Picture this: A candlelit bedroom with rose petals strewn across a white duvet. On the floor, a soft shag rug with two freshly emptied champagne glasses beside it. Romantic music plays softly in the background. On the bed, two lovers engaged in a passionate kiss, her legs wrapped around his waist, his fingers trailing lovingly through her hair. 

Everything seems perfect. But they just can’t seem to do the one thing they came here to do.

She’s dressed in her sexiest lingerie, but he can’t get hard. Or he’s spent 10 minutes going down on her, but she’s too nervous to get wet. You can set up the most storybook love scene with the most attractive partner and end the night feeling embarrassed and dissatisfied. 

In many cases, the culprit is sexual performance anxiety. It’s normal, but it’s disheartening — especially when you just want to get it on. Here’s our guide to feeling confident in bed for people of every gender and sexuality.

What is sexual performance anxiety?

It’s normal to feel nervous before sex, especially when you’re getting intimate with someone for the first time. But don’t confuse run-of-the-mill nervousness with sexual performance anxiety. 

Nerves tend to fade away with time and familiarity, but if they start impacting your ability to enjoy sexual activity, that’s when you know there may be something bigger at play. If your anxiety about sex, your body, or your performance turns into an actual inability to perform, you’re likely dealing with sexual performance anxiety — which affects up to 25% of men and 16% of women.

But what that anxiety looks like for you may not be the same as what others experience. If you have a penis, you might have erectile dysfunction (ED), while someone else might have no problem getting hard but can’t last more than a few seconds before climaxing. If you have a vagina, you might find yourself drying up at the thought of being touched, or you might just find that you get too “in your head” to come.

Here are some of the other symptoms:

• Inability to climax: The pressure to perform can inhibit the body’s sexual response, making reaching orgasm a struggle.

• Premature ejaculation: Delayed ejaculation is frustrating, but ejaculating too soon also makes it hard for a couple to enjoy sex — especially if they haven’t figured out the art of multiple orgasms.

• Fear during sex: You might worry about pleasing a partner or performing sexually, and your fixation on those fears makes them a reality.

• Fear of judgment: Worrying about what your partner is thinking and feeling can create a significant mental barrier that makes it hard to perform.

• Low libido: Anxiety can significantly reduce sexual desire, killing your libido and making it hard to get or stay in the mood.

• Upset stomach: Does standing on a stage in front of a roomful of people make you queasy? Sexual performance can lead to that same sick feeling.

• Vaginal dryness: Anxiety can lead to decreased lubrication, which can have a dramatic effect on the sexual comfort of both partners.

• Pelvic muscle tension: Anxiety can cause vaginismus, an involuntary tightening of the muscles around the vagina, making penetration painful.

What causes sexual performance anxiety?

There are as many anxiety causes as there are ways for the anxiety to manifest. Here’s a look at some of the factors that could influence your ability to have or enjoy sex.

Erectile dysfunction

Anxiety isn’t always the cause of ED. Health issues sometimes make it difficult to get an erection or stay hard, and ED is a side effect of some pharmaceuticals. But once you’ve experienced this, you might worry it’ll happen again, creating a cyclical problem — the ED causes anxiety, which worsens the ED, which fuels more anxiety, and so on. 

Porn usage

Traditional porn often creates unrealistic expectations about sex, leading people of all genders to feel inadequate if their sexual experiences don't match what they see on screen. This can exacerbate performance anxiety and impact sexual self-esteem.

Low testosterone

Testosterone is a sex hormone produced by the testicles or ovaries, and it affects the libido of people of every gender. Your testosterone levels will naturally fall as you age, but abnormally low testosterone can affect your sex drive and, if you have a penis, your erectile function.

Social anxiety

People who struggle with social anxiety — an often paralyzing fear of judgment or rejection — sometimes also suffer from sexual performance anxiety. This can especially apply when you’re hooking up with someone new.

Mental health conditions

The cause of sexual performance anxiety is often mental, not physical. Anxiety, depression, and stress can all contribute to the problem. If you suspect your mental health may be the source of your troubles, your sexual performance anxiety treatment should involve a sex therapist or other mental health professional. A trained therapist can help you answer the question, “Why do I get nervous before sex?” and explore the root of your anxiety.

How to overcome sexual performance anxiety

There’s no quick fix for performance anxiety. But before deciding what to do about it, you’ll need to identify what’s causing you to feel this way. You may be experiencing a combination of factors — ED, for example, often requires a holistic approach involving a combination of psychological therapy and medication to treat the root cause.

Here are some of the avenues you may want to explore (with the help of a professional when necessary):

1. Psychotherapy

Trying therapy, especially cognitive behavioral therapy (CBT), can help you address any underlying psychological causes of sexual performance anxiety. By restructuring negative thought patterns and reducing anxiety levels, CBT can go a long way toward reducing your symptoms.

2. Medication

If your performance problems are a side effect of a prescription, weaning off or taking another medication may be the answer. In the case of ED or premature ejaculation, an ED medication like Viagra could help alleviate physical symptoms, which should also reduce anxiety. And if your hormone levels aren’t where they should be for a person your age, hormone replacement therapy might get your body back on track. Just be sure to involve a doctor when starting or adjusting medications.

3. Communication

Talking openly about your fears and expectations will help you build trust with your partner, which may lessen anxiety. Intimacy and understanding are crucial to overcoming performance anxiety, and good communication is one of the most effective ways to make it happen. If your feelings stem from insecurity about how your body looks, for example, talking it through could show you that your partner thinks you’re sexy and you don’t have anything to worry about.

4. Lifestyle changes

You may not be able to conquer sexual dysfunction without professional help, but self-care can make a big difference. Try these strategies:

• Masturbate regularly: Regular masturbation can help you better understand your body and its response to different types of stimulation.

• Practice yoga: An activity that promotes both physical and mental wellness can be a great way to improve your body image and reduce stress, which may indirectly affect your sexual performance.

• Meditate: Meditation and mindfulness are powerful tools for managing performance anxiety by creating a positive mental environment and reducing stress.

• Eliminate stress: Meditation and yoga are effective ways to cope with stress, but go a step further and look for changes you can make. Try to remove or lessen sources of stress from your life, whether that’s a situationship or a bad sleep schedule.

5. Tantric sex

When it’s time to get busy in the bedroom, take it slow. The ancient practice of tantra is all about slowness and conscious sensuality, which can help you process and overcome anxiety in the moment. Make time for foreplay, and talk to your partner about your needs and desires. Tantra has been shown to help many people overcome ED and premature ejaculation, and tantric sex can help you take control of your sexual energy.

Improve your sexual health with Quinn

We made Quinn, the audio erotica app created by women for the world, to address many of the same issues that contribute to sexual performance anxiety. You can find audios that uplift your body image, teach you more about self-pleasure, and deconstruct the unrealistic expectations created by traditional porn. If you’re interested in guided masturbation, self-care, or foreplay inspiration, the wide range of erotic content on Quinn is a great place to start.

To access thousands of audio stories and guided sessions, download the Quinn app for iOS or Android.