- Feeling anxious during sex is incredibly common and valid.
- This can be a result of poor body image, a hyperfocus on your partner, or prior bad experiences.
When you think of performance anxiety, you might think of tests or talent shows, but this fear is also common during sex. In fact, up to 25% of men and 16% of women experience sexual performance anxiety.
Performance anxiety manifests during sexual encounters as a worry about what your partner will think of your performance. For example, people may be afraid of not getting an erection or experiencing lubrication, says Jennifer Litner, a sexologist and the founder of sex therapy practice Embrace Sexual Wellness.
But other anxieties, like worrying how your body appears to your partner, can be part of performance anxiety, too.
If you're experiencing performance anxiety during sex, here's some things that could be causing it, as well as some information on how it can be treated.
1. Poor body image
Not feeling great about your body can make it hard to have a great time during sex, says Lena Elkhatib, a licensed marriage and family therapist, certified sex therapist, and founder of Essentia Therapy.
After all, being naked and vulnerable with someone is hard even when you feel great about how you look.
Moreover, if you're preoccupied with what you look like, you're probably not focused on the sensations of sex. "It really takes us out of the experience of, what are the feelings in my body, which is what we want to be focused on," says Rachel Zar, a licensed marriage and family therapist and certified sex therapist who practices at Spark Chicago Therapy.
As a result, it might take you a longer time to orgasm – which might make you even more self-conscious, fueling performance anxiety.
How to overcome it: Working towards body acceptance is a difficult, but empowering way to reconnect with your body. In practice, this can look like:
- Re-evaluating your relationship with food and movement: Societal bias and weight stigma has taught us to demonize food and overly celebrate exercise. Neutralizing or accepting your relationship with food and movement can help you to be kinder to yourself and celebrate all that your body does for you each day.
- Incorporating joyful movement: We often associate the word "movement" with exercise, but fun movements like dancing, walking, or even cleaning can encourage more positive feelings about your body.
- Visit a boudoir photographer: Taking photos of your body that you feel good about can encourage you to channel that version of your body image in the bedroom.
2. Feeling disconnected from your partner
Sometimes, you might feel distant from a sexual partner because you don't know them very well. But even if you're having sex with a long-term significant other, you could feel disconnected if you've recently had an argument or spent some time apart.
This disconnection could make your mind wander during sex, giving anxiety a space to creep in, Zar says. Moreover, if you're feeling distant from your partner(s), your brain is more likely to kick into "performance mode," triggering performance anxiety.
"Sometimes, you need some time to reconnect to a partner before you're able to reconnect sexually," Zar says. "After all, sex is a really vulnerable thing to do with someone."
How to overcome it: The best thing to do is talk to your partner about what's bothering you, Zar says.
She also recommends focusing on foreplay – not just in bed, but also in the hours or days leading up to sex. That might include touching or kissing each other throughout the day, or cuddling on the couch.
Foreplay gives you an opportunity to reconnect with your partner without rushing straight into sex, and it promotes intimacy.
For many, establishing emotional intimacy increases sexual energy. Some ways to increase emotional intimacy include:
- Vulnerable conversations that spark more curosity about one another
- Games like TableTopics, Where Should We Begin, or The Gottman Insititute's Card Deck App
- Scheduling time for emotional intimacy
- Going on fun adventures together
- Creating and sticking with a regular habit of dating each other
3. Negative beliefs or shame about sex
One of the most common causes of performance anxiety is negative beliefs about sex, Elkhatib says. For instance, if you were taught as a kid that sex is bad or dirty, you might feel ashamed about engaging in sexual behaviors.
This shame, in turn, might make you worry about how your partner(s) perceive you or feel about your sexual encounters.
"Shame is not a sexy feeling," Zar says. "If you think that something you're doing is shameful, you may be easily embarrassed by it or monitor your actions or responses."
How to overcome it: Attending therapy with a sex-affirming mental health professional is one key way to dismantle sexual shame.
In particular, a therapist can work to help you understand what messages have led you to feel ashamed about your sexuality, Elkhatib says. You can then start to replace those narratives with more sex-positive thoughts.
Sex positive literature can help correct negative sexual beliefs. If your negative thoughts stem from a religious background, you can usually find books that can be helpful. "Come As You Are" by Emily Nagiski could be helpful to everyone.
4. Focusing too much on you partner during sex
We tend to think that being tuned in to our partners' desires during sex is a good thing, but if you focus on your partner(s) to the detriment of your own pleasure, it can cause performance anxiety.
For instance, if you're super dialed in to your partner(s), you may notice if they sigh or glance away from you – potentially meaningless signs that may make you worry they're not enjoying themselves.
