Why Sexual Performance Anxiety Happens — And How to Finally Break the Cycle

8 minute read

Losing your erection, struggling to get wet, or feeling your mind spiral into panic during sex, can feel so lonely. But it’s an experience you share with millions around the world — sexual performance anxiety.

As a sex therapist, I’ve helped countless people break the cycle.

One of the most important pieces to doing this is understanding why it’s happening in the first place. Because when we feel like we’re failing in bed, or like something is physically wrong, it increases pressure (and also the likelihood that it will happen again – arguably one of the worst parts of performance anxiety).

I interviewed Dr. David Rowland & Dr. Evie Kirana — leading researchers and clinicians in sexual function — about sexual performance anxiety, why it happens, and what actually helps.

And the good news, is that it’s far more fixable than you think.

This article is based on this paper from Sexual Medicine Reviews.

Prefer to listen instead? Listen to the podcast episodes from In Bed with Science: a Sex Podcast, below.

What Sexual Performance Anxiety Actually Is

Sexual performance anxiety is what happens when you get so worried about how you’re performing — getting hard, staying hard, lasting long enough, pleasing your partner — that your body shuts down the very things needed for sex to be pleasurable.

Because when your brain senses threat, even imagined threat, like “I hope I don’t lose it again”, your body prioritises survival over pleasure. Your heart rate shifts, your breathing changes and blood effectively flows away from the genitals.

And arousal needs blood flow to occur.

Even if it feels like your body is working against you — it isn’t. It’s just trying to protect you. An annoying neurobiological truth.

Sex requires:

• Relaxation
• Safety
• Openness
• Mental presence
• Connection to touch and sensation

Anxiety requires the opposite:

• Hypervigilance
• Self-monitoring
• Evaluation
• Prediction
• Scanning for threats

So if you’re stuck in thoughts like “Is it working?” or “Am I hard enough?” or “Are they losing interest?” — you’re in evaluation mode. And evaluation mode switches off desire.

The Spiral: How Worry Turns Into a Self-Fulfilling Prophecy

One of the worst parts of sexual performance anxiety is that the more you worry it will happen — the likelier it will. Essentially, you get stuck in a trap. You worry you’ll lose your erection or feel less aroused, so you panic. When you panic your brain locks onto the fear of it happening again.

That fear then increases anxiety ahead of your next sexual encounter. And because anxiety decreases arousal — the very thing you feared — happens again

Not because something is wrong with you — but because your nervous system is learning in real time. The same one that evolved to protect you from a tiger, is getting involved in something it really needn’t be.

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Why “Trying Harder” Makes It Worse

Most of us respond to performance anxiety by trying harder. We put more pressure on ourselves, hoping that will push our body to do what we want it to.

We push our anxiety down, hide it, rush through sex, or wait desperately for our erection to come back.

But the harder we try, the more we veer into the same mental territory that kills desire and arousal. Just like trying to fall asleep by concentrating on falling asleep — the harder we try — the more impossible it becomes.

Performance anxiety resolves when the pressure decreases, not when the effort increases.

How to Overcome Performance Anxiety (Science-Backed Steps That Help)

1. Allow the Anxiety (Instead of Trying to Get Rid of It)

I get it, this is the opposite of what most of us want to hear. Anxiety feels truly awful. But it’s the first step to stopping the vicious cycle.

Because when anxiety shows up, your job isn’t to calm down or get it together. It’s to simply let the anxiety be — without fighting it or expecting your arousal to magically fix itself while you’re anxious.

When you accept it, you’re effectively telling your nervous system that it’s safe. There is no tiger anymore. And it can more easily shift out of anxiety and into arousal again.

2. Slow Everything Down

When anxiety hits, adrenaline speeds everything up. Your thoughts start racing a million miles an hour. Your heartbeat feels like the beat at a rave, and the pace of sex can become lightning fast.

A common trap we fall into then is to think “Quick, I’m getting hard, let’s go before I lose it”. And it makes complete sense, right?

But the actual route to getting your erection to stick around is slowing everything down. This counteracts the biological rush and teaches your body and brain you’re safe. With more safety, you can experience more arousal.

3. Shift Your Attention Back to Your Senses

This is one of the most powerful tools out there, and I use it with my clients in sex therapy and sex coaching all of the time.

By focusing on your senses, you’re bringing your attention out of evaluation mode — and into your body. When you can tap into how someone feels on your lips, the warmth of their skin, the weight of their body — you anchor yourself to the moment.

And desire and arousal need that presence to thrive.

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4. Replace Performance Goals With Connection Goals

Kirana & Rowland’s clinical model also focuses on “Connection goals” as a way to beat the anxiety.

Common performance goals are the need to stay hard, to satisfy our partner, or to orgasm. Whereas a connection goal is more about feeling in sync with your partner, experiencing the moment as fully as you can no matter what happens, or staying present.

When you focus on the connection piece — with your partner and yourself — it lowers that pesky pressure and ironically, helps you reach those old performance goals more easily.

5. Practice Transparency (Instead of Hiding)

When we experience performance anxiety our gut reaction is often to hide it. Because it feels shameful and like something is really wrong. But the hiding makes it so much worse.

Sharing with your sex partner(s) that you sometimes get in your head and that if you lose your arousal, they should know you’re working on it and it’s not them — can help.

This works, because you’re eliminating the fear of being “found out” during sex. An attuned, understanding sex partner, also reduces the shame. And it all increases connection — signalling safety. And, (say it with me again), safety is required for arousal.

6. Focus on Touch That Doesn’t Require an Erection

Choosing forms of connection where nothing is “expected” of your genitals is often a crucial part of moving past performance anxiety. And, as with everything else, it usually feels like the opposite of what you want to do in the moment.

Our culture is heavily focused on bodily arousal. Especially for those with penises, an erection feels like an essential part that needs to work right away, or else sex is off the table entirely.

But broadening your view of pleasure and focusing on the other stuff that feels good — can break the negative pattern. And, in the long term, enhance your sex life. Because our genitals are only one of many, many erogenous zones. When we focus solely on our erection we forget that there is so much else that can feel good.

And over time, this willingness to let your erection happen or not resets your body’s associations with sex.

It no longer thinks of sex as a “test” to see if you can get hard or come. It views sex as devoid of pressure – which is what arousal and pleasure need to occur.

Completely Normal And Completely Reversible

Sexual performance anxiety often feels like a complete failure. But it isn’t — it’s common and it’s not a sign things are permanently wrong.

Once you understand how (and why) anxiety hijacks arousal — and learn how to lower the pressure instead of increasing it — your body can do what it usually did so easily.

And if you want professional, tailored support for your specific difficulties, my 1:1 coaching program Re:Desire is open for enrollment.

Based on my Master of Science in Sexology, and nearly a decade of experience, it’s designed to help you want and enjoy sex without pressure, anxiety, or the fear of “not performing.”

Because your body isn’t broken. It just needs to feel safe again.