Sexual Performance Anxiety

Do you have Sexual Performance Anxiety (SPA)?  SPA can throw cold water on an otherwise hot moment.  Although SPA does not have an official diagnosis, many people are familiar with the issue and its effects on a relationship.

A recent literature review (Pyke, R. 2020, “Sexual Performance,” Sexual Medicine Reviews, vol. 8, issue 2, p. 1.) found that SPA affects 9-25% of men and 6-16% of women.  SPA contributes to premature ejaculation and psychogenic erectile dysfunction (ED) in men.  It increases the likelihood of low desire/interest and difficulty obtaining orgasm in women.

SPA happens when your mind is too stressed out to enjoy sex because your brain is preoccupied with negative thoughts about body image, pleasing your partner, orgasms, penis size, or relationship issues.

It is fear based.  Which means it is activated by the threat system.  The threat system sends stress hormones throughout the body, producing physiological and psychological changes.  A physiological effect is decreased blood flow, which can cause difficulties with erections and lubrication.  A psychological effect is hypervigilance, which means you focus more on negative thoughts than you do on desire and pleasure.
 
SPA can be treated with Cognitive Behavioral Therapy, learning mindfulness techniques, and working through relationship issues.  A therapist or counselor who specializes in sexual issues would be able to provide those types of interventions.  A referral to a medical doctor to rule out physical causes or for medication management may also be necessary.

Don't let fear keep you from having enjoyable sex!     

Yvette Massey, MA, LPC, CST

Photo by Suzy Hazelwood from Pexels