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10 Symptoms & Treatments For Sexual Anxiety

Sexual Anxiety is a combination of anxious feelings and emotions of distress regarding sexuality in one’s life when either thinking, talking, attempting or performing anything sexual.

Sexual anxiety is defined as the tendency to experience tension, discomfort, and anxiety about the sexual aspects of one’s life (Snell et al., 1993).

This anxiety can become a cycle, and it’s important to be aware of this, the thought and act, including the stress, therefore resulting in more stress, concern, worry (both currently and for/in the future) can become repetitive. The ability to overcome any anxieties or insecurities is possible, resulting in an intimate connection with another and psychological and physiological harmony. Recognizable traits are often present in sexual anxiety, and by assessing these behaviors, one can easily work to modify and eliminate them.

Symptoms Of Sexual Anxiety

Symptoms can vary, and have different durations, yet are manageable once someone is aware that they are suffering from sexual stress and anxiety and how the symptoms present themselves.

  1. DISCOMFORT – Discomfort and tension are among the top traits and within the definition of sexual anxiety itself. An overall/overwhelming emotion of feeling as if something is ‘wrong’, ‘not right’, ‘going to go wrong’, or worry that it will.
  2. NERVOUS – Anxious – A form of anxiety and apprehension. This can range from a concern of technique, ability, involvement, or being wanted by another. It can be felt as ‘fumbling’, ‘unsure’ and ‘panic,‘ either to approach or engage in actual sexual contact.
  3. FEAR – Fear based thoughts. Many times, these are fears that aren’t based on actual issues being presented, but instead fear of the fear that they may occur. Fears such as being rejected, laughed at, mocked or physically shunned. There is also the fear of sinning, failing one’s religious faith, their family honor, or cultural expectation of sexual behaviors.
  4. DANGER – ‘Danger’ fear-based thoughts can be paralyzing and even have physical reactions. Thoughts such as contracting a disease, getting pregnant or being ‘changed’ from an encounter can result in sexual anxiety that limits behaviors and enjoyment.
  5. FAILURE– Failing sexually, such as being let down, either by the partner’s actions or their own actions. The assumption that it won’t be satisfying, having a high-expectation of outcome including the pressure to perform both before, during, or even after. Having a possible previous sexual issue and the concern it may occur again.
  6. EXTREME EXPECTATION – There is normalcy to having an abnormal and/or awkward experience every so often, yet an extreme expectation is expecting everything to go perfectly, always, no matter what. This can be seen in expecting a certain reaction, or scenario to be played out perfectly, as planned in our minds. It’s important to let the high expectations go, and instead ‘go with the flow’, find an ease and comfort to each changing situation, and adapt quickly based on the present.
  7. EMBARRASSED – An uneasy feeling of being embarrassed. This can be related to body issues, physical stamina or fear-based thoughts. This can range from feelings of inadequacy from an adolescent perspective (i.e., being laughed at in the locker room or perhaps teased when trying to have a first kiss). Relevant reasons for the association of the embarrassment may have been valid, yet it’s important to assess current situations for any true trauma, outside of anxious thoughts.
  8. PHYSICAL RESULTS – Physically, the anxiety is seen manifested in physical symptoms such as lack of erections, inability to become engaged, painful penetration/intercourse and/or climax or climaxing before wanting to (premature ejaculation).

As part of the multifactorial nature of erectile dysfunction, anxiety associated with sexual performance (SPA) remains a major contributing factor to its progression (Brien, 2002).

  1. PANIC ATTACK – In addition to physical results, the thoughts can manifest (i.e., fear of becoming pregnant or laughed at), a panic attack may occur. This includes rapid thoughts, quick and shallow breathing and an increased pulse rate.
  2. VICIOUS CYCLE – The most damaging factor of the anxiety is that of the ‘loop’. It begins as a sexual thought (enjoyable sexual thought), and anxious thoughts begin (worry, fear, anxious), followed by a reaction with anxiety (rapid thoughts, overwhelming discomfort, and tension), leading to a physical response (loss and/or inability to obtain erection), which in turn produces a dissatisfied sexual achievement and not achieving a satisfying sexual experience

Treatments For Sexual Anxiety

The wonderful news is that this cycle can easily be identified and therefore managed and treated. Sexual thoughts can, instead of leading to worry and anxiety, lead to calming, comforting thoughts, which therefore provide sexual satisfaction versus dissatisfaction. The change of thoughts and patterns to thinking can cause thoughts that were once destructive and limiting, to now instead of being those that allow one to get out of their head and into their body for total pleasure.

Treatments can be effective, long-lasting and inexpensive and free options can also be incorporated into a treatment plan.

