He Has Low Confidence or Low Self-Esteem

Low confidence in a man is easily seen through the way he acts alone and how he interacts with others. Signs of low self-esteem include:

• Slouching
• Not making regular full eye contact
• Appearing tired (i.e., circles under the eyes)

If you’re very stressed or concerned about your body image, such as weight, it can cause sexual performance anxiety as you may worry if your partner is still attracted to you. Body image issues often start early in life and sometimes carry into adulthood and rear their head when we least expect it.

Loss of a job can cause a crisis of self-esteem and make a man question his masculinity, also leading to anxiety in the bedroom. As if that’s not bad enough, the performance problems caused can compound the initial anxiety!

The Man Is Suffering From Clinical Depression

If a man is seemingly depressed, it may signify that he suffers from SPA. Clinical depression can manifest in a lot of different ways that are typically unique to the person suffering it, but a few are common signs of depression:

• Sadness
• Apathy
• Loss of interest in previously beloved activities or subjects
• Insomnia
• Emotional withdrawal

If you notice a man exhibiting these signs, he may be suffering from clinical depression and the odds are pretty good that he may suffer from SPA as well.

Depression can cause very serious effects in emotional and sexual relationships, and it’s important to stay vigilant for signs of depression in our loved ones.

He Begins Fighting With His Partner

Relationship troubles like regular arguments or violent altercations can cause hostility and stress toward a partner, and can signify if a man has sexual performance anxiety. Emotional changes in the body can cause premature ejaculation (PE) or erectile dysfunction (ED) symptoms because hormones produced by strong emotions can affect the whole body, including the ability to get an erection or ejaculate.

If there are regular arguments or stress within a relationship, sexual performance anxiety might be in the picture as well.

Additionally, men with severe sexual performance anxiety may pick fights with their partners to avoid getting intimate. Men who feel like they aren’t performing well in the bedroom may try to avoid sex altogether, starting an argument to shift focus instead.

Premature Ejaculation Becomes a Problem

Premature ejaculation is when a man ejaculates too early during sexual activity. This can cause self-esteem issues as the man asks himself what is wrong with him, or perhaps the partner can become resentful at their perceived inability to satisfy them. Premature ejaculation is commonly seen in young men, often teenagers, during their early sexual experiences.

Most instances of premature ejaculation happen right before penetration, during foreplay, or right after penetration during intercourse with a partner. This is oftentimes distressing to both the man and his partner, for differing reasons, one of them being sexual performance anxiety.

A man who is insecure about his performance may be so nervous and eager to please that he finishes just as things get started.

He Suffers from Erectile Dysfunction

Erectile dysfunction can present as an inability to get and maintain a firm erection for sexual activity and intercourse. ED may only make erections hard to keep, or it can render a man completely impotent and unable to achieve an erection at all. Inability to achieve climax and ejaculate goes hand in hand with ED.

Sexual performance anxiety can be the main driving force behind why ED occurs at all. If a man is having trouble keeping or maintaining an erection, sexual performance anxiety may be the cause.

ED is a very complex issue that may be primarily psychological, or there can be physical factors at play, including:

• Medication
• Exercise level
• Diet
• Relationship status

Sexual performance is one possible cause of ED, but far from the only one.

He’s Experiencing New or Worsening Anxiety

Anxiety, especially that created by generalized anxiety disorder, is capable of ruining a life.

When someone is very anxious, it overrides all rational thought and can cause panic attacks. You can notice anxiety in others with signs like hyperventilation, signs of dread or fear, and shaking.

Anxiety can extend to sexual performance as well, and it often does because sex is a sensitive subject for many men. Someone suffering extreme anxiety is more likely to experience SPA, and conversely, someone suffering from SPA is more likely to exhibit signs of anxiety about their SPA.

He Has a Low Libido

If you’re his partner, it’s easy to notice when a man’s libido wanes. He won’t initiate sex as often and may even brush off sexual advances when he usually accepts them. It’s normal for his sexual appetite to fade as his anxiety peaks, and confronting him about it can cause greater anxiety.

Low libido may be caused by SPA, or it may have been an underlying cause behind it. Either way, it’s inextricably linked with the condition.

The Man Has an Unexpected Midlife Crisis

Sometimes when a man hits middle age, 40 or so, it can trigger a midlife crisis. Men who have midlife crises often act out or experience depression, and these feelings often stem from guilt or shame that life didn’t turn out the way they imagined it. Sometimes a man feels as if he isn’t in touch with who he is as a person and gets swept away with life and all its obligations.

