in a woman not being lubricated enough for sexual activity. This can lead to sex being physically uncomfortable. 


What makes sexual performance anxiety such a vicious circle is that a few bad or disappointing sexual experiences can put a person off from wanting to have sex for a while or even altogether. This could go on to impact a person’s confidence, their relationship with their partner and future sexual experiences.


What can help with sexual performance anxiety?


With treatment, sexual performance anxiety can be overcome so that you can go on to enjoy sex and perform sexually. There are several treatment options available so if you don’t feel a particular treatment is right for you, you might find another is more suitable.


Speaking to your partner


Talking about the issues that are bothering you could improve your sexual performance anxiety. Whether this is talking to your partner or speaking to a therapist, communication is key. You might even find that confiding in your partner allows them to support and reassure you.   
This may also be a good opportunity for both you and your partner to think of solutions to overcome your nerves, such as discussing what you feel comfortable with, or perhaps coming up with different or creative approaches to sex that you’ll both enjoy or benefit from. 


Psychological therapy


One of the most effective treatment options for general anxiety and depression, psychological therapy can also be used to help overcome sexual performance anxiety. Therapy allows patients to talk about any worries with a medical professional who will be able to listen to your concerns and help resolve the underlying issues. They can also help you understand and change your feelings about your body and sex. As well as being somebody to talk to, a therapist will be able to help you find solutions such as helping you manage your anxieties and provide guidance on changing behaviour patterns that may cause or contribute to your symptoms. 


You can also receive therapy for couples too, so this might be an option worth exploring if you and your partner would like to manage your issues together. Sex therapy may be available on the NHS in some areas, so speak to your GP to see if they can refer you. Private therapy is another option if you want to avoid waiting a long time for an appointment but it does mean having to pay for your treatment.


Medication


If you are having problems getting and maintaining an erection (erectile dysfunction), then there are a range of different treatments available. You can begin by speaking to your doctor to discuss your symptoms and check that your erectile dysfunction is not the result of an underlying issue. 


You can also visit the Boots Erectile Dysfunction Online Clinic*, where after answering a few questions to assess your suitability for treatment you’ll be offered access to a range of oral erectile dysfunction medicines. This means that you won’t need to have a face-to-face consultation and, if treatment is suitable for you, you can pick up your ED treatment in store or have it delivered to your address with no postage fees. 


There are also several treatment options which can help with premature ejaculation. This includes medication which comes in the form of prescription tablets or anaesthetic creams. 
For women who find that they might not be lubricated enough for sex due to their anxiety, lubricants such as gels and jelly can be used to help make sex more comfortable. 


*Subject to availability and clinician approval. Charges apply. 


Exercise


Whether it’s taking up strength training to help you feel good or pelvic floor exercises to gain control of your vaginal muscles, exercise is a great way to help overcome a range of different causes of sexual performance anxiety and boost your confidence. When you exercise, your body releases hormones called endorphins, which increase feelings of happiness and positivity. As well as helping to improve your general health, exercise can also help lower stress levels and help improve mental wellbeing. 


You’ll probably find that these are quite different from the types of exercise you’re used to doing at the gym, but pelvic floor exercises are an effective way of strengthening muscles that are key to sexual performance. Pelvic floor exercises are useful for everyone as they can reduce symptoms of erectile dysfunction in men and can help women to experience stronger orgasms. If you’re unsure where your pelvic muscles are and how they feel, a good tip is to try to stop the flow of urine when you next go to the toilet. This is a good way to discover and test your pelvic muscles if you’re new to this, but don’t do it often as stopping your flow while in the middle of urinating can harm your bladder. 


Now that you know how to flex your pelvic muscles, you can strengthen them by sitting comfortably and squeezing them up to 10-15 times in a row. When you feel you’ve got used to squeezing your muscles, try holding each squeeze for a few seconds to really improve your pelvic floor’s strength. You can add more squeezes each week but be careful not to overdo it and remember to rest between each set. You should find that you start to notice results after a few months but make sure to carry on exercising your pelvic muscles so that you continue to benefit from it.


Be kind to yourself


While the above tips are all effective ways of helping to overcome sexual performance anxiety, it’s important to set realistic expectations for yourself.  No one else has the same body as you or experiences sex in the exact same way that you do. Being kind to yourself is perhaps the best start to overcoming your anxiety. 

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