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.
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What Is Sexual Anxiety?
Sexual anxiety is a form of anxiety that involves fear, nervousness, or worry related to sexual activity or intimacy. Sexual anxiety can be triggered by a wide range of factors, including past experiences, fear of judgment, performance pressures, body image concerns, relationship issues, and even cultural or religious beliefs about sex and intimacy.
Sexual anxiety might show up before, during, or after being intimate. For men, sexual anxiety often centers around worries about performance, while for women, it’s usually tied to concerns about pleasing their partner or feeling comfortable with being turned on.
Symptoms of Sexual Anxiety
Sexual anxiety can show up in a variety of ways—physically, emotionally, and behaviorally. Recognizing these different types of symptoms is an important first step in understanding sexual anxiety and finding ways to address it in a supportive and compassionate way.
Here are some common signs that someone is struggling with sex anxiety:
- Fear of intimacy: Fear of intimacy often looks like avoiding situations where vulnerability is required, such as deep conversations or sexual encounters. It might stem from worries about rejection, judgment, or being emotionally exposed. This fear can lead to withdrawal, emotional distancing, or difficulty forming meaningful connections with a partner.
- Self-critical thoughts: Sexual anxiety often comes with a harsh inner dialogue, including thoughts like, “I’m not attractive enough,” “I’m doing this wrong,” or “I’ll never satisfy my partner.” These self-critical thoughts can create a spiral of doubt and shame, making it hard to relax and enjoy intimacy.
- Physical symptoms of anxiety: Sexual anxiety can trigger physical symptoms like a racing heart, shortness or breath, or sweating, especially in anticipation of sexual activity. Muscle tension, including in the pelvic region, is also common and can contribute to discomfort during sex. These physical symptoms can feel overwhelming and hard to control in the moment.
- Avoidance behaviors: When anxiety about sex becomes overwhelming, some people may start avoiding intimacy or relationships altogether. Initially, this might feel protective, helping them manage fears around performance, body image, or unresolved trauma. However, over time, this avoidance can grow stronger, leading to a cycle where the person increasingly withdraws from situations involving intimacy, missing out on meaningful connections and experiences.2
- Decreased libido: Anxiety often dampens sexual desire.1 Someone with sexual anxiety might find themselves avoiding sexual thoughts or situations altogether because they trigger stress instead of excitement. This can feel frustrating, especially if you or your partner notice a significant change in your interest in intimacy.
- Overthinking performance: Overthinking performance can make sex feel like a test rather than a natural experience. Someone with sexual anxiety might obsess over whether their partner is enjoying themselves, worry about how their body looks or functions, or fixate on their ability to perform. This hyperfocus can take them out of the moment and heighten anxiety.
- Difficulty with arousal or orgasm: When anxiety takes over, it can be hard for the body to respond.1 Difficulty achieving or maintaining an erection, trouble becoming naturally lubricated, or challenges reaching orgasm are common signs. Anxiety interrupts the mind-body connection needed for pleasure.
- Low self-esteem: Low self-esteem can show up as feeling “not good enough” for one’s partner or assuming one’s partner is dissatisfied. This insecurity can create a barrier to enjoying intimacy, leaving someone with sexual anxiety constantly comparing themselves to others or questioning their worth.
- Feeling detached during sex: Detachment during sex can feel like being physically present but emotionally or mentally checked out. Someone with sexual anxiety might find themselves going through the motions without truly engaging, which can lead to frustration. This often stems from a protective response to anxiety.
- Compulsive need for reassurance: A compulsive need for reassurance might look like frequently asking, “Do you still find me attractive?” While seeking connection is normal, a constant need for validation can strain relationships and reinforce feelings of insecurity.
- Avoidance of physical touch: For some, sexual anxiety extends to avoiding physical affection altogether, like hugs, cuddles, or casual touches. This avoidance comes from associating physical closeness with the stress or pressure of intimacy. It can lead to misunderstandings or feelings of rejection in a relationship.
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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.