Focusing too much on your partner can also be tied into messaging we've been taught about sex, Elkhatib says.
For example, if you were raised in an environment where you were told sex is a duty you must perform to please your partner(s), that could lead you to solely focus on your partner's pleasure during sex – and it could incite performance anxiety as you worry what might happen if you don't satisfy them.
How to overcome it: Treating this kind of performance anxiety is all about learning to focus on yourself. That might include exercises like masturbating to relearn what feels good in your body or practicing having sex with your partner where you're the center of attention.
For instance, Elkhatib says you might have sex with your partner(s) where you're not allowed to give pleasure to them: they're only allowed to pleasure you.
If past lessons about sex have contributed to your desire to focus on a partner, then examining the source of those beliefs can be helpful too, Elkhatib says.
Focusing on other forms of bodily pleasure that aren't sex can also shift your focus: Such as how you eat your food, shower, listen to music, or move during walks.
Mindfulness training is a great way to defeat performance anxiety, Zar says. In mindfulness training, you focus on how your body feels instead of focusing on your anxiety. This can help bring you back into your body so you can enjoy sex more.
According to Zar, a few ways you can practice sexual mindfulness include:
- Focus on the sensation of your partner touching you. For instance, if your partner touches your thigh, instead of worrying about what they think about the size of your legs, try to focus on the sensation of someone touching you on a sensitive part of your body.
- Focus on your breathing. Breathing exercises can help bring you back into your body if you're having distracting thoughts.
- Do pelvic floor exercises, like kegels. This can increase blood flow towards your genitals, which can help you improve sensation, and it can also help you direct your focus towards the feelings in your body instead of your anxieties.
Mindfulness can be hard at first, but you can practice it in non-sexual situations, such as at the gym or nail salon, before applying the technique in the bedroom, says Zar.
5. Physical hurdles
If something has changed in your life so that you're not functioning sexually in the way that you used to, that can cause performance anxiety, Zar says.
For example, if you're no longer able to consistently achieve an erection – something that happens to many men as they age – you may develop anxiety, wondering if you'll be able to perform as you'd like to the next time you have sex.
This may also happen if you experience
- A lack of ability to orgasm because of taking medications like antidepressants
- An injury or condition that impacts your sex organs
- Other physical health conditions, such as heart disease or diabetes, that can impact erectile and orgasmic functioning
How to overcome it: Depending on the cause of the changes, you may be able to work with a primary care physician or a psychiatrist to manage your symptoms, says Litner. For instance, antidepressants can often affect your libido or ability to achieve orgasm. Your psychiatrist may be able to reduce your dosage or change your meds to alleviate these symptoms.
Even if the physical changes don't abate, you can still manage your performance anxiety by changing how you approach sexual encounters. Litner suggests shifting from a performance-based mindset, which relies on a specific outcome being achieved, to a pleasure-based mindset, in which it's the enjoyment of yourself and your partner that matters. Studies have shown that mindfulness training can help with this.
Working with a sex therapist that's specifically focused on people with disabilities can also be helpful. Sex therapists can validate the different, yet equally important challenges that folks with disabilities face when it comes to sex.
6. Past negative experience with a partner
If someone has negatively commented on your sexual performance in the past, that can make you anxious about future sexual encounters.
"A lot of times we see this show up if somebody says something that is more of a rigid comment," Litner says. "'How come you're not hard?' or, 'How come you're not having an orgasm?'"
Even small comments made by well-meaning partners can cause performance anxiety, Litner says.
How to overcome it: Treatment will depend on the severity of the past negative experience, Litner says. If the experience was traumatic or took place during a formative period in someone's life, trauma-based therapies can be effective. In other cases, psychotherapies like cognitive behavioral therapy and narrative-based therapy can be used.
Important: Though people tend to think of performance anxiety as a personal problem, it's actually a relational issue, Elkhatib says. That's because a partner who's anxious might change their behavior in certain ways, like avoiding sex, the create self-doubt and anxiety in their significant other(s). As such, it's important to address any issues about performance anxiety together.
Insider's takeaway
Performance anxiety during sex is very common, and can be caused by poor body image, feeling disconnected from your partner(s), or changes in your sexual functioning. Treatment for performance anxiety depends on what is causing it, but a combination of therapy and mindfulness exercises are often effective.
Remember, even if you're never able to totally eliminate your anxiety around sex, that doesn't mean your sex life is over. "Intimacy does not mean sex, and sex doesn't mean intercourse," Elkhatib says. "The more that people can broaden their library of intimacy… the less pressure there will be to look and feel a certain way."