Midlife crises are often indicative of sexual performance anxiety, which can be a primary factor or even a minor effect. Midlife crises can be spotted by the man ‘acting out,’ which has an array of relevant signs:

• Infidelity
• Gambling
• Substance abuse
• Extreme nostalgia
• Drastic changes in appearance or behavior
• Boredom

Regardless of the cause, midlife crises are known to produce high levels of anxiety that can cause erectile dysfunction. Also common is a general disinterest in sex, or even an inability to derive pleasure from sex.

What Is Sexual Performance Anxiety?

Sexual performance anxiety (SPA) is a type of severe anxiety or fear before, during, and even after sex. This anxiety can manifest in numerous ways, including erectile dysfunction, premature ejaculation, self-esteem problems, and more.

SPA can occur for many reasons, including stress from other areas of life, relationship woes, new relationships, and mental health. Unfortunately, the effects it typically causes more often than not exacerbate stress and anxiety – a kind of anxiety loop forms and perpetuates itself in what’s called a negative feedback loop.

There’s no single catch-all symptom, cause, or treatment for all cases of sexual performance anxiety, but that last word, anxiety, is typically the common denominator. There’s almost always something causing enormous amounts of stress when a man is unable to perform – it can be financial, emotional, work-related, social, or any number of combinations of these causes together.

A few common situations that can cause Sexual Performance Anxiety (SPA) in a man are:

• Loss of job or income
• Relationship problems
• Loss of a loved one
• Debt or other financial obligations
• Changes in health or appearance (especially aging)

Symptoms of Sexual Performance Anxiety

Sexual performance anxiety is often caused by complex and highly personal factors and can manifest itself in different ways. The two most concerning symptoms of SPA are premature ejaculation and erectile dysfunction, either partial or full.

Is Sexual Performance Anxiety the Same Thing As Erectile Dysfunction?

Sexual performance anxiety isn’t the same as erectile dysfunction. Erectile dysfunction means there’s a problem getting or maintaining an erection. This can range from difficulty getting the penis hard at all to the penis becoming flaccid partway through sex.

Virtually all erectile dysfunction also makes it difficult or impossible to achieve orgasm and ejaculate.

Sexual performance anxiety may cause erectile dysfunction as a symptom and the two can be confused for each other as well. Drawing a clear distinction between the two is a vital first step to finding and addressing the underlying issue.

Erectile dysfunction can also occur as a result of chemical or physical problems, whereas SPA is completely psychological. Differentiating how the two are related can help develop a course of treatment to solve the problem in the future.

Erectile dysfunction by itself without related anxiety or stress can be a sign of more serious underlying conditions within the cardiovascular system or prostate. When erectile dysfunction happens, it can create a sense of anxiety, but this shouldn’t be confused with anxiety that causes ED, which would be sexual performance anxiety.

How To Treat Sexual Performance Anxiety

Treating sexual performance anxiety is multifaceted because every case of SPD is unique, with a different cause and wildly different treatment needs. What works for a depressed man won’t work as well on a man facing chronic arguments, for example. Tailor your treatment to your circumstances for ideal results!

Address Mental Health

Mental health problems, whether diagnosed or not, can wreak havoc on a man’s sex life. Depression, bipolar, general anxiety disorder, and many other mental illnesses can manifest as sexual performance anxiety.

Anhedonia, or the inability to feel pleasure from once-beloved things, can make getting erections very difficult even if you’re not particularly worried about anything at the moment.

Without proper care for the underlying mental illness causing SPA, the issue is unlikely to resolve or improve. Therapy and medication can be extremely effective at getting to the root of the true problem within the man’s brain chemistry.

Confirm the Problem Isn’t Physical

Before assuming that you’re just anxious, you should attempt to masturbate in a private setting separately. If you’re able to get an erection by yourself, you can rule out any medical problems and confirm that your performance anxiety is purely psychological. In some ways, that makes it easier, but in other ways, harder.

Get Physical

Regular exercise is essential for optimal health. Exercise can raise our endorphin levels, cardiovascular health, muscle strength, and overall mental well-being. While exercise alone may not play a major role in fixing performance anxiety, it can aid other treatments and improve your ability to maintain a positive mindset.

