Male Sexual Performance Anxiety And How To Overcome It

Arx Team
15 Jul 2021
Male Sexual Performance Anxiety And How To Overcome It

Image credit: Ellen Wishart

What happens when a man thinks of sex as a performance? He gets nervous, really nervous. Soon, his mind becomes filled with negative thoughts and paranoia. “Is my penis too small?” “Will I be able to perform well?” “What if my partner doesn’t like the sex?” Unfortunately, these racing thoughts often become a self-fulfilling prophecy, eventually translating into unsatisfactory sexual performance.

Performance Anxiety in Our Daily Lives 

Performance anxiety, or “stage fright”, has hit most of us at some points in our lives. Perhaps, some of you can vaguely recall being so nervous during a school play that you forgot your lines on stage. Many of us have also had butterflies in our stomachs as we fumble through an important presentation at work. Even well-trained athletes may fail to perform their best when under stress. Indeed, it’s not uncommon for humans to choke under pressure in many scenarios, and for some of us, this includes sex.

What is Sexual Performance Anxiety?

It’s normal to feel jittery about sex sometimes, especially if it’s your first time. However, to some men, sex, or even just the thought of having sex, is a persistent source of anxiety instead of pleasure. Unfortunately, the mind is a dominant force in controlling men’s sex drive and erections. Therefore, anxiety affects sexual performance. Inevitably, the dissatisfactory sexual performance calls for more panic and anxiety, which once again, becomes the bane of one’s sexual performance. As a man becomes trapped in the vicious cycle of anxiety and poor sexual performance, he despairs and may possibly abandon the idea of sex altogether. 

How Common is Sexual Performance Anxiety?

Sexual performance anxiety affects both men and women, although it is less prevalent in the latter population. According to population-representative surveys, sexual performance anxiety is more common among men, affecting about 9-25% of men while affecting only 6-16% of women. 

Symptoms of Sexual Performance Anxiety

To identify if you are suffering from sexual performance anxiety, look out for these common signs the next time you engage in sexual activities: 

  • Raised heart rate
  • Panic attacks
  • Guilt 
  • Reluctance to engage in sexual activity, or avoidance of sexual activities altogether
  • Loss of sexual desire
  • Difficulty getting aroused
  • Premature ejaculation (PE), or ejaculating faster than you and your partner desire
  • Delayed or blocked ejaculation
  • Erectile dysfunction (ED), or the long-term inability to get or maintain an erection

Causes of Sexual Performance Anxiety

A multitude of factors can contribute to sexual performance anxiety. It’s not the same for everyone, so getting an idea of what’s causing your performance anxiety is the first stepping stone towards conquering it. 

  • Poor body image
  • Worry about penis size
  • Low confidence and self-esteem
  • Negative sexual experiences in the past
  • Lack of previous sexual experience
  • Relationship conflicts
  • Fear of not being able to perform sexually
  • Worry about not being able to satisfy the partner
  • Stress 
  • Depression or anxiety disorders
  • Watching internet porn excessively (Stay tuned to our next blog article on internet porn’s effect on erectile function to find out more!)

The Science Behind Sexual Performance Anxiety

Your mind plays a big role in determining your ability to get aroused and perform well in bed. When you feel anxious or stressed over not being able to perform well, your brain sends signals to your body to release stress hormones – adrenaline and noradrenaline. These stress hormones narrow your blood vessels, including those in your penis. As a result, less blood flows into your penis, making it more difficult to achieve an erection. That’s how anxiety and stress can lead to poor or dissatisfactory sexual performance in men. 

Association with Erectile Dysfunction (ED) and Premature Ejaculation (PE)

A study in 2015 has promising evidence that points towards a connection between performance anxiety and ED, which is the persistent inability to get or sustain an erection. 

Another study that was conducted between January 2012 and January 2013 in India revealed a high rate of anxiety (70%) in patients with the acquired (secondary) form of PE. Men with the acquired (secondary) form of PE previously had normal ejaculations but later developed PE due to factors such as anxiety.