Here are some common reasons why someone might experience sexual anxiety:
- Body image issues: Those who struggle with body image may feel self-conscious during intimacy, leading to anxiety about being seen or judged. Concerns about weight, scars, or other perceived imperfections can take someone out of the moment, making it hard to relax. Focusing on how someone looks instead of how they feel can make intimacy a source of stress rather than connection.
- Sexual dysfunctions for either partner: Sexual dysfunction can contribute significantly to sexual anxiety. If either partner struggles with issues like low interest, arousal difficulties, or pain during sex, it often leads to worry about future encounters. For men, challenges like erectile dysfunction, inability to ejaculate, or premature ejaculation may heighten performance concerns and self-doubt. Women may experience discomfort from vaginal dryness or tension in the pelvic muscles (such as with vaginismus), creating a cycle where physical symptoms feed anxiety and fear of intimacy.3
- Performance pressure: Performance pressure is a common driver of sexual anxiety and can look different for men and women. Men may worry about maintaining an erection or lasting “long enough,” while women may feel pressure to look perfect or have an orgasm. This pressure to perform often leads to performance anxiety, where the fear of “failing” creates a cycle of stress that makes those fears more likely to come true.
- History of sexual trauma: If someone has experienced sexual trauma, it’s completely natural for that history to make intimacy feel difficult or even overwhelming at times. Traumatic memories can bring up flashbacks or unwanted thoughts, creating a sense of unease or even avoidance in new relationships. This can make it hard to feel comfortable or safe, especially when trying to embrace a new, healthy connection.4
- Relationship conflicts: When there are ongoing issues in a relationship—like frequent arguments, communication struggles, or unresolved tension—it can really affect intimacy. If you’re not feeling understood or emotionally connected, it’s normal to feel a bit guarded or even hesitant about getting close.
- A lack of sexual experience: Inexperience can leave someone feeling unsure of what to expect or how to navigate intimacy, which can quickly turn into anxiety. The fear of the unknown or the possibility of judgment can make sexual situations feel intimidating instead of enjoyable.
- Cultural or religious beliefs: Cultural or religious beliefs can shape how someone views sex, sometimes creating feelings of guilt or shame. If someone has been taught that sex is taboo or only acceptable in certain contexts, those messages can linger, even if they are internally rejected. This internal conflict can lead to anxiety, especially when one’s desires clash with the values they were raised with.
- Physical health concerns: Physical health issues, like chronic pain, hormonal imbalances, or erectile dysfunction, can create additional layers of anxiety around intimacy. Worrying about discomfort, one’s body “not cooperating,” or how one’s partner might react can make sexual activity feel more stressful than pleasurable. These concerns may also amplify feelings of inadequacy or fear of rejection.
How to Overcome 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 nine ways to overcome sexual anxiety:
1. Identify Your Triggers
The first step in coping with sexual anxiety is understanding what’s causing it. Take time to notice when and where the anxiety shows up. Are there specific situations, thoughts, or feelings that seem to set it off? Identifying these triggers helps you recognize patterns and gives you a starting point for understanding it. Awareness is empowering. It allows you to take control instead of feeling like the anxiety is running the show.
How to Identify Your Sex Anxiety Triggers
To identify your sexual anxiety triggers, try approaching your feelings with curiosity instead of judgment. Instead of thinking, “Why am I feeling this way?” with frustration, try asking yourself with genuine interest, “What might be behind this feeling?” This shift in tone can open up space for self-understanding.
For instance, maybe you’re anxious because of a fear of not being good enough, a past experience that left you feeling vulnerable, or a worry about body image. By exploring these moments with an open mind, you can start to identify specific situations, thoughts, or memories that bring up your anxiety, helping you understand your unique triggers.
2. Communicate Openly With Your Partner(s)
Talking openly about your experiences, even if it feels uncomfortable, is an essential step in reducing anxiety. Communication allows your partner to understand what triggers your anxiety, so they can support you and avoid actions that may unintentionally heighten it. Regular check-ins help ensure you’re both comfortable, making intimacy feel safer and less pressured. Building this trust can reduce anxiety, helping you both enjoy a more connected and fulfilling relationship.