Exercise can help improve confidence, lessen anxieties, and spend time by ourselves that can have a beneficial effect on mental well-being.

Avoid Smoking, Drinking, and Drugs

Stress and anxiety can lead to relying on smoking, drinking, or using illicit drugs to cope. On the other hand, drug addiction in itself can be a gateway to crippling anxiety. More sinister still is that drugs rewire the brain when consumed regularly – they trick your brain into making you feel like you need more of the drug later, and reduce the ability to feel pleasure from normal things, like sex.

Drinking large amounts of alcohol has been known to cause temporary impotence for years in the phenomenon colorfully called ‘whiskey dick.’

Keeping your body free of toxins like nicotine, alcohol, and illegal drugs will give your body the ability to heal and rewire its network of hormones and chemicals.

Get More Sleep

A 2019 study on how sleep affects sex yielded invaluable insight: Poor sleep quality in men leads to decreased testosterone, which can dramatically alter how we perform in the bedroom.

Especially in middle-aged men, getting enough sleep is vital for our bodies to produce enough hormones, namely testosterone. Regularly getting eight hours of sleep will help your body regulate itself and fix imbalances that may cause performance anxiety.

Break the Cycle

Sexual performance anxiety is psychological in origin, which makes treatment hard to specify – everyone’s needs are different. Generally, though, anxiety is exacerbated by the inability to perform sexually. The inability to perform is because of the anxiety, but it can also feed it. This creates a type of negative feedback loop.

Too confusing for you? Well, it’s a cycle of ‘anxious, can’t perform, that makes me more anxious, so I definitely can’t perform next time.’ At some point, you have to step back and look at the root of the underlying problem and how to fix that.

Don’t Prioritize Sex

The more you obsess over your sexual woes, the worse they can get. Tell your partner you’d like to put sex on the back burner for a bit in order to get your head right. Support from your partner is critical to making this work, however.

Without both partners being on the same page about this, resentment and misapprehension can grow and create a bigger problem. You and your partner should both understand that there aren’t any hurt feelings about this temporary period without sex.

Focus instead on spending quality time with your partner – do things together, go on a trip, anything! The details aren’t what’s important so much as sparking a deeper emotional connection and attraction between partners.

Consider Therapy or Counseling

If you simply can’t find a way to communicate your frustrations and needs with your partner in a way that’s making your performance anxiety worse, counselling may be just the thing you need. Intimacy problems with your partner can amplify performance anxiety and eat at the foundation of your sexual relationship.

Counselling with your partner in a controlled setting with a trained therapist can help express all unresolved issues and explore options in a judgment-free zone free of hostility or expectations.

Try New Things

Experimenting can help change your entire perspective on sex.

If you always go into the bedroom to have sex, consider trying a different room! With SPA, just going into a familiar setting like the bedroom to have sex can cause the anxiety to ‘switch on.’

Unfamiliar situations force your brain to process them first, and can hopefully confuse any lingering anxieties causing performance problems.

In simple terms, it helps shake your brain loose from its day-to-day rut.

Don’t Overthink

If you over analyse every interaction and thing that happens, you’re more likely to fixate on performance anxiety and other negative emotions that feed it. When in an intimate setting, it helps to try and ‘turn your brain off,’ so to speak.

Try to focus on the physical sensations of the moment, rather than doubts and fears that may crop up and kill the mood. Don’t worry about what you should do, and just do what you can!

Reframe ‘Performance’

When we frame sexual satisfaction as stemming from ‘performance,’ it can make sex seem like an unpleasant task that we have to ‘perform’ well in, rather than an awesome, stress-relieving activity to enjoy with partners.

Remind yourself that it’s not a race, and you’re not a workhorse who has to ‘perform,’ and share your concerns with your partner. Doubtless, they will understand and try to provide you reassurance.

Final Thoughts: When To See a Doctor About SPA

If you discover that you’re unable to get an erection under any circumstances, that merits a doctor visit – sexual performance anxiety can be powerful, but men can usually still get erections when masturbating and ‘morning wood’ erections while sleeping.

Persistent erectile dysfunction is more likely to be an actual medical condition and might be fixable with medications. Talk to your doctor about your concerns – that you thought you were just anxious at first, but fear you’re losing your ability to get erections at all. Your doctor can help by performing bloodwork and asking clarifying questions to pinpoint a specific cause.