NYC Psychotherapist Blog

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Thursday, December 22, 2022

What is Sexual Anxiety?

Sexual anxiety is a common problem for both men and women. It can come up while dating, in an established relationship, in casual relationships or in any other situation where people have sex (see my article: What is Sex Therapy? ).

Overcoming Sexual Anxiety

Sexual anxiety can be a problem that comes up occasionally or it can be a chronic issue that gets in the way of sexual pleasure (see my article: Common Misconceptions About Sex Therapy).

In this article, which is Part 1 on the topic of sexual anxiety, I'm identifying some of the most common situations where people experience sexual anxiety (see my article: What Are the Most Common Issues Discussed in Sex Therapy?).

In Part 2, I'll provide clinical vignettes to show specific examples.

What is Sexual Anxiety? 
Sexual anxiety is any anxiety you experience related to sex.  It can lead to avoiding sexual activities, talking about sex or anything related to sex.

Why Do People Experience Sexual Anxiety?
Sexual anxiety can come up for many different reasons, including:
  • Body Image ProblemsBody image issues are common for both men and women.  Many people, especially people who watch mainstream pornography (as opposed to ethical porn), feel insecure about their body. Many men feel insecure about their penis size because they see images of men with large penises in mainstream porn.  Many women worry about being too fat or they worry about other physical aspects, including the size of their breasts.  If one or both people are feeling insecure or ashamed of their body, they often feel anxious and have problems feeling sexually aroused or remaining sexually engaged.
Sexual Anxiety: Body Image Issues

  • Sexual Dysfunction: Body image issues, as well as other types of sexual anxiety, can contribute to erectile dysfunction, problems having an orgasm, low libidopainful sex for women, and other sexual issues.
  • Shame and Guilt About Having Sex: Whether the problem is related to cultural, religious, family of origin or other issues, shame and guilt can create sexual anxiety for people before, during and after sex.
  • Relationship Problems: When people in a relationship are experiencing conflict, arguments, stress in the relationship and other problems, these problems often lead to anxiety and an inability to experience sexual pleasure.
Sexual Anxiety: Relationship Problems

  • Sexual Trauma: A history of sexual abuse can create sexual anxiety if the trauma remains unresolved.  Even when someone is with a partner they love and trust, current sexual activity can trigger emotions from the past.
  • Infidelity in the Relationship: When someone discovers that their partner has been cheating, they can feel anxious about sex with their partner.  Sexual anxiety can develop when a partner worries that they can't trust their partner. They might worry about contracting a sexually transmitted infection.  Also, discovering infidelity often brings feelings of resentment, anger, insecurity and sadness as well as anxiety that interfere with sex.
Sexual Anxiety: Infidelity in the Relationship

  • Pressure to Have Sex: Sexual pressure, whether it's spoken or unspoken, is the opposite of sexual pleasure.  Sex should always be consensual.  If a person feels pressured to have sex or to engage in sexual activities they don't want to do, they can feel anxious. It they go along with it just to appease a partner, this isn't consensual.  Feeling pressured creates stress and anxiety as well as anger and resentment.
  • Lack of Sexual Experience: If one or both partners have little or no sexual experience, they can experience sexual anxiety about how they will "perform." Rather than being focused on their own and their partner's pleasure, they worry about their performance, which takes them outside the experience. This often leads to "spectatoring," which is being self conscious and stuck in their head instead of focusing on their own and their partner's sexual pleasure. Lack of sexual experience might also mean one or both partners isn't sexually informed due to a lack of sexual education.
Sexual Anxiety: Lack of Sexual Experience

  • Stress and Worry: A little stress in the form of sexual anticipation can make sex enjoyable, but too much stress can create sexual anxiety, especially when stress takes one or both people outside their sexual experience.  Even if the stress and worry aren't directly related to sex, it can be difficult to relax enough to enjoy sex.
Sexual Anxiety: Worry and Stress

  • Other Mental Health Issues: Mental health issues like generalized anxiety, depression and other problems, can create problems during sex, including sexual anxiety.  
Next Article
As I mentioned earlier, I'll give clinical vignettes about some of these issues in my next article: How Sex Therapy Can Help With Sexual Anxiety.

Getting Help in Sex Therapy
If you're experiencing sexual anxiety, you're not alone--sexual anxiety is a common problem.

Without help, sexual anxiety can get worse over time.

You deserve to have a fulfilling sex life, so instead of suffering on your own, seek help to resolved your problem from a licensed psychotherapist who is a sex therapist.  

About Me
I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist.

I am a sex positive therapist who works with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.