If you are suffering from ED or PE, Arx can help you with that. Connect with one of our friendly doctors here to find out more!

How to Overcome Sexual Performance Anxiety

1. Practice mindfulness

Get out of your head and get into the moment! Try shifting your focus off those negative thoughts and forget about evaluating your sexual performance. Instead, focus your attention on the pleasurable sensations that you are experiencing – touch, sight, sound, smell and taste. Enjoy the moment and focus on the pleasant emotions that you may feel, such as enjoyment, excitement and affection.   

2. Cognitive-behavioural therapy (CBT) 

This involves cognitive restructuring or changing your negative attitudes during sex and masturbation. Identify the thoughts that are causing your sexual anxiety. It can sound something like “If I don’t perform well, my partner and I won’t enjoy the sex.” Now that you are mindful of your negative thoughts, it’s time to turn those thoughts into something more positive! Write down a constructive alternate attitude, such as “As long as I focus on the pleasant sensations, feelings and experiences, my partner and I will both enjoy the sex, no matter how the performance is like.”

3. Talk to your partner

Opening up to your partner about your sexual performance anxiety can take a big weight off your mind. Perhaps, you may come to understand that your partner is in fact, very understanding, and that your worries and anxieties may have been unfounded. Talking can also strengthen the bonds between you and your partner as you try to come up with solutions together. 

4. Explore other ways of intimacy

Getting intimate doesn’t always involve penetrative sex. Try giving each other a sensual massage or taking a warm bath together. Extend your foreplay, and you may even want to try role-playing to shake things up a little!

5. Distract yourself from your negative thoughts

Taking your focus away from your sexual performance will remove the huge burden that hinders your sexual excitement. Try playing some romantic music or lighting up scented candles to set the mood. Otherwise, you can invite your partner to “Netflix and chill” with you; simply turn on a sexy movie in the background while you make love. 

6. Set realistic expectations

With internet porn being only one click away, it’s easy to get carried away and develop an unrealistic view of sex. However, keep in mind that porn is an exaggerated portrayal of sex and is vastly different from what normal sex looks like. Porn is also simply a sexual act for commercial purposes, devoid of the context of a loving relationship. Porn sets unrealistic expectations surrounding sex and your body. As such, taking lessons from porn may not be wise. Porn doesn’t give you better sex, but embracing your body does!

Our next blog article will cover porn-induced erectile dysfunction (PIED), so stay tuned for it!

7. Relaxation and meditation

Stress and anxiety in your daily life can spill over into your sexual life. While removing stressful factors from your life isn’t always possible, you can always try to cope with them! Try meditation or meditative exercises such as yoga. Remember to practice mindfulness not just under the sheets, but also as you go about your day. 

Friendly Reminder: Your Sexual Performance Doesn’t Define Your Masculinity

Your bedroom isn’t a stage, and neither are you a performer. There is no need to scrutinize and evaluate your sexual performance, which will only cause you to beat yourself up. For a happier and healthier sex life, try focusing on the things that you can do, instead of what you cannot do.


  • Pyke, R. E. (2020). Sexual Performance Anxiety. Sexual Medicine Reviews, 8(2), 183–190. 
  • Rajkumar, R. P., & Kumaran, A. K. (2015). Depression and anxiety in men with sexual dysfunction: a retrospective study. Comprehensive Psychiatry, 60, 114–118. 
  • Park, B., Wilson, G., Berger, J., Christman, M., Reina, B., Bishop, F., Klam, W., & Doan, A. (2016). Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports. Behavioral Sciences, 6(3), 17. 
  • Rajkumar, R. P., & Kumaran, A. K. (2014). The Association of Anxiety With the Subtypes of Premature Ejaculation. The Primary Care Companion For CNS Disorders. 
  • Male Sexual Performance Anxiety. National Social Anxiety Center. (n.d.).