3. Focus on Breathing & Grounding Techniques
When you feel anxiety creeping in during sex, grounding techniques can be a simple yet powerful way to calm your body and mind. Begin by slowing down your breathing; try inhaling deeply through your nose, holding for a moment, and then exhaling slowly through your mouth. This kind of controlled breathing activates the parasympathetic nervous system, helping to shift your body out of a stressed state.
You might also try a quick grounding exercise, like focusing on the sensation of the sheets or the weight of your body against the bed. Notice specific details: the texture, warmth, or softness beneath you. Grounding in these physical sensations pulls you into the present moment and helps quiet the anxious thoughts that may arise.
4. Challenge Negative Thoughts
Negative thoughts about your body, performance, or worth can fuel sexual anxiety, but you don’t have to believe everything your mind tells you. When these thoughts arise, try a technique like tensing and releasing your muscles. Start by clenching your fists or tightening your shoulders, then release and notice the relaxation that follows. Pair this with cognitive reframing or gently questioning the thought: Is this true? Would I say this to someone I care about?
5. Explore Masturbation
Exploring masturbation can be a gentle way to become more comfortable with your body and your own desires. It’s a private space where you can learn what feels good without any pressure, which can be incredibly empowering and can boost your sexual confidence over time. As you explore self-touch, you’re building a positive association with pleasure, which can help reduce the link between sex and anxiety.
6. Express Your Likes & Dislikes
Once you have discovered what turns you on through masturbation, communicate it openly with your sexual partner. Expressing your likes and dislikes gives you a sense of agency, which is often a key factor in reducing anxiety—knowing that you have a say in the experience. Using assertive yet gentle statements, like, “I’d like it if you would try to touch me here instead,” helps clarify your needs without fear of judgment.
7. Prioritize Intimacy Without the Pressure of Sex
One of the best ways to ease sexual anxiety is to focus on connecting with your partner, not on reaching a specific goal like intercourse or orgasm. When the focus is on simply being together and exploring what feels good for both of you, it takes the pressure off and helps you both relax. Start with small moments that emphasize connection, like holding hands, making eye contact, cuddling, or even just sitting close and talking. These moments remind you both that intimacy is about enjoying each other’s presence and that it doesn’t have to be rushed or have a set outcome.
Exploring each other’s erogenous zones can be a great way to deepen this connection. Erogenous zones—areas of the body that are sensitive to touch and can respond to gentle stimulation—offer a variety of ways to experience pleasure without the focus on intercourse.5 Each person experiences these areas differently, and common zones include the lips, ears, neck, breasts, and inner thighs. Some lesser-known but still effective areas include the scalp, inner wrists, navel, and calves.6
8. Work on Body Image & Self-Acceptance
Feeling good in your own skin can make a huge difference when it comes to easing sexual anxiety. Start by practicing self-compassion. Notice and challenge harsh judgments about your body, and remind yourself that no one’s perfect. It can also help to focus on what your body does for you rather than how it looks. Engaging in activities that make you feel joyful, relaxed, or confident, like yoga, dance, or a walk, can help you reconnect with your body.
9. Speak to a Therapist
A therapist who specializes in relationships, intimacy, or trauma can provide a safe space to explore fears and work through underlying issues. They can also help build tools for managing anxiety, improving communication, and reconnecting with your body. Search for terms like sex therapist, trauma therapist, somatic therapy, or relationship counselor. Check profiles for mentions of experience with sexual anxiety or related issues. Look for someone who feels like a good fit. Therapy works best when you feel comfortable and understood.
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How to Find Professional Support
Finding support for sexual anxiety can feel intimidating, but it doesn’t have to be complicated. A good first step is looking for a therapist who has experience with sexual health, anxiety, or relationships—someone who understands these kinds of challenges and can help you work through them. You can use a local therapist directory to narrow down options to therapists who focus on areas like sex therapy or sexual trauma. Alternatively, there are many different online therapy services that can provide a therapist with expertise in your unique concerns, including online couples therapy platforms you and your partner can explore together.
