Your Anxiety and Sexual Issues Might Be Related: What to Do about It

Your Anxiety and Sexual Issues Might Be Related: What to Do about It

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Medically reviewed by Katelyn Haggerty, FNP. Last updated 8/18/2021


Have you noticed something screwy in your sex life? We jest, but it isn’t funny. Anxiety could be the problem.

According to the National Institute of Mental Health, almost 40 million people between the ages of 18 and older are diagnosed with some type of anxiety disorder.1

If you are suffering from clinical anxiety, you are fully aware of its destructive nature. If you have not been diagnosed, you may be experiencing an Anxiety Disorder and not even know it.

Due to the stigma surrounding mental health disorders, you may not feel safe talking about your anxiety issues. 

Those who are misinformed may dismiss anxiety as imaginary. They may tell you to relax or stop stressing, but severe anxiety goes beyond the average everyday strain of life.

Anxiety disorders are in fact serious, as they interfere with the ability to live life to the fullest. The significant impairment caused by anxiety disorders affects multiple life domains—often including one’s sex life.


How Does Anxiety Affect Sex?

Trying to have sex when you are anxious is like asking your body to fight itself.

Anxiety draws from the autonomic nervous system, and so does sexual activity.

You need to feel relaxed in order to have sex. It is extremely challenging, if not impossible, for your body to relax when it is at war with itself.

Also, feelings of anxiety and stress produce high levels of cortisol in your body which can squelch sex hormones. 

Not to mention the physical symptoms of anxiety such as tight muscles, shortness of breath, and dizziness; which make it difficult to focus on having sex with your partner.

It is also possible to feel anxious about the act of sex itself, particularly among those who have been abused or body shamed in the past. 

A history of violence or emotional abuse may predict anxiety disorders, which may interfere with sexual performance and enjoyment.

There are many reasons for anxiety to be related to sexual problems. Talking about the issue is often the first step toward getting over anxiety, so let’s talk about some of the undercover issues that may be lying under your covers.

Mental Health in the Bedroom: Sex and Anxiety

Confidence

Anxiety disorders may affect confidence in several areas, such as body confidence, confidence to ask for what you want in bed, and confidence to meet new people.

It is nerve-racking to approach someone to whom you feel attracted, but many of us are able to overcome the stress and attempt to start a conversation anyway. 

However, if you have more anxiety than the average person (i.e., clinical anxiety or Social Anxiety Disorder), it becomes a painful obstacle that interferes with the ability to reach out to others. 

This situation often results in a great deal of social isolation and loneliness.

Many people feel self-conscious about taking their clothes off in front of others, but one’s insecurities may be heightened by some Anxiety Disorder symptoms. 

For example, anxious rumination may involve worries about perceived body flaws such as size issues. It also may cause perceived unattractiveness due to insecurities about how one moves, feels, smells or tastes.

Most people experience these kinds of feelings; however, only those with severe anxiety issues experience them to the point where they cannot function sexually.


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You and Your Partner

Anxiety may be holding you back from telling your partner what you need or want—including sexual desires you fear may be out of the ordinary. 

Your partner might, at best, be understanding and also interested in similar behaviors; and, at worst, shame you for having such needs and fantasies. 

Either way, talking about your fears is the first step toward identifying and expressing your sexual needs.

While it may be difficult to begin a dialogue about one’s fantasies and desires when feeling anxious, it is much healthier to be open with your partner. 

Revealing your sexual needs may help to diminish any emotional barriers between you and your lover. 

And, if it also reveals that your partner is not the best match for you sexually, this insight will ultimately prove invaluable.

New York city, view of empire state building, city full of anxious people.

Libido

Libido comes from the Latin word for ‘desire.’ It refers to sex drive or interest, and is impacted by several pathways (e.g., physiological, affective and cognitive).

Anxiety may contribute to the inability to achieve or maintain an erection. When a person’s body is in fight or flight mode, it shuts down all functions except for those intended for survival. 

Naturally, it is hard to get in the mood when one’s body is fighting for its life. Whether you are worried about your performance or just plain awkwardness, anxiety can knock the sex drive right out of you.

Perhaps ironically, some antidepressant medications lead to increased sexual problems2

Doctors often prescribe Selective Serotonin Reuptake Inhibitors (SSRIs) to treat anxiety and depression by increasing serotonin. 

However, greater serotonin levels may also lead to reduced libido and the inability to function sexually.


Sensations and Orgasm

Anxiety may dull your senses. When your body is in fight or flight mode, the blood flows to your vital organs and away from your genitals. 

Obviously, you are going to feel less sexual sensation when this occurs.

Your body is coursing with adrenaline, which puts all other feelings on hold. Therefore, it is understandable that an orgasm is not going to happen when one is overcome with panic and fear.


Feelings of Intimacy

Being comfortable and open with one’s partner is also likely to be diminished by feelings of tension, anxiety and stress. 

Not surprisingly, failure to practice open communication does not predict healthy relationships.

Satisfying and loving relationships are associated with higher levels of sexual satisfaction.3

Intimacy requires a level of trust that cannot be achieved when you are unable to connect with your partner. 

As trepidation and nervousness are incongruent with trust, one cannot expect to have a good sexual experience when experiencing a high level of anxiety.


Communication and Support

It is difficult for most people to discuss the negative impact of anxiety on their sex lives. The two topics of sex and anxiety are tough enough; putting them together may feel like a double whammy. But not talking about these roadblocks will only make each of them worse.

Man and woman laying in bed together talking about their sex life.

