In my previous article we discussed the fear of intimacy. Some people who have intimacy anxiety will be reluctant to commit to a relationship. Others may fear opening up to their partner emotionally. And in some cases the fear of intimacy may translate to anxiety in the bedroom. Sexuality anxiety is not specific to one sex. Both men and women can experience great anxiety when it comes to sexual intimacy. If you suffer from fear and anxiety when it comes to sex, you are not alone.

Here are some of the ways that women may be affected by sexual anxiety:

• Low interest or desire to have sexual relations.

• Difficulty or inability to achieve orgasm.

• Physical pain or discomfort during sexual intercourse.

Men are also greatly affected by sexual anxiety. Here are some of the ways this anxiety can manifest in symptoms:

• Low desire or interest in having sex.

• Inability to achieve an erection or to sustain an erection during sexual intercourse.

• Problems with ejaculation. Some men will experience premature ejaculation while others will have delayed ejaculation or they may often find it difficult to achieve orgasm at all.

The causes for sexual anxiety are many and varied. If you are experiencing any of the symptoms listed above it is a wise decision to rule out any medical reasons for sexual dysfunction first.

Medical reasons for sexual problems may include: Hormonal imbalances, trauma to the genital region, surgeries, and certain diseases and medical conditions can affect one’s sexual desire and ability to enjoy sex. Some of these medical conditions may include heart disease, diabetes, high blood pressure, chronic pain, and Multiple Sclerosis.

One’s stage of life may also impact upon libido and sexual functioning. Women who are pregnant or menopausal, for example, may experience changes in their sexual desire. Issues of aging can also have a dramatic effect on men’s sexuality. For example, the decline of testosterone in later years, may make it difficult to achieve and sustain an erection for some men.

Mental illness such as depression and Bipolar Disorder can also have a great impact on one’s sexual desire and performance.

Some medications can put a damper on one’s sex life. If you are suffering from depression, your antidepressant medication could be the culprit for lowered libido and sexual dysfunction. In an article for MyDepressionConnection I discuss which antidepressants are most likely to cause sexual problems and what you can do about it. Some of your anti-anxiety medications may also contribute to unwanted sexual side effects. Drugs such as Paxil (paroxetine) list a decreased interest in sex or changes in sexual ability as some of the possible side effects. Valium is another medication sometimes used to decrease anxiety which can also decrease one’s libido. Here is more information about medications and sexual problems. And here is a comprehensive list of drugs which can cause sexual dysfunction if you want to see if your medication is on the list.

If the medical reasons for sexual dysfunction have been ruled out then it is time to explore some of the psychological causes. It is very possible, however, to experience problems in the bedroom due to both medical and psychological reasons.

It is not that uncommon to feel some anxiety about having sexual relations. You may have doubts about the relationship. You may be in a situation where you are experiencing great marital stress. Normal circumstances such as raising children or working can make some people feel too fatigued or stressed to think about sex. If you have difficulty maintaining a positive body image, you may fear the judgment of your partner when they see you unclothed. Some men may anguish over the size of their penis. Women may be overly critical of their overall shape or the size of their breasts. Men and women may fear not being able to adequately please their partner and letting them down. Both men and women may experience great anxiety over the ability to perform. In women this may manifest in the inability to reach an orgasm and with men it can be the underlying culprit of premature ejaculation or erectile dysfunction.

Sometimes the fear of sex may be rooted in what we were told about sex as children or teens. We may feel guilty or ashamed for enjoying sex or feel that it is somehow "dirty." Individuals who have been sexually abused, molested, or raped will have an especially challenging time when it comes to developing the trust needed to explore sexual feelings with a loving partner.

There is no overnight solution to overcoming anxiety in the bedroom. The first step is to recognize that there is a problem. If you are not enjoying sexual relations with your partner due to anxiety, and you want to change this, there are things you can do. One thing that can help is to discuss the issue with your partner. It may be awkward but clearing the air can make you feel less alone and that you are working through this as a team. The next thing to do is to talk to your doctor about any symptoms of sexual dysfunction. It may seem embarrassing but I am quite certain that your doctor has heard it all before. This way you can rule out any underlying medical causes for any sexual problems and also get the appropriate treatment.

If you feel that anxiety is the main reason for your problems in the bedroom, it may be time to explore these issues with a qualified therapist. Sexual intimacy can be one of the great pleasures in life. Don’t miss out on being intimate with your partner because you were afraid to talk about your anxiety. Anxiety related sexual dysfunction can be successfully treated.

Here are some links to resources which may be of help in understanding and overcoming sexual problems.

• Sexual Health Connection

• Erectile Dysfunction Connection

• American Association of Sexuality Educators, Counselors and Therapists (AASECT)