How Male Performance Anxiety Can Deflate Sexual Intimacy

Man in bed rubs eyes with handsWe’ve all known boys or young men who insist they can do it all. That confidence, of course, often extends into the sexual arena, where some can experience arousal to the point of erection (or beyond) without help, or even active cooperation, from a partner. Until they can’t.

A college senior lamented to me about problems he was having: “I used to think that erections were easy, automatic, and most important, autonomous—but not anymore.” The women he was dating were confident, experienced, and, he felt, had high expectations he suddenly felt ill-equipped to measure up to.

Such fearful preoccupations with sexual performance aren’t necessarily testosterone-driven. Many boys grow up learning that they need to “suck it up” and deny any neediness or vulnerability they might feel. By the time they hit adolescence, they’ve become experts at repressing insecurity—and what teenage boy feels secure about sex?

When boys hit puberty, all those repressed emotions suddenly assert themselves below the belt. The often voracious sexuality that drives boys and men can feel impersonal and even cruel to many girls and women, but at its core, it’s generally a well-disguised expression of the same yearning we all have: to connect with another person.

The growing popularity of male performance-enhancement pills illustrates many men’s misalignment with their sexuality as they age. As a middle-aged male friend recently told me, “We expect the libido of young studs long past the time when our bodies can keep up the pretense.”

I’m now seeing many couples who have bought into the myth of 100% “successful” sex. And how are they measuring success? Vaginal intercourse in which both participants are fulfilled and satisfied. Uh oh.

Please believe me when I tell you that all loving couples experience lackluster sex occasionally. This flies in the face of media myths, films, and male braggadocio that sexual ecstasy is certain if only the guy can “keep it up.” Men who haven’t moved beyond the equation of sex = erection = intercourse become vulnerable to what some sex therapists call “inhibited sexual desire.”

I’m now seeing many couples who have bought into the myth of 100% “successful” sex. And how are they measuring success? Vaginal intercourse in which both participants are fulfilled and satisfied. Uh oh.

Once the “plumbing” fails to function a few times like it reliably had, confidence in the usual cycle of positive anticipation, enjoyable sex, and a regular rhythm of sexual intimacy typically suffers. Instead, a pernicious cycle takes its place: anticipatory fear, tension, and “failed” intercourse, leading to shame and sexual avoidance. Any desire to engage his partner withers as he becomes a fearful and passive observer of his genitals—a state of mind that’s the very antithesis of eroticism.

Issues like this aren’t limited to middle age and older; witness the college senior I mentioned earlier. By a certain age, however, men need to learn what most women already know and trust: satisfying and pleasurable sex, particularly as we age, is more a matter of intimate teamwork than of physical hydraulics.

I highly recommend Barry McCarthy’s book Rekindling Desire, which he wrote with his wife Emily. In it, he talks about “good enough sex,” reinforcing the need for loving couples to work together to move past the inhibitions that performance anxiety throws in the way of loving intimacy.

Sex therapy, of course, can be a boon for couples who seek a more customized approach to mutual sexual healing and enhancement. I utilize an approach that involves both couples and individual sessions. I learn about each person’s psychological and sexual background and make suggestions for building bridges to sexual desire, discovering cues, settings, and scenes that are inviting for each partner. Sexual healing can be fun!

I encourage single people to consider therapy as well. A man I worked with in the therapy room who’s now married recently emailed to say he didn’t think he could have “stayed in the game” long enough to meet his wife if he hadn’t faced his embarrassment and let go of his “pass-fail” approach.

© Copyright 2016 GoodTherapy.org. All rights reserved. Permission to publish granted by Jill Denton, LMFT, CSAT, CSE, CCS, Sexuality / Sex Therapy Topic Expert Contributor

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Davisha

    February 19th, 2016 at 8:03 AM

    I had to have a long talk with my boyfriend early on to let him know, make sure that he understood that vaginal intercourse is great but that I usually need a little more than that. He was cool but I am glad that I was straight up front with him and so he did not have any misconceptions of what our sex life would or wouldn’t be like.

  • Jerime

    February 19th, 2016 at 12:35 PM

    If you are only focusing on will I be able to do this or will I be able to do that there is a pretty good chance that you will not be bale to do much at all.

  • Cate

    February 20th, 2016 at 5:13 AM

    My husband really did lose a whole lot of his self esteem once this started to happen to him regularly. He wouldn’t even want to try to have sex anymore and I think that a big part of that was because he was afraid of how it made him feel if he wasn’t able to perform. He finally agreed to go the doctor, have T levels checked and things like that, and we have even seen a counselor about it a few times and that seems to be helping as well. Now I know the things that I can do to help or should not say that only makes him feel worse even if I thought that I was trying to help.

  • Cameron

    February 22nd, 2016 at 10:27 AM

    As young men we have these expectations that we feel have been placed on us. You think that women have a weird thing about their bodies, but so do guys. And the thought of not being able to get and erection or maintain one gives most of us terrors. We have become so accustomed to what we think that sex should be and when it si not like that in reality we are all thinking that someone is going to be disappointed. It would be so much better if we could just be content with the life that we have been given.

  • jen

    February 22nd, 2016 at 3:30 PM

    and when I know my man is worried that’s all I can think about too so there is definitely reciprocal pressure!

  • Hollis

    February 23rd, 2016 at 7:06 AM

    I am assuming that Viagra alone would not help resolve this issue?

  • Joe

    February 26th, 2016 at 11:37 AM

    Once the confidence fails, and this can so easily happen after a few times, then it is only natural that you start to avoid sex because you don’t want this to happen again. Instead of facing the problem and looking for a solution the solution becomes avoidance

  • percy

    February 28th, 2016 at 7:39 AM

    This could be a time when a good sex therapist could step in a help you and your partner with issues like this.

  • Annette

    February 29th, 2016 at 10:47 AM

    And what about the female issues that can also lead to a lack of intimacy between partners?

  • SamC

    November 12th, 2016 at 9:46 AM

    have suffered from sexual performance anxiety since I started having sex at age 15. I am now 60. My problems do not occur when having sex with a one night stand or with prostitutes, only with women who want some kind of romantic relationship. My marriage has been sexless since the beginning 20 years ago. When I try to engage in sex with a woman who wants to be emotionally intimate as well as physically intimate my body shuts down sexually. It starts with the inability to have an orgasm then ends with loss of erection. Sensate Focus and other sex therapy treatments did NOT work . As a matter of fact they made my wife and I feel worse about our situation. So much so she quit Sex Therapy because she found the Sensate Focus exercises humiliating because I was unable to respond sexually to her. The various therapists I have been to over the years have been unable to help saying only that the probable cause was to be found in family of origin childhood (non sexual) abuse which has caused me to suffer from a Adult Attachment Disorder.

  • Daniel S L

    April 5th, 2017 at 4:36 AM

    I don’t know if this is the right section to ask this but I’ll take my chances anyway.
    Hi All, I just want to ask if you ever tried using cannabis for anxiety? I am 35 years old now and been battling anxiety and panic attacks for almost half of my life. I have read many articles about medical marijuana and how it can help you in terms of pain management, anxiety disorders and panic attacks, inflamation, even cancer and a lot more. Cbd and thc are also new to me and I don’t even smoke. If this is true I cant find any solid conclusive evidence that speaks to its efficacy. Any personal experience or testimonial would be highly appreciated. Thanks

  • Tramadolshop

    January 17th, 2020 at 2:11 AM

    According to me, a person’s psychology plays a crucial role in his sex life. For getting confidence in sexual performance, medications can also help.

  • Gonny

    October 27th, 2021 at 5:39 AM

    For me