New research sheds light on the effects of sexual performance anxiety in couples

Sexual performance anxiety has long been recognized as a challenge for many, yet its true impact on relationships has remained somewhat of a mystery. New research published in The Journal of Sex Research has now shed light on how this anxiety affects both partners in a relationship. The findings highlight that both men and women experience sexual performance anxiety, though the specific worries and reactions may differ.

Previous studies have highlighted the negative impact of sexual dysfunction on both individual satisfaction and relationship dynamics, yet the specific role of sexual performance anxiety in these outcomes had not been thoroughly investigated. The researchers aimed to explore not only the cognitive and emotional aspects of sexual performance anxiety but also how these experiences might be influenced by gender role expectations.

“Several years ago, I stumbled upon an article, I believe by Ian Kerner, that spoke about late adolescent to young adult men using Viagra to alleviate their sexual performance anxiety,” said study author ​Amanda Bockaj, a PhD student in clinical psychology at the University of New Brunswick.

“What I found so interesting, besides the fact of how young these males were, was that these individuals did not have erectile dysfunction but were more so worried about the potential of not achieving or maintaining an erection, and the embarrassment that would follow. Therefore, before even experiencing that issue, these men would take Viagra which would then alleviate their anxiety.”

“I spoke to my supervisor about this work and dug into the literature on sexual performance anxiety. To our surprise, there wasn’t that much research focused on this form of anxiety, and the work that had been done was highly focused on men. That’s when we decided to look into men’s and women’s experiences with sexual performance anxiety and how this form of anxiety may be related to personal and relationship well-being among community couples (couples who may not experience frequent sexual performance anxiety).”

To explore how men and women describe their experiences of sexual performance anxiety, the researchers recruited a sample of 51 individuals through an online platform, focusing on those who reported frequent sexual performance anxiety. Participants were asked to complete an open-ended survey in which they described their most recent experiences with sexual performance anxiety. The survey included questions about the thoughts running through their minds during these episodes, the feelings they experienced, how they tried to cope with their anxiety, and whether they believed this anxiety had affected their sex life or relationship.

The findings revealed three primary themes in participants’ experiences: feelings of inadequacy, physiological concerns such as low arousal, and distraction during sexual activity. Feelings of inadequacy were the most commonly reported, particularly among women, who often worried about their appearance and their ability to please their partner. Men were more likely to express concerns about their physical performance, such as maintaining an erection.

The study also highlighted different coping strategies, with some participants using approach strategies, like communication and focusing on other forms of intimacy, while others employed avoidance strategies, such as avoiding sex altogether or continuing sex despite discomfort to avoid conflict. These findings provided valuable insights into the cognitive and emotional processes involved in sexual performance anxiety and underscored the importance of considering both gender and relationship dynamics in understanding this issue.

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“We saw in Study 1 that both men and women experience difficulties with frequent sexual performance anxiety, so it’s not just experienced by men, which has been the focus of previous research,” Bockaj told PsyPost. “Among our men and women participants, the most common negative thoughts reported during their sexual experiences were inadequacy (i.e., worrying about not pleasing their partner, body image concerns/attractiveness, not feeling confident in a new sexual position) and physiological and low arousal (i.e., achieving and/or maintaining an erection or vaginal wetness).”

“We hypothesize these negative thoughts may be learned through sexual social norms and experiences; which may be myths or dysfunctional beliefs such as men should be ready at all times to have sex and women should be attractive and know how to please their partner. People who experience frequent sexual performance anxiety and these negative thoughts during sexual experiences may find therapeutic services beneficial. During therapy, these individuals can challenge these negative thoughts and gain some sexual education knowledge to debunk those dysfunctional beliefs.”

Building on these insights, the researchers conducted a second study to examine how sexual performance anxiety affects not just the individual, but also their romantic partner and the overall relationship. The researchers recruited a larger and more diverse sample of 228 couples through online advertisements. Both partners in each couple were asked to complete surveys that assessed their levels of sexual performance anxiety, sexual distress, sexual satisfaction, and relationship satisfaction.

The results revealed that higher levels of sexual performance anxiety in one partner were indeed associated with higher sexual distress and lower sexual and relationship satisfaction in both partners. These effects were consistent across genders, indicating that sexual performance anxiety is not just a male issue but affects people of all genders in similar ways. This study demonstrated that sexual performance anxiety has significant implications for relationship dynamics, and that it can negatively impact both partners’ well-being, not just the individual experiencing the anxiety.

“When individuals report higher levels of sexual performance anxiety, they report higher sexual distress, lower sexual satisfaction, and lower relationship satisfaction, and so do their partners,” Bockaj said. “This showed that one individual’s sexual performance anxiety is not only linked to their own personal well-being but also their partner’s well-being as well.”

“We propose that individuals be open with their partners by using sexual communication. Letting your partner know where you are at when having sex can be very helpful to be on the same page and work as a team to make sure both partners are comfortable and working towards a satisfying sexual experience. These recommendations are based on both Study 1 and 2 findings.”

While this study provides valuable insights into sexual performance anxiety, it has some limitations to consider. For instance, the cross-sectional nature of the study also means that the researchers could not determine the direction of the effects — whether sexual performance anxiety leads to lower satisfaction, or if lower satisfaction increases anxiety. Longitudinal studies, which follow participants over time, could also help clarify the direction of the relationships between sexual performance anxiety, sexual distress, and relationship satisfaction.

“Currently, we are examining the relationship between sexual dysfunctional beliefs and sexual performance anxiety among individuals who experience this form of anxiety frequently,” Bockaj said. “We also are examining whether sexual motives (avoidance versus approach) play a role in moderating between sexual performance anxiety and sexual well-being outcomes.”

The study, “Under Pressure: Men’s and Women’s Sexual Performance Anxiety in the Sexual Interactions of Adult Couples,” was authored by Amanda Bockaj, Megan D. Muise, Charlene F. Belu, Natalie O. Rosen, and Lucia F. O’Sullivan.