Sexual anxiety can happen whether you’re dating someone new or if you’re in a long-term relationship. Anxiety about sex is often related to concerns about performance, worries about sexual health and conception, body image, past trauma, and relationship problems.1 Many people experience sexual anxiety, but there are ways to work through this issue, in and outside of the bedroom.
What Is Sexual Anxiety?
Sexual anxiety is a fear-based response to sex and/or intimacy. It often impedes sexual activity and can hijack a person psychologically, physiologically, and emotionally. There are many triggers for sexual anxiety and they can have an impact before, during, and after sexual activity. For men, there may be a concern about sexual performance, and for women, anxiety is often related to worries about pleasing their partner or arousal issues.
It is normal to feel some level of excitement or even nervousness before sex. Sexual anxiety is not the same as getting butterflies about having sex with a new partner or the feeling of anticipation you get when trying out a new sex toy with a long-term partner.
How Anxiety Can Get in the Way of Your Sex Life
People struggling with sexual anxiety often experience negative physical and emotional feelings, like sexual frustration. Oftentimes, this may cause negative thoughts before, during, and after sex which results in more worry or fear. When anxiety takes over, it’s often hard to be in the moment and catch the mood. Then the struggle to “get in the mood” can lead to feelings of guilt or inadequacy. Sometimes, these feelings can become so intense that someone decides to avoid them and, as a result, avoids sex altogether.
People who have been diagnosed with an anxiety disorder that is unrelated to sex and intimacy, and have been prescribed anti-anxiety medications, may be at risk of sexual anxiety due to a lowered sex drive. There are two main classes of medications prescribed to treat anxiety disorders, benzodiazepines like Valium, Xanax, and Ativan, and SSRIs (selective serotonin reuptake inhibitors) like Prozac, Zoloft, Lexapro, and Effexor.2 These medications often do wonders to help treat the symptoms of anxiety, but they often come with the side effect of lowering someone’s sex drive, along with other potential side effects like weight gain.
Symptoms of Sex Anxiety
People experiencing sexual anxiety may experience intrusive thoughts or concerns, as well as physical symptoms such as a gastrointestinal upset, a racing heartbeat, or a feeling of dread surrounding the idea of sex and/or intimacy.3 They may also be coping with sexual performance anxiety, sexual dysfunction, or sexual avoidance.
Sexual Performance Anxiety
When a person deals with stress and negative thoughts related to their ability to perform sexually, they may experience sexual performance anxiety. Feelings of inadequacy may also be complicated by penis size, body image, struggles within the relationship, and other external stressors. Sexual performance anxiety often occurs at the onset of a relationship, however, if the problem is escalating and has been occurring for longer than three months, it may be time to seek the help of a professional to rule out any medical concerns.
Sexual Dysfunction
Sexual dysfunction is an issue that prevents an individual from having an enjoyable sexual experience. It is a common, yet taboo topic, that isn’t frequently discussed and occurs during any phase of the sexual response cycle.4 The sexual response cycle includes the following phases: excitement, plateau, orgasm, and resolution. These phases include both arousal and desire and it’s important to clarify that women don’t always follow these phases in exact order.
The four main types of sexual dysfunction are desire disorders, arousal disorders, orgasm disorders, and pain disorders.4 Both men and women may experience a lack of interest in sex, difficulty with arousal, and pain with intercourse. There are also symptoms that are only present in men, which may include difficulty getting and keeping an erection, inability to ejaculate, or premature ejaculation. Some symptoms that are only relevant for women are an inability to orgasm, vaginal dryness before and during intercourse, and an inability to relax the vaginal muscles during intercourse (vaginismus).3
Sexual dysfunction can be caused by many different physical reasons (medical issues, alcohol misuse, drug use, or certain prescription medications) or psychological reasons (stress, depression, anxiety, or trauma).4 It’s important to always work with a medical professional to discover the cause of any sexual issues and determine the best method of treatment.
Sexual Avoidance
When fear and worry about sex lead to extreme levels of anxiety, many people may shy away from dating, intimacy, relationships, and sex. This may start as a protective mechanism but can snowball into the more extreme sexual avoidance, where individuals evade sex in order to avoid experiencing any feelings of discomfort related to body image, performance, or past trauma.5 Through the use of professional anxiety-reducing treatments, sexual avoidance behaviors can be targeted and addressed.
What Causes Sexual Anxiety?
There are many different causes of sexual anxiety and they typically differ from person to person. Individuals struggling with mental health concerns, trauma, and various relationship issues may see an increase in anxiety about sex. In addition, anxiety is often cyclical, and people tend to have difficulty controlling feelings of worry.1
Mental Health Concerns
Mental health factors have a huge impact on quality of life. For many people, body image and being self-conscious about the way they look can impede their self-esteem and confidence when attempting to be intimate with a partner. In addition, high levels of work, family, or life stress and anxiety can also cause problems in the bedroom. Fortunately, talking to a professional about these areas of concern can have a positive impact on mental health. In addition, making healthy life changes, such as ensuring a good night’s sleep, eating nutritious and balanced meals, and exercising can all improve mental health.
Previous Traumatic Experiences
When people enter into a relationship with a history of sexual trauma, they often have trouble normalizing any sexual experience. Past traumatic experiences and relationship PTSD may cause flashbacks, intrusive memories, or avoidance in new intimate relationships.3 Through the development of a solid therapeutic relationship, a survivor of trauma is able to process the traumatic event and then learn skills to cope with anxiety-inducing events and stress.