  1. STRESS LESS – The number step to take is to de-stress. Begin to relax, know that this is treatable, and that sexual experiences can be enjoyable again. Along with de-stressing, begin to also include mild and positive sexual tension, excitement is an element that can stimulate and remove stress from the mindset.
  2. SHAME-LESS – Address and remove/work through any shame, embarrassment that is present. Treatment professionally for any sexual trauma, including emotional and physical abuse, should be addressed immediately.
  3. SPEAK FREELY – Talk to your partner, psychologist, sexual therapist, spiritual advisor and/or confidant openly. Share any other issues in the relationship that may be contributing to sexual anxiety. Address the issue to improve it and allow the opportunity for growth and honest advice to be given. This will take great strength as this fundamentally requires an overcoming of embarrassment, anxiety, apprehension, and more, yet it’s possible and ultimately rewarding.
  4. PRESSURE-LESS – Remove the pressure to perform. While this includes the ease of worries from day to day life and responsibilities and any big events that are occurring, it strongly suggests the entirety of the sexual experience and any stress that may be related (i.e., expectation, worry, fear). This can be done by approaching the topic casually, to simply seek to connect through an intimate exchange that isn’t sexual in purpose. This also instantly removes to pressure to sexually satisfy, please, etc.
  5. POSITIVE – Take a positive approach, particularly with self-speech. It’s important to use pleasing self-statements. For example, “I have love and attention to offer” is far more positive and pleasing compared to “What if my biggest fear comes true?” One can be terrifying to simply think of, due to it calling forth the thought of fear, what it is, and then an entire process can occur where a spiral situation escalates, whereas a sexually pleasing thought, that can be very true, and can lead to more thoughts of ‘how, who, where’, etc. is that of ‘I have love and attention to offer’. By being fully aware of all thoughts, one can remove the negative thoughts and replace them with less-pressuring and more pleasing self-speech and patterns.
  6. PLAY – Intimacy, not sexuality is the goal (i.e., cuddling, kissing, massage, dual-bathing, tickling, BDSM/role-playing scene). You are wanting to create an environment where there is giving and pleasing that isn’t associated with expectation, performance and/or outcome of sexual acts.
  7. SELF SATISFACTION – Self-pleasing allows for one to understand their self-needs, their body, and reactions to certain stimuli. When one masturbates, it assists in many areas such as their ability to learn their self-needs, to understand their thoughts during a pleasing performance, what is exciting, and better understand what ‘works well and doesn’t’.
  8. WELLNESS – Once an issue is understood as anxiety (and not medically related to any other diagnosis/symptoms) steps can be taken to ensure health is maintained. A healthy lifestyle includes limitations on alcohol as well as refraining from drug use/abuse. When anxiety begins, one should immediately become aware of their thoughts, and focus on their breathing. Meditation is a key aspect to controlling one’s thoughts and being aware of their inner dialogue. It’s also scientifically proven to have health benefits (reduced insomnia and cortisol levels, lowered risk of stroke and heart attack). Apps on smart devices are easily downloaded and often for free. Apps can provide reminders, timers, and guides to assist in meditation techniques and walk beginners through the steps. Beginning meditation at 10 minutes per day and increasing to 30 minutes per day is strongly suggested for everyone.
  9. PROFESSIONAL – Speak with a medical professional regarding any medical diagnosis, speak with a sex specialist such as a sex therapist, relationship expert and/or a psychiatrist/psychologist to address all sexual concerns directly. A Pastoral Counselor can also assist with issues regarding guilt, shame, embarrassment, etc. regarding the religious approach. A primary approach is that of cognitive therapy.

Therapeutic techniques that target maladaptive cognitions may be effective in alleviating sexual distress or dysfunction (Dang, 2018).

  1. JOYFUL JOURNEY – Remember, this is a trip to take together, to share and enjoy and make memories in the moment. If you find yourself stressing, it’s important to be mindful of your thoughts, calm your breathing and be in the moment, not the ‘fearful future’.

References:
Brien, S. E., Smallegange, C., Gofton, W. T., Heaton, J. P. W., & Adams, M. A. (2002). Development of a rat model of sexual performance anxiety:

Effect of behavioural and pharmacological hyperadrenergic stimulation on APO-induced erections. International Journal of Impotence Research, 14(2), 107-115. doi:10.1038/sj.ijir.3900836 Dang, S. S., Northey, L., Dunkley, C. R., Rigby, R. A., & Gorzalka, B. B. (2018).

Sexual anxiety and sexual beliefs as mediators of the association between attachment orientation with sexual functioning and distress in university men and women. The Canadian Journal of Human Sexuality, 27(1), 21-32. doi:10.3138/cjhs.2017-0025 Snell, W. E., Fisher, T. D., & Walters, A. S. (1993). The Multidimensional Sexuality Questionnaire: An objective self-report measure of psychological tendencies associated with human sexuality. Annals of Sex Research, 6, 27–55.

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ReBecca Byrd, Phd Psychology
ReBecca Byrd, Phd Psychology

ReBecca has a background in psychology, spirituality and relationships, with her primary focus being on BDSM behaviors. Her graduate degree in psychology, along with her numerous certifications, such as being a Certified Pastoral Counselor, allow her the luxury of pursuing her passion which is to help others. In her free time, she enjoys frolicking in the water with manatees, living the salt life in Florida and enjoying as many moments with friends and family as possible.

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