Sexual Anxiety: What it Is and How to Combat It

Sexual anxiety appears either before, during or after sexual intercourse. Having it can harm self-esteem, personal well-being and even the relationship with your partner. Why does it appear and how to combat it?
Sexual Anxiety: What it Is and How to Combat It
Laura Ruiz Mitjana

Written and verified by la psicóloga Laura Ruiz Mitjana.

Last update: 16 April, 2021

Most of us have felt anxiety at some time in our lives – an uncomfortable state of tension and physiological hyperarousal that appears for many reasons. However, when it is linked to (or interferes with) sexual intercourse, then we speak of sexual anxiety.

This condition can cause the person to stop enjoying sex, avoid having it, and even, in more extreme cases, develop a phobia towards it (or sexual dysfunction). In this article, we’ll tell you what this problem consists of, what symptoms it produces, how it affects the person’s life, and how to approach it from a psychotherapeutic perspective.

Sexual anxiety: what is it?

Before describing sexual anxiety, it should be noted that anxiety is a physiological and psychological response that appears when we feel that our personal resources are insufficient to cope with the demands of the environment.

It can also appear when the person feels threatened by an external or internal danger. What we mean here is that it’s a reaction that we manifest when we feel overwhelmed, either on a physical or mental level.

In the case of sexual anxiety, we’re talking about an unnatural reaction that occurs either before, during, or after sexual intercourse.

This type of anxiety prevents the person from enjoying their sexuality, and leads to a series of characteristic symptoms: malaise, dizziness, tremors, ruminative thoughts, nausea, sleep disturbances, and the feeling of losing control.

All this may have an impact on self-esteem and the person’s partner. Its causes are multiple, and we’re now going to talk about the most frequent ones.

Sexual anxiety often causes relationship problems.
Anxiety can negatively affect various aspects of a relationship.

Consequences of sexual anxiety

Sexual anxiety interferes with the well-being of the person who suffers from it. It can also have very detrimental effects on your self-esteem, self-concept, and personal confidence.

Affected people experience worry when having or thinking about sexual intercourse, with considerable associated discomfort. This causes them to end up avoiding sex, losing interest in it, or feeling dissatisfied.

As a result of all this, sexual anxiety can end up leading to other problems or disorders such as loss of sexual desire, anorgasmia, lubrication problems, and difficulty maintaining an erection, etc. This makes sex difficult and, as a consequence, can further increase your anxiety (it’s really a kind of vicious circle).

Relationship problems

It is clear that sexual anxiety affects self-esteem and personal well-being, but it can also end up damaging the relationship (if you have one). Thus, the person can start to resent their partner if there’s no good communication or there’s any other type of pre-existing problem.

In these moments, it will be more important than ever to communicate with our partner and come together to face the problem.

Symptoms of sexual anxiety

The symptoms of sexual anxiety are typical of normal anxiety. In this way, they can appear when someone is expecting, or hoping, to have sexual relations, during the sexual act, or after it, in the form of discomfort, suffering, and constant worry. These symptoms include the following:

  • Dry mouth
  • Tingling sensation
  • Difficulty breathing
  • Tachycardia
  • Sleep disturbances
  • Trembling
  • Instability and dizziness
  • A feeling of losing control
  • Cervical or generalized tension
  • Nausea and vomiting
  • Abdominal pain
  • Digestive disorders

In addition, all these symptoms cause discomfort in the person’s mind, as they suffer at the idea of having sex or even while practicing it. In summary, it interferes in your sex life, but often also in your social, personal, and even family life.

There are also repercussions on one’s self-esteem, well-being, and one’s relationship with oneself. Because of this, and as we’ll see later, it will be important to work on all these aspects in therapy.

Sexual anxiety can lead to psychological problems.
Some people with sexual anxiety may be more likely to withdraw and engage in depressive behaviors.

Possible causes

Sexual anxiety can appear for multiple reasons. Leaving aside the organic reasons and focusing on the psychological ones, we find the following:

  • Lack of security and personal trust
  • Traumatic experiences related to sex
  • Little trust in the partner (for example, as a result of infidelity)
  • Dissatisfaction with the relationship
  • Sexual dysfunctions
  • Self-esteem problems
  • Stress and worries
  • Emotional problems

Sexuality and self-esteem

Sexuality is related to personal satisfaction and self-concept. This means that it’s very difficult to separate self-concept or self-esteem from sexuality (either with oneself or with the other person).

That’s why, very often, when dealing with sexual anxiety, we find self-esteem problems, personal insecurities, and a lack of trust in the partner, among others things.

This is because, when our self-conception is damaged, we can feel unable to maintain a satisfactory sexual relationship, for fear that the other person won’t enjoy it or won’t feel it enough.

“Loving yourself is the beginning of a lifelong romance.”

-Oscar Wilde-

On the other hand, there is a fear of not meeting the other person’s expectations, and this can produce this type of anxiety. Associated with all this, we often find irrational thoughts related to sex, oneself, or the relationship with a partner. That’s why it is so important to work on it from a psychotherapeutic perspective, as we’ll see below.

How to combat sexual anxiety

Sexual anxiety usually appears as a consequence of psychological or relational factors.

So, if there’s no medical problem or organic reason to explain it, then it’s best to consult a mental health expert to help you. This, we insist, after ruling out possible medical causes by a specialist.

It’s best to have individual psychotherapy sessions, although couples therapy is also recommended if you are in a relationship. The goal will be to find the causes of that sexual anxiety and start working on them.

Beyond this, it will be important to work with the patient on all the dysfunctional or unrealistic thoughts they have that are associated with their problem, or sexuality in general.

Aspects to explore

In this sense, you should seek to discover which factors have caused and maintained the problem. There may be irrational thoughts, avoidance behaviors, low self-esteem, poor communication with the partner, unresolved conflicts, jealousy, infidelity, various insecurities, little trust in the partner, or traumatic experiences.

Once the causes and the factors that maintain the problem have been identified, you can start working on all of them.

Importance of patient perception

It will be important for the patient to be able to express how they feel, how they perceive their problem, what they associate it with, why they think it appears or intensifies, etc. It’s important to ask about their motivation for change, what expectations they have in therapy, and whether they have asked for help before.

Once all this information has been collected, it’s possible to start working with the patient using different psychological techniques, such as cognitive restructuring (to identify and modify dysfunctional thoughts), exposure therapy, and validation of emotions.

  • American Psychiatric Association –APA- (2014). DSM-5. Manual diagnóstico y estadístico de los trastornos mentales. Madrid: Panamericana.
  • Belloch, A., Sandín, B. y Ramos, F. (2010). Manual de Psicopatología. Volumen I y II. Madrid: McGraw-Hill.
  • Cáceres, C. (2013). Diversidad sexual, salud y ciudadanía. Artículo especial, Rev Perú Med Exp Salud Pública: 698-704.
  • Morgado, I. (2007). Emociones e inteligencia social: las claves para una alianza entre los sentimientos y la razón. Barcelona: Editorial Ariel.
  • Pérez, M., Fernández, J.R., Fernández, C. y Amigo, I. (2010). Guía de tratamientos psicológicos eficaces I y II. Madrid: Pirámide.

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