Relationship Issues
Relationship issues can also impact intimacy. Some of the things that are important to look out for are problems with or lack of communication in a relationship, which may include an increase in fighting or arguing without resolution, a fear of intimacy, and compatibility issues. Communication is key with all of these factors. It may feel a bit overwhelming to broach the topic with your significant other, but keeping these issues bottled up may actually increase the feelings of anxiety. Couples therapy is an option to help rebuild a connection and improve the relationship.
How to Identify Your Sex Anxiety Triggers
To start identifying your sexual anxiety triggers, try to get curious about what you’re feeling without blame or judgment. Make note of when the feelings appear and then try back-tracking to determine the cause. Perhaps it starts with a stressful day at work where you feel underappreciated and then it gets carried into the bedroom. It could also stem from a specific memory that is triggered from your past. After you determine your triggers, it’s important to talk with your partner. Openly share what you’re experiencing and how you believe you can best be supported.
7 Tips for Coping With Sexual Anxiety
While it can seem overwhelming to have to face sexual anxiety, there are several techniques you can use to help overcome those feelings. It’s important to be honest with yourself and your partner about your anxiety—trying to bottle it up may ultimately lead to more avoidance.
Here are seven ways to overcome sex anxiety:
1. Practice Mindfulness
Rather than paying attention to the feelings of anxiety, fear, or worry that come to mind, try grounding yourself through focusing on your breath or on other physical sensations.
2. Focus on Self-Touch/Masturbation
Exploring self-touch can lead to feelings of empowerment and can strengthen the libido.6 This may help decrease the association between sex and anxiety and help to increase feelings of positivity toward sex.
3. Express Your Likes & Dislikes
Once you have discovered what turns you on through self-touch, share what you’ve learned with your partner with open, assertive communication. This can be done through statements like, “I’d like it if you would try to touch me here instead.”
4. Reduce Your Stress
If you’re noticing increased feelings of stress in the rest of your life, in addition to sexual anxiety, it may be helpful to pay attention to the source of these stressful feelings. Try to ensure that you’re getting enough sleep each night, eating nutritional meals, and exercising regularly to help manage your life stress. In doing so, you may notice that anxiety in all aspects of your life feels more manageable.
5. Prioritize Connection With Your Partner
The most important aspect of sexual intimacy is connecting with your partner. The end goal is not necessarily sexual intercourse or orgasm, but rather, building a safe and intimate relationship with a focus on exploration.
6. Communicate
Regardless of how difficult or uncomfortable it may feel, it’s important to verbalize what you’re experiencing. It’s valuable to share what you’re going through with your partner, how your needs and preferences have changed, and find solutions that feel good for both of you. Healthy communication about sex will require frequent check-ins to make sure that you’re both on the same page, and continuing to work toward the same goals.
7. Focus on Erogenous Zones & Intimacy Without the Pressure of Sex
Erogenous zones are areas of the body that are sensitive to touch and can be stimulated to arousal. According to a study, 12% of women can orgasm from stimulation of nongenital erogenous zones.7 There are many different erogenous zones and everyone experiences them differently. Some of the more common erogenous zones are the lips, ears, neck, breasts, and inner thighs. Some that aren’t quite as popular, but still effective are the scalp, the inner wrist, the navel, and the calves.8 To stimulate the erogenous zones, there are many options–gentle caressing, blowing on the area, using the tongue and mouth, or incorporating sex toys to stimulate the area.
Getting Professional Help for Sex Anxiety
If you have tried these techniques or have experienced a traumatic event and are still experiencing anxiety, it may be time to speak with a professional. A good first step is to speak with your doctor to rule out a medical condition or a medication side effect. Another option is sex therapy to explore the sexual concerns in the relationship. An alternative is sex therapy with sensate focus, which is a straightforward and effective way to increase intimacy and connection between a couple through structured touching exercises. Seeking help from a professional can be a vulnerable, but also very rewarding experience.
How to Support a Partner With Sexual Anxiety
When a partner is experiencing sexual anxiety, it can bring up a variety of fears and emotions on both sides. It’s important to practice patience and offer compassion. You may not exactly understand what your partner is going through, but practice being willing to listen to work together and come up with solutions. Open and honest communication, without guilt, shame or judgment will also help create a safe environment that fosters intimacy.
As you begin to navigate sexual anxiety, focus on doing what feels best. There are a variety of ways to be physically intimate that do not involve penetration, like hand holding, hugs, kisses, and caresses. Instead of getting caught up in fears or worries, couples can also try staying in the present moment with one another by tuning into their sense of touch, smell, and hearing. Moving past sexual anxiety in a relationship can feel like a daunting task, but when addressed together, it can be a way to strengthen and solidify a relationship.
Final Thoughts
Sexual anxiety can be difficult to overcome in a relationship, but through open communication and honesty, it can be managed. Relationships are about fostering a connection with one another and this can be done by placing a priority on creating a safe and nurturing intimate partnership. Taking the fear and anxiety out of sex through focusing on connection and intimacy will help create a safe and pleasurable experience.
For Further Reading
- Anxiety and Depression Association of America: Various resources available to help learn to manage life with anxiety
- National Coalition for Sexual Health: Various resources available related to sexual wellness and sexuality
- National Institute of Mental Health: Studies, statistics, and resources available for anxiety and other mental illnesses.
Sexual Anxiety Infographics