It is important to recognize that if you struggle with anxiety and sexual challenges, you are not alone. Co-occurring sexual issues and anxiety disorders are extremely common among the general population.4

While talking about how anxiety affects your pleasure in the bedroom may feel like a daunting task, it is crucial for both enhancing closeness with your partner, as well as improving the quality of your sex life.

By keeping the lines of communication open, you and your partner will be in a better position to weather any future events that may cause anxiety and other forms of distress. And doing so will enhance the quality and resiliency of your relationship.


What Else Can You Do?

If you feel like you’ve tried everything and still find that anxiety is negatively affecting your sex life, you would most likely benefit from online counseling or therapy.

If your sex life is no longer fun or satisfying because of anxiety, it’s time to seek help.

A good therapist will help you to identify the underlying reasons for your anxiety and how they relate to sex. 

There are numerous effective tools and skills applied during sex therapy, including mindfulness approaches such as relaxation training and meditation.5

New York city, view of buildings, city full of anxious people.

Some Therapists Might Say to “Slow It Down!”

It may be suggested that you slow down the sexual part of your relationship. In other words, take as much time as you need to feel more intimate with the other person before hopping into the sack. Your anxiety might be telling you that you aren’t ready for a deeper commitment. 

You might try holding hands more often and sticking with good old-fashioned hugging and kissing for a while. And remember to tell your partner when you are feeling uneasy and talk about what you need.


Music

You might also play music that triggers positive memories or use apps for guided mindfulness. This may help you to imagine yourself having a nice time together sexually. 

Music also has the benefit of promoting relaxation, which will help to reduce negative thoughts such as anticipatory anxiety.


Go to a Doctor and Ask about Medication for Your Anxiety

It is best to find a doctor who specializes in anxiety disorders, sexual problems, or both. If you decide to try medication, be wary of addictive medications such as benzodiazepines—which may lead to a whole host of other problems. 

Antidepressant medication may be your best bet, but remember that some antidepressants may cause sexual dysfunction

Do your research, speak with your doctor, and find the best pharmaceutical approach that fits your needs.

 And be patient, as antidepressant medications take time to kick in; and you may need to try more than one before finding the best match.


YOU Are Your Best Advocate

It is also important to remember that YOU are responsible for what you get out of sex. Of course, your partner needs to help, but you need to take control of your own body. 

No one else can do that for you. If it is difficult for you to relax enough to orgasm, remind yourself that you are the sole occupant of your body. 

Don’t expect your partner to make sure you orgasm. It takes two to tango, as the saying goes. So, take responsibility for ensuring that your needs are communicated and, in this way, be your own best advocate in the bedroom.

A degree of anxiety that is above and beyond that necessary to function in a given situation is not healthy. 

Excessive anxiety leads to various negative outcomes, including a diminished quality of relationship with your partner.

Man and woman laying in bed together talking about anxiety and reading a book.

It is common for people who have Sexual Dysfunction (SD) to also have an anxiety disorder.4

Many times, it feels like a “chicken or egg” type of dilemma. In other words, while anxiety may be related to the biological, psychological, and social predictors of sexual issue; sexual issues may also lead to increased anxiety. Sometimes it is difficult to determine which problem began first.

Regardless of how they began, anxiety disorders may cause Erectile Dysfunction (ED), a downward spiral in your sex drive, dull sensations, and/or problems orgasming. 

They may also create a distance between you and your partner that can be harmful to your relationship. Trust is essential for a meaningful sex life.

By trusting your partner enough to share your innermost thoughts and feelings, your relationship will reach new heights in terms of closeness, intimacy, and stability.



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Take Your Time and Try New Things

There are many terrific ways to increase intimacy with your partner such as slowly exploring each other’s bodies while focusing on the pleasure of being touched, or taking baths or showers together. You might even play sex board games. 

For example, such a game might start by simply taking one piece of clothing off at a time. The excitement would then escalate as each person takes turns touching only one part of each other’s bodies—and not just erogenous zones. 

By moving across the board and acting out what the game says to do, you might find that you feel closer to your partner AND derive more enjoyment from your sexual relationship.

Always remember; if you suffer from anxiety, you are not alone!

There is nothing weird or unusual about anxiety—even severe anxiety. Even though people can’t always see your anxiety symptoms, it neither means it’s imaginary nor benign. There is no reason to feel shame or to hide how you feel, which will only make it worse.

Take care of yourself and seek the help you need and deserve. There are therapists and doctors everywhere who understand what you’re going through, so there is no reason to suffer in silence. Help is out there, just reach for it!

References

1National Alliance on Mental Illness. Anxiety disorders. Retrieved from https://www.nami.org/Learn-More/Mental-Health-Conditions/Anxiety-Disorders

2Csoka, A., Bahrick, A., & Mehtonen, O. (2008). Persistent sexual dysfunction after discontinuation of Selective Serotonin Reuptake Inhibitors. The Journal of Sexual Medicine, 5, 227–233.

3Sprecher, S. (2002). Sexual satisfaction in premarital relationships: Associations with satisfaction, love, commitment, and stability. Journal of Sex Research, 39, 190–196.

4Laurent, S. M., & Simons, A. D. (2009). Sexual dysfunction in depression and anxiety: Conceptualizing sexual dysfunction as part of an internalizing dimension. Clinical Psychology Review, 29, 573–585.

5Kimmes, J. G., Mallory, A. B., Cameron, C., & Köse, Ö. (2015). A treatment model for anxiety-related sexual dysfunctions using mindfulness meditation within a sex-positive framework. Sexual and Relationship Therapy, 30, 286–296.

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