Ultimate Guide to Sexual Performance Anxiety for Men

Feeling anxious about preforming in the bedroom? Experiencing erectile dysfunction or premature ejaculation and unsure why it may be occurring? This guide to sexual performance anxiety will tell you what is, why it occurs, how its linked to ED and PE, and how you can overcome it to get back to a fulfilling sex life.

Has this happened to you?

You're about to get hot and heavy with a gorgeous woman, you're excited, your mind is racing, and all the sudden a little thought pops into your head…

“Oh god, I hope I stay hard this time!”

Or

“Please, please, please don’t cum to quickly”

And then your self-fulling prophecy is realized… You go soft or you cum too quickly.

You feel a metric ton of shame hit you like a semi truck as you see her beautiful eyes staring at you and disappointment on her face. In that moment you feel as if you could curl up into a ball and die.

It’s ok, brother. I’ve been there, too. Many times. 

Good news is, nothing is wrong with you. You’re still a man. There is a way to overcome this problem and enjoy a fulfilling sex life.

You need to address your Sexual Performance Anxiety.

What is sexual performance anxiety?

Sexual performance anxiety is a form of performance anxiety where you anticipate not being able to perform in bed the way you would like (either staying erect the entire time or lasting as long as you think you should). The anxiety is induced by fears and worries of humiliation, embarrassment, or shame but also involves the fear of rejection and how “failure” might impact your future sex life.

Before we continue, I want you to know that although the technical term for this phenomenon is “performance” anxiety, calling sex a performance is actually part of the problem. When we think we must perform, we put pressure on ourselves to perform at our best, and this extra pressure further induces our anxiety. When we get to how to overcome this later in the article, we’ll reframe this and stop viewing it as a performance.

Is sexual performance anxiety common?

Absolutely. You are not alone.

There is evidence to suggest that over half of the male population (52%) has erectile dysfunction. All of those men struggling with psychological ED issues will have sexual performance anxiety. Research reveals that up to 1 in every 4 men (25%) experience performance anxiety sexually.

However, those are only figures from the men who spoke up about it. Many find the topic taboo, or worse, shameful and I wouldn’t be surprised if the number of people suffering was even higher than the figures suggest.

Anecdotally, I have personally struggled with sexual performance anxiety from time to time over many years. I’ve learned that it shows up depending on how I am focusing and treating sexual interactions in my life. If my mindset is good, everything works great and I last as long as I’d like. If my mindset is poor, it will present both as erectile dysfunction and premature ejaculation. 

Sexual performance anxiety symptoms

Sexual performance anxiety can be a sneaky dragon because it can show up differently for each person. It may show up as erectile dysfunction, premature ejaculation, or a low libido which can lead to a vicious cycle causing further anxiety about the situation. Here’s a list of what may come up for you.

Erectile dysfunction

Sexual performance anxiety and erectile dysfunction (ED) are very closely linked.

In order to obtain an erection and keep an erection, your body must be relaxed, or in the parasympathetic state, which encourages blood flow to your groin.

However, if you have anxiety about how you’ll perform sexually, your body will enter a sympathetic state, or better known as fight, flight, or freeze mode. Your body believes it’s in danger, so it directs blood flow away from body parts less vital to your survival. Your reproductive system is on the less vital list at that moment, meaning goodbye erection.

This occurrence can create a nasty feedback loop where if you're unable to get an erection on one occasion you deem really important (say the first night with a hot girl), you might start to overthink your future performance, leading to subsequent and longer term erection issues.

Premature ejaculation 

First off, the amount of time that you think you should last is subjective to you and your partner. The amount of time that woman would like to have intercourse with you before you ejaculate can vary widely. Furthermore, not every interaction you have with that same woman will be all night long sexcapades. There’s really no right or wrong timeframe to cum if you both are left satisfied. 

In order to ejaculate, your body actually enters momentarily into the sympathetic state (fight, fight, or freeze) and causes muscles to contract. In our pelvis, we have what is called the pubococcygeus (PC) muscle which rapidly contracts and tightens causing us orgasm. 

When you get so caught up in “lasting a long time” that you get anxious about your performance, you can get so panicked that you wind up losing control of this PC muscle and contracting your body, and this can lead to rapid ejaculation.

