It’s quite normal to feel a little apprehensive before sex, especially if it’s the first time. But when apprehension tips over to anxiety, that’s when intimacy problems really start. Anxiety and intimacy are incompatible, so let’s look at some of the reasons why anxious thinking affects sex, and what can be done to make things a little easier.
Anxious thinking sinks the sex drive
Anxiety gives rise to a rush of adrenaline and stress hormones that flood the system. During anxiety our heart rate increases, our skin becomes clammy, and our muscles tense. Our body is getting ready to run and, when it comes to sex, this has a totally negative effect on mood and performance. Men can lose their erection or they may ejaculate prematurely. Women may experience painful sex or vaginismus, a condition in which the vaginal muscles tighten up involuntarily, making penetration impossible. Even if these more extreme situations aren’t experienced one or both parties may struggle to reach orgasm. Sex itself may be clumsy or awkward and with that can arise a desire for it just to be over with.
Roots of sexually anxious thinking
The issues that underpin sexual anxiety range from the trivial to the traumatic. Common to both men and women are concerns over unwanted pregnancies or the possibility of contracting a sexually transmitted disease. These are perfectly reasonable concerns where unsafe sex is taking place. Other common anxieties relate to performance in bed, or even whether sex should be taking place at all.
Men’s anxieties typically involve issues such as penis size, premature ejaculation, body shape, having to put on a condom, and whether their performance and staying power will be “good enough.”
In some cases sexual anxieties run deeper. The website Anxiety Care UK points to other anxieties like doubts over sexual orientation or other issues like “spectatoring,” which refers to the man who is so occupied with monitoring his own sexual performance that he forgets about his partner. The man who can’t see beyond his own needs typically finds sex unfulfilling, something that will affect both him and his partner. On the other hand, if self-worth is tied too closely with sexual interest from others, there is a danger that normalcy will become intertwined with sex. This will result in anxieties when the man is not being sexually aroused or entertaining sexual interest.
Women’s anxieties typically involve issues like whether sex will hurt, overall physical attractiveness, and vaginal odors. In terms of online searches, vaginal odor appears to top the list as the number one concern, according to Michael Castleman’s article in Psychology Today. This same article points to the fact that around 300,000 American women a year have breast augmentation surgery. This is testament to the unhappiness so many women experience over breast size or shape. An article in the Journal of Plastic and Reconstructive Plastic Surgery associates breast asymmetry with issues of low self-esteem.
If you’re on medication for anxiety or depression, you may have seen some of the side effects related to an increased risk of sexual dysfunction. It really depends on which medication you are taking and the dosage involved. If you believe meds are a factor, it may be possible to switch these or discuss with your doctor the possibility of a lower dose.
Childhood sexual abuse
Our childhood experiences can and do affect our adult lives in profound ways. Sexual abuse casts a long shadow into adulthood and complex emotions involving shame, anxiety, pain, fear and confusion may follow. The shame and secrecy that accompanies early years of sexual abuse do not fade away during adulthood. Aversion to sex and sexual anorexia (a kind of self-imposed exile from sexuality) are just two possible outcomes.
Where to turn?
It helps to acknowledge the fact that you do feel anxious before, during or after sex. That said, the next step is to try and identify the nature and possible cause. In many instances simply talking to your partner can turn things around. Where things seem to run deeper ― that is, you struggle to identify a cause or you find it hard to reconcile a cause ― then therapy is the best option. There are various talk-therapy options and some therapists do specialize as sex therapists.
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Jerry Kennard, Ph.D., is a chartered psychologist and associate fellow of the British Psychological Society. Jerry’s clinical background is in mental health and, most recently, higher education. He is the author of various self-help books and is co-founder of positivityguides.net.