Sexual performance anxiety: How to break the cycle

Wanting to last as long as possible in the bedroom is just as common as experiencing sexual performance anxiety.

Written by
Lucinda Starr
Medically reviewed by
Last updated
September 3, 2024
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Sexual performance anxiety: How to break the cycle
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Wanting to last as long as possible in the bedroom is a common goal for many blokes. But it's also pretty common to experience sexual performance anxiety.

From feeling anxious to experiencing poor body image and being unable to focus on your sexual partner, sexual performance anxiety can have many symptoms, including erectile dysfunction (ED) and premature ejaculation (PE).

But how can you tell if you have performance anxiety, erectile dysfunction, or premature ejaculation?

Let's break down the differences and take a look at some reasons you might experience performance anxiety in the bedroom (as well as explore the most effective ways to overcome performance anxiety).

What is performance anxiety?

Experiencing sexual performance anxiety might feel a bit like waves of fear washing over you right when things are about to get hot. While this definitely isn't ideal in this situation, it's pretty common, and not just for the blokes.

First up, it's important to call out that performance anxiety in the bedroom is totally normal. It can often manifest in ways that could be considered medical conditions, such as with symptoms like erectile dysfunction or premature ejaculation.

It might be helpful to know that just because performance anxiety may lead to these conditions, it doesn't necessarily mean you're suffering from a medical condition.

Sexual performance anxiety is often more about mindset than it is about any physical condition. Overthinking can lead to feeling tense, overly self-critical, and self-conscious, right when you should be at the peak of sexual desire.

Another reason might be that when we're in the middle of sexual activity, we're thinking about our partner's pleasure as much as ours, if not more. And while that can be a great thing (especially for your partner) it can feel like the pressure is on you to perform well and make sure you both get over the finish line.

This can make us feel anxious and end up in distracting thoughts that take us out of the moment.

What can cause sexual performance anxiety?

Sexual anxiety is relatively common, affecting up to 25% of men [1]. If you've ever experienced any feelings of fear or anxiety during sexual activity, it's normal to be wondering why.

There are a lot of factors behind why you might be feeling sexual performance anxiety, and it's interesting to note that they might not always be related to your sex life.

Feeling stressed about work? Is your to-do list nagging at you? Worried about a relationship with a friend or family member? Or just not really feeling your body right now?

All of these things are related to things outside of the bedroom, but can potentially affect your performance in the bedroom.

Anxiety is an underlying condition that also often leads to sexual dysfunction [2]. While it's common to experience negative thoughts or feel self-conscious if these feelings of fear, stress and anxiety pop up in other aspects of your life, it might be time to seek the guidance of a healthcare professional.

Sexual performance anxiety and erectile dysfunction

Sexual performance anxiety and erectile dysfunction can both make it difficult to get it up and keep it hard. But what's the difference? Erectile dysfunction (ED) is a medical condition that limits the physical ability to get or maintain an erection.

While these things often feel and look the same, they are 2 different conditions. Let's take a closer look at ED.

It's estimated that ED affects 1 in 5 men over the age of 40 [3], and 1 in 10 men will experience ED on a long-term basis. But what exactly makes ED different to sexual performance anxiety?

Some causes of ED are psychological and some are physical. The physical causes include [4][5]:

  • General ageing
  • Complications to do with blood vessels
  • Decreased blood flow
  • Testosterone deficiency
  • Nerve damage

And it's not just physical conditions that can lead to ED. Studies have shown that men with alcohol dependence have a 60-70% chance of having sexual dysfunction [6], and certain medications can also make it tricky to get it up. Even recreational drugs can impact erections [7].

As you can see, there are a ton of reasons why you might be experiencing symptoms of sexual dysfunction. As it can be hard to tell the difference between sexual performance anxiety and ED, it's best to talk to a healthcare provider to get to the root cause and discuss treatment options that might be right for you.

Sexual performance anxiety and premature ejaculation

We've discussed the symptoms and causes of sexual performance anxiety and ED, but what about premature ejaculation (PE)?