How to Support a Partner With Sexual Anxiety
When your partner is dealing with sexual anxiety, it’s natural for both of you to feel a mix of emotions. Patience and compassion are key here, as you may not fully understand what they’re going through, but showing a willingness to listen can make a big difference. Try to approach these conversations openly, without guilt or judgment, creating a safe space where they feel comfortable sharing. It’s okay if you don’t have all the answers—what matters most is your support and openness to finding solutions together.
Instead of focusing on what feels challenging, explore ways to be close that don’t involve penetration, such as holding hands, hugging, or sharing a warm embrace. These small moments of physical intimacy can build trust and ease the pressure to “perform” in any specific way. Staying present with each other—like savoring the warmth of touch, the sound of each other’s voice, or the scent of familiar cologne or perfume—can also bring you closer without added anxiety. Working through sexual anxiety together can feel intimidating, but by approaching it as a team, you can strengthen your bond and create a more meaningful, supportive relationship.
In My Experience
“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.”
Frequently Asked Questions
Why Do I Have Panic Attacks After Sex?
Panic attacks after sex can happen for several reasons, often tied to physical or emotional triggers. Intimacy can bring up vulnerability, past trauma, or unresolved feelings that your body responds to with panic. Physical factors, like hormone fluctuations or overstimulation, can also play a role. These reactions are signals that deserve compassion and exploration.
Why Does Sex Make Me Uncomfortable All of a Sudden?
Feeling uncomfortable with sex all of a sudden can stem from emotional, physical, or situational changes. Stress, shifts in your relationship, unresolved trauma, or hormonal changes can affect how you feel about intimacy. It might also reflect unmet emotional needs or a lack of safety at the moment. Explore these feelings with curiosity to help uncover the root cause.
Sexual Anxiety Infographics
Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.
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Kaplan, H. S. (1988). Anxiety and sexual dysfunction. The Journal of clinical psychiatry, 49, 21-25.
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Van Minnen, A., & Kampman, M. (2000). The interaction between anxiety and sexual functioning: A controlled study of sexual functioning in women with anxiety disorders. Sexual and Relationship Therapy, 15(1), 47-57.
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Sexual dysfunction. (2024, August 5). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/9121-sexual-dysfunction
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Avasthi, A., Grover, S., & Rao, T. S. (2017). Clinical practice guidelines for management of sexual dysfunction. Indian journal of psychiatry, 59(Suppl 1), S91-S115.
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Younis, Ihab; Fattah, Menhaabdel; Maamoun, Marwa. (2016). Female Hotspots: Extragenital Erogenous Zones. Human Andrology, 6(1), 20-26. Retrieved from https://journals.lww.com/humanandrology/pages/default.aspx
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Turnbull, O. H., Lovett, V. E., Chaldecott, J., & Lucas, M. D. (2014). Reports of intimate touch: erogenous zones and somatosensory cortical organization. Cortex; a journal devoted to the study of the nervous system and behavior, 53, 146–154. https://doi.org/10.1016/j.cortex.2013.07.010
We regularly update the articles on ChoosingTherapy.com to ensure we continue to reflect scientific consensus on the topics we cover, to incorporate new research into our articles, and to better answer our audience’s questions. When our content undergoes a significant revision, we summarize the changes that were made and the date on which they occurred. We also record the authors and medical reviewers who contributed to previous versions of the article. Read more about our editorial policies here.
Author: No Change
Reviewer: No Change
Primary Changes: Edited for readability and clarity. Added “Symptoms of Sexual Anxiety”, “ Identify Your Triggers”, “Challenge Negative Thoughts”, “Work on Body Image & Self-Acceptance”, “Speak to a Therapist”, “Why Do I Have Panic Attacks After Sex?”, and “Why Does Sex Make Me Uncomfortable All of a Sudden?”. Revised “What Causes Sexual Anxiety?” New material written by Amanda Stretcher MA, LPC-S and medically reviewed by Rajy Abulhosn, MD. Added anxiety worksheets.
Author: Tricia Johnson, LCSW
Reviewer: Kristen Fuller, MD
Primary Changes: Rewritten for readability and clarity.
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