What to Do if Sex Gives You Anxiety

Mar 15, 2018 at 3:00 p.m. ET
Image: Tory Rust/Design: Ashley Britton/SheKnows

Sex is a natural part of the human experience, but when something that's supposed to be super-fun and feel great leads to a serious bout of anxiety, it can cause distress that goes far beyond the bedroom. Let's take a look at what sex anxiety is all about and what you can do about it.

Sexual anxiety: What is it?

While there's a lot of research and writings about sexual and performance anxiety in men, it's unsurprising that sexual anxiety in women is a less talked-about issue. Why? Because it can be more difficult to define, says Courtney Cleman, sex and relationship expert — after all, women don't require an erection for sexual activity (and of course, there may be social issues at hand that place more value on a man's sexual satisfaction than a woman's, but that's a topic for another article).

For us gals, there are a few symptoms you can look for to see if this malady is affecting your life:

  • Feeling less pleasure
  • Inability to be "in the moment"
  • Reduced libido
  • Tightening of the pelvic floor muscles, which can render penetration difficult or impossible

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Also, there are symptoms that are not necessarily sex-specific that can mean you're experiencing anxiety. These include:

  • Feeling nervous
  • Increased heart rate
  • Trouble sleeping
  • Rapid breathing
  • Feeling of impending doom
  • Trouble concentrating
  • Trembling
  • Sweating
  • Avoiding activities (like sex) that trigger anxiety

Causes of sexual anxiety

As with other types of anxiety, there are a number of different causes for that of the sexual type. Here are some of the key causes.

  • Self-esteem issues. While there are many reasons one might lack self-esteem, it can certainly impact your sex life, says The Sex Docs, Drs. Cristina Bosch and John A. Robinson.
  • Stress about orgasms. Some women worry about achieving orgasms, which can dampen their desire and lead to sexual anxiety, says Cleman.
  • Hormone imbalances. Women can and do become affected by hormone imbalances. Interestingly, this includes testosterone in addition to other female hormones, including estrogen.
  • Guilt or shame. Restrictive religious attitudes, cultural norms or living in a society where women's sexual pleasure takes a backseat to men's (hint: you're probably living in one) can result in internalized guilt or shame that can have a negative impact on your sexual comfort.
  • Past experiences. Amy McManus, owner of Thrive Therapy and a licensed marriage and family therapist in Los Angeles who specializes in anxiety, notes that past experiences that can lead to sexual anxiety can include thoughtless comments from past partners, but can also include sexual abuse or assault.
  • Thyroid problems. Anxiety can stem from thyroid disorders, including sexual anxiety.

How to treat sexual anxiety

Sexual anxiety is treated according to the cause. For those with hormone imbalances or thyroid disease, testing will first reveal the issue, and your doctor can work on treating it. For those who have anxiety that stems from other causes, there are other options.

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"Knowledge is power," says Cleman. "Many of the common causes of sexual anxiety in women can be treated and improved with the understanding of the female anatomy and how to achieve clitoral and vaginal orgasm faster and more consistently."

Additionally, it can help to work with a therapist — or even attend support groups. McManus notes, "There are two different factors to consider: There is the anxiety that occurs in the moment — you are in the heat of the moment and start to experience anxiety — and there is the anxiety that occurs beforehand — anxiety about the anxiety, so to speak. Both the anxiety in the moment and the meta-anxiety beforehand can be addressed and drastically improved with some help from a therapist who specializes in [cognitive behavioral therapy] for anxiety."

Reach out & get help

If you're experiencing sexual anxiety, reach out to a health care professional. It's logical to start with your regular doctor, who can refer you to a specialist or a therapist if needed and get you to a point where sex is a welcome part of your life.

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