PE is when you experience trouble controlling when you orgasm or ejaculate at a time that seems too soon for you (or your partner). But this is where it gets a little tricky because there's actually no way to quantify what's 'too soon.'

Men go a long way to try to distract themselves and last as long as possible in bed. But it's easy to end up finishing before you want to. If you're climaxing during foreplay or right at the moment of insertion, it can be frustrating, but it's not uncommon.

So what causes PE? First of all, we need to look at the 2 different types of PE: lifelong PE and acquired PE [8].

Lifelong is fairly self-explanatory: it's when a man has experienced PE for as long as he's been sexually active. Acquired PE, on the other hand, is when the problem arises after having previous sexual experiences without PE.

But why does it happen? Like any sexual dysfunction, the list of possible reasons is pretty extensive.

Acquired PE might be caused by things like relationship problems [9]. And it's most commonly experienced alongside feelings of performance anxiety as well as general anxiety [10].

Lifelong PE might also be affected by performance anxiety or sexual dysfunctions linked to traumatic experiences, or it might just be biological, relating to genetic and epigenetic causes [11].

Again, because it can seem so similar to sexual performance anxiety, it's best to seek some professional medical guidance to find out what's really going on with your erections.

How do you know if you have sexual performance anxiety?

Sexual performance anxiety, erectile dysfunction, and premature ejaculation can manifest in so many ways. That means it can be pretty hard to know why you're experiencing any difficulties around getting it up, keeping it there, or shooting too soon.

Next time you're in this situation, take a moment and see where your mind goes. Is it consumed by negative thoughts, feelings of fear, or just having trouble focusing on the task at hand? If that's the case, you might be experiencing sexual performance anxiety.

Is sexual performance anxiety normal?

It's perfectly normal to experience this at some point, and the good news is that with the right guidance, you'll be feeling like yourself again.

Sure, experiencing any type of sexual dysfunction can seem embarrassing. But knowing that you're not alone is the first step in getting things back on track.

Once you've realised that it's normal, and doesn't have to last. Overcoming sexual performance anxiety can seem daunting, but knowing you're not alone can be helpful.

How to treat performance anxiety in the bedroom

Think you're experiencing performance anxiety? You might be wondering how you go about treating sexual performance anxiety, let's dive in.

Firstly, you need to find out why you're experiencing sexual dysfunction. Is it related to psychological factors, or is it a physical response?

Sexual performance anxiety treatment can take many forms, from medication to mindfulness, meditation, training, and stress management.

Cognitive behavioural therapy is also often recommended as it helps to develop the relationship between mind, body, emotions, and behaviour. This is a great way to work through how your feelings are relating to your physical reactions and help you replace your negative thoughts with some spicier ones.

It can be tricky, but it's important to talk. Prioritise open communication with your partner, it's more likely than not that they'll be understanding.

Alternatively, seeking guidance from a therapist is a great way to talk through any underlying emotions that could be contributing.

How to treat physical responses to performance anxiety

While erectile dysfunction and premature ejaculation are separate medical conditions that require different medical treatments, it's easy to confuse them both with performance anxiety, as all 3 share common symptoms.

Again, finding the root cause behind any sexual dysfunction is critical to proper treatment. However, there are specific ways to treat the physical responses of sexual dysfunction conditions.

Seeking help and talking to your doctor is a great place to start, but it can be challenging to work up the courage. Pilot offers an online consultation with an Aussie practitioner so that you can get the medication you need without those awkward GP visits.

At Pilot, we offer medical treatments that can be specifically tailored to erectile dysfunction or premature ejaculation.

And if you want to learn more about the mind-body connection of erections and orgasms or just want to level up your bedroom game (who doesn't), Pilot's Last Longer Program will have you lasting longer and living your best (sex) life.

Ultimately, we know how difficult it is to experience sexual dysfunction, but overthinking and having feelings of anxiety in the bedroom is totally normal.

Luckily, there are a lot of treatment options, from lifestyle changes to medication, that will help you get your game back in the bedroom.

Image credit: Getty Images

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