The other scenario is if you’re worried about losing your erection, you can really rush things to try to make the most of it while it’s still there. This can result in hurrying through foreplay, getting to penetration as quickly as possible, and then ultimately cumming quicker than you’d like.

Premature ejaculation can also have a nasty feedback loop. If you cum too quickly one time, this can lead to sexual performance anxiety, and lead you to overthink your ejaculation every time in the future.

Spectatoring

When you start focusing so much on yourself and your performance, you lose awareness of the sensations in your body and of your partner. All you can think about is if you will stay erect or if you’ll last long enough. You’re completely in your head and disassociated from the pleasure in your body or what your partner is experiencing.This is known as spectatoring.

This obviously takes you straight into anxiety and fight or flight, and away from all the actual enjoyment of sex. As a result, you enter into the ED or PE loop described above.

Decreased sexual desire (and avoiding sex)

By no surprise, if you have anxiety every time you have sex, you might find that you don’t look forward to sex anymore. In fact, lots of men who feel anxiety about sexual performance end up dreading sex altogether. You may even go as far as sabotaging opportunities to have sex in order to not feel the negative emotions associated with when you have bad outcomes.

Loud Inner Critic

When you get sexual performance anxiety, it seems like the little voice in your head starts screaming at you some really terrible, unhelpful, and untrue things about yourself. You know the thoughts: “You’re a failure. You’re not a man. She’s going to leave..” On and on it goes. Your inner critic is there to point out every flaw you have so you will fix the problem, which is going to fuel your anxiety.

Other side effects

When you’re dealing with sexual performance anxiety, it can feel devastating and impact other areas of your life. It’s not uncommon to also experience:

• Low mood or depression
• General anxiety
• Low self-esteem
• Relationship or dating difficulties

Why does performance anxiety happen?

We discussed this earlier, when you get anxiety about performing sexually, your body enters the sympathetic state (fight, fight, or freeze) which triggers your body to divert resources away from your reproductive system to areas of your body that are used for your survival. This means if you’re having sex, it wants you to finish as quickly as possible and weaken blood flow to your penis so you can be getting a move on from the perceived danger.

The reason sexual performance anxiety can be so difficult to treat is because the anxiety can be triggered by just about anything and is particular to how you perceive your experiences. 

But here are some common causes so you can start troubleshooting:

• general anxiety and stress (which can also cause ED)
• low mood or depression (which can also cause ED)
• lack of sexual experience or being a virgin
• lack of sex education or skills
• penis insecurities
• body confidence problems
• low self-esteem

Bad Previous Experience Feedback Loop

It’s inevitable that at some point in your sexual life you’ll have a night where your sexual performance just wasn’t that great. Totally normal and it happens to everyone. 

What can happen though is that you start using this as a reference point in your mind and start believing that you won't be able to perform again in the future. These thoughts cause anxiety and when the time comes, you remain anxious and end up fulfilling your fear, causing you to solidify the belief that it will happen again in the future. The cycle continues and reinforces itself.

Performance anxiety with a new partner

New partner nerves can happen for everyone because it’s an entirely new person you have to learn. You might be anxious because of expectations to be a sex god for them, feeling less experienced then they are, trying to figure out what they like sexually, or just having a fear that if things don’t go well in the bedroom they’ll leave and you’ll never see them again. 

If you’re someone who has multiple partners, you could have an entirely different set of anxiety triggers with one than you do the others depending on the dynamic and your perceptions.

How to overcome sexual performance anxiety

Can performance anxiety be cured?

Considering sexual performance anxiety is not a medical diagnosis, disease, or mallady to the body, there is no “cure”. Rather there are practical techniques you can use to treat and minimize or eradicate its occurrence. If you start having a healthy and positive mindset around sex, you may never experience it again. If your mindset waivers, it may come and go, and you can revisit these techniques. They’ll refresh your memory and make sure you’re enjoying sex, not overthinking it, on a long-term, ongoing basis.

Share with your partner

A lot of your anxieties stem from how you perceive what you think your partner, ongoing or new, is going to judge about your performance. You have a list in your head of all the things they will say, how they will shame you, how you’ll be embarrassed, and what they are going to do. This is known as catastrophizing. You're jumping to the worst possible conclusion without any information about what your partner is actually thinking.

Instead, it would be more helpful to be honest with them and tell them you’re anxious. I know that is probably the last thing you want to do, but it relieves A LOT of the anxiety because you will see that they are more often than not quite kind, understanding, and supportive. It’s now two people working together, rather than you battling this on your own. 

If it’s a new partner, you can just level with them and let them know you’re a bit anxious about whatever it is you're anxious about. If you're currently stuck in the nasty feedback loop, just be honest that you may get ED or cum quicker. This will help set expectations for them and you two can work together to make sure you both have a pleasurable night. The worst thing you can do is lie or pretend you're a sex god, and then have a bad experience happen, because it will only reinforce the loop more.

You may think no guy would ever do this, but I have on a handful of occasions just leveled with the girl right as it’s happening. We’ve had lots of foreplay, she’s begging for intercourse, I’m not hard at all, she’s looking at me with hopeful eyes, my chest sinks into the deepest pits… and I just have to take a deep breath and tell her it’s not happening that night. Usually we’ll lie down together and cuddle and I’ll tell her what I’m nervous about. Every single girl I have done this with has been compassionate and it feels like a major weight being lifted. Sometimes we’ll play some more, sometimes I’ll get hard and we’ll have intercourse, sometimes I won’t and we’ll focus on her, and sometimes we’ll just chat and enjoy each other's company. All of those are ok.

If it’s an ongoing partner, they already know you're having some issues. Staying quiet about it doesn’t allow them to help and support you. Instead, be vulnerable with them and let them know what is troubling your mind. I bet they will help you lay many of your worries to rest by telling you that is not at all what they think of you or the problem. 

Reframing beliefs that don’t serve you

No doubt that there are some beliefs you hold that are causing you anxiety. Some of these beliefs have been culturally conditioned, have been built on past experiences, and may even hold an ounce of truth to them. However, believing them is not serving you which means they are not effective. When it comes to reframing, we’re not trying to believe something that we blatantly know is not true or sugar coat the belief with positivity. Instead, we’re trying to instill doubt into the negative belief to release its chokehold and open our mind to the possibility of other beliefs that may serve us better in reaching our goals, in this case a pleasurable experience for all parties involved.

Here are some common beliefs you may have:

“I must stay hard the entire time”

Did you know that it is 100% normal for your penis to cycle in getting softer and then hard again? Most of the time you and your partner never notice because you're focused on the pleasure and sensations, so when you do go soft for a little while, you get aroused by the sex you're having, and it triggers the response to get hard again. You’re never 100% firm the entire time.

The reason you lose your erection entirely is because you focus on it too much and believe it's supposed to be able to cut diamonds the entire time, even though that’s not the body’s natural response.

Instead, it’s better to realize you will go soft, focus on the sensations and pleasure, and let your body do its natural thing.

“I must have an erection to experience pleasure.”

Look, I get it. Having a hard on and getting it stimulated feels amazing. However, it’s not the only way sex can be pleasurable for you. Again, you have been conditioned to just focus solely on the feeling of your penis during sex. However, just like a woman, you have erogenous zones all over your body. Skin to skin contact actually feels pretty good everywhere. In fact, just receiving a really good massage can feel just as good as intercourse if you let it. You just haven’t built the awareness to allow that sensation to be pleasurable for you.

Furthermore, your penis does not even have to be hard for you to feel a pleasurable sensation in it. There are practices like soft penis massage where the purpose is just to focus on the pleasure when not having an erection and not working towards an orgasm.

If you believe that an erection is the only way you can feel pleasure during sex, you put a ton of pressure on yourself. If you believe you can experience pleasure the entire time, you don’t need an erection to happen as badly (and paradoxically it will be more likely to happen.)

“I’m not a man unless I can get an erection and have intercourse with her.”

I understand that biologically this is one of the things that a man should be able to do and how if you’re not able to do it, you feel less of a man. So while there is a small ounce of truth here, is holding this belief serving you?

What the real problem here is that you're conflating the validation you receive from sex as validation for your masculinity as a whole. Being able to get an erection and have intercourse is just one small facet of masculinity and its absence does not entirely negate all the other positive attributes you hold as a man.

You’re not less of a man. You’re a man that has something he wishes to improve in his life, and with these other techniques, you will be able to do so. So stop putting the extra shame and guilt on yourself and making it harder.

“I have to perform well so she will like me.”

Oh boy. This is a nasty one. It’s one that has personally gripped my psyche from time to time. If you are someone who is having casual relationships that are primarily based on sex, then in some regards, the belief has some validity. If the relationship is based on sex, and the sex isn’t that great in your partner’s perception, then they most likely will not continue on in the relationship so they can find better sex.

There are several layers to this belief so let’s break it down.

First is the fear that she will leave. This is our greatest fear in a relationship and I have already written about it in depth here. Reality is that you’re not in control of that, as much as you’d like to think you are. You could fuck her like a rockstar, and she still might leave for reasons that are entirely out of your control. So you have to let go of wanting to control the outcome.

Second, you're conflating what you do (self-efficacy) with who you are (self-esteem). You’re believing that what you do in this world somehow makes you more or less of a human being. When in fact, sex can be broken down into a set of skills. If you’re not seeing this yet, even having and maintaining an erection for the amount of time you would like is a skill which can be learned by some of the techniques here. Just because you don’t know those skills yet does not mean you're suddenly a worse human being. If a kid does not know how to ride a bike, are they less of a person? 

On the flip side, if you give an amazing “performance”, meaning you skillfully applied sexual techniques and both of you thoroughly enjoyed the experience, does that mean you're now a god and better human being than everyone else? No. That’s your ego talking. The truth is you’re just like the rest except that you are more skillful.

What you do, who you are, and how you perceive yourself are actually separate but interrelated areas of the Self. Sex is not the only area of your life that you're conflating these three parts. Separating them will be difficult, but sex is a great place to practice.

Lastly, stop seeing sex as performance altogether. A performance implies competition, pressure, an audience, a right and wrong way to perform, a goal to achieve. None of those make for pleasurable sex (well maybe an audience does if you’re an exhibitionist). In kink we call everything play which I quite like because play implies there is no goal and the purpose of the act is for the enjoyment of itself. Play implies fun, celebration, connection, discovering and exploring pleasure, enjoying the journey, appreciating whatever arises, and no right or wrong way to enjoy the experience. 

“I will make her orgasm. I am the source of her pleasure.”

To be blunt. You are never the source of her pleasure. You may have helped facilitate her pleasure by being skillful, but she is still the ultimate arbiter of her own pleasure. Even if you’re doing extremely kinky things tied to forced orgasms, it does not mean she finds them pleasurable.

Pleasure is subjective to her. She’s in control of that. Not you. You know this to some degree when you’re being very skillful and stimulating her even in the same ways she likes to be stimulated, and she still is not able to orgasm. That’s out of your control. There are dozens of thoughts and feelings in her head that dictate if she will allow that to happen or not. Yet a lot of times if you ask her, she tells you what you're doing is still very pleasurable.

So, you need to take the pressure off yourself to make her orgasm and you need to take the pressure off yourself that you are the sole source of her pleasure. Believing you are, particularly believing that your penis is the sole source of her pleasure, is putting a metric ton of pressure on it to be hard. 

Instead you can pleasure her in a multitude of ways other than using your penis. Ask her. She’s the one who controls her pleasure, so let her help you give you the keys to the kingdom.

Now, none of these reframes are an excuse to not improve your sexual performance anxiety. They are there to make the process easier for you to do so. 

Focus on your pleasure

The reason that you’re having sexual performance anxiety is because you're in your head and not in your body. You’re in your head for a multitude of reasons and while you’re in there, you’re so focused on your performance thoughts that you’re ignoring the pleasurable sensations happening to you.

I just mentioned focusing on her pleasure above when you believe you’re the source of her pleasure. When sexual performance anxiety is occuring, it’s more helpful to focus on YOUR pleasure and making the experience as pleasurable for yourself as possible in the moment. Of course we want both parties to have a good time, but right now you need to be selfish, just for the moment.

At any moment during sex, you can ask yourself, “What would feel most pleasurable right now?”

Emphasis on the feel. I want you to get really picky about exactly how you want to feel the sensation that would make it go from feeling kind of good to extraordinary. Want more spit in the blowjob? Tell her. Want her to stoke in one direction rather than another? Show her. Want her to lightly rub your arms? Tell her. Want her to move her body into a certain position so you feel more sensation? Move her. Want her to say certain words to arouse you? Prompt her. 

Guess what buddy, you’re in control of your pleasure! Just like she’s in control of hers. 

What this is going to do is allow you to stop focusing on the thoughts in your head about your performance and focus solely on your pleasure in that moment. The more you focus on what you're feeling, the more aroused you’ll be, and your body will do its natural thing by sending blood to your penis. 

Meditation

All of the techniques below can be used in the bedroom. However, it's best to practice them outside the bedroom as a regular meditation practice so that you can skillfully apply them when sexual performance anxiety arises.

Mindfulness 

Mindfulness practices can help train the skill of quieting or letting thoughts pass without grasping on to them. This is particularly helpful when those pesky thoughts are occuring during sex. If a thought arises about your sexual performance, instead of grasping it, see if you can let it pass. Don’t judge it or say you shouldn’t be thinking about it. Instead redirect your focus back to the positive and pleasurable sensations you’re having. In the beginning of your journey with sexual performance anxiety, this will be difficult to do because your thoughts will be screaming at you. However, as you start implementing some of these treatment techniques, mindfulness may be the only thing you need to do in order to maintain a healthy mindset around sex.

Box Breathing (or any downregulating breath technique)

I’ve previously spoken about how breath is linked to your arousal levels in my guide to Tantric Sex. Anxiety is a form of being overstimulated or hyper arousal, so by using breath, you can down regulate that arousal. 

What’s beneficial in this context is that focusing on the breath gets you out of your head and into your body. Box breathing requires a little more focus because you're breathing for 4 seconds in, holding for 4, exhaling for 4, and holding again for 4, then repeating. If you catch yourself getting into your head before a sex session or maybe even in the middle and everything is spiraling down, you can use box breathing to recenter yourself in your body.

Body Scanning

Body scanning is when you use your mind to scan the entire body and recognize the sensations happening in your body. Should be obvious how this is helpful. As you scan I would look for either of these things depending on what feels better for you:

• Look for areas of tension and see if you can use your awareness of it to relax and release that tension
• Look for areas of pleasurable sensations and see if you can use your awareness to amplify the intensity of that pleasure

When you feel yourself getting too much in your head, you can use body scanning to reorientate you to the body.

Sensate Focus

Sensate focus is a practice that promotes the elimination of performance expectations that can lead to sexual anxiety. During the practice, you’re encouraged to maintain your focus on the sensory experience. This practice can be done alone or with a partner. If a partner is included, the practice also promotes using non-verbal communication to express your comfort and desired touch.

You’ll begin with designating roughly 30 minutes to an hour of uninterrupted time, two to three times a week, to practice these steps on your own.

Solo Sensate Focus Practice:

• Stage 1 - Non-Genital Sensual Touch: Engage in self-exploration of your body with only your hands and fingers while avoiding your genitals.
• Stage 2 - Sensual Touch (Including Genitals): Continue to explore the pleasurable areas identified in stage one. At this stage, you may include the exploration of the genitals, but continue to avoid stimulating for achieving an erection or the goal of orgasm. 
• Stage 3 - Adding Lotion & Lubricant: Adding lotion and lubricant can increase friction and sensation, making the experience more pleasurable. Altering the medium of touch is intended to enhance sensory awareness.
• Stage 4 - Full Sensual Stimulation: In the final stage, you are allowed to stimulate more for erection and orgasm. However, this should be sensual stimulation where you are slowing down and mindfully continue noticing the sensations and emotions that occur.

Therapy

Therapy for sexual performance anxiety will include many different tools, but will most often center around forms of talk therapy and cognitive behavioral therapy (CBT), which helps disrupt the negative self-talk, and shame-based thought patterns that exacerbate the fears surrounding sexual performance. During therapy, the therapist will help you focus on your feelings, both emotions and bodily sensations. 

Coaches can also help you to learn skills in identifying your feelings while giving you a plan of action to help you overcome the issue. This will include many of the techniques above, practical exercises and sexual mindfulness techniques.

If you can’t afford a therapist or coach, or would like to to stay anonymous, you find online therapy courses designed by experts in sexual performance anxiety such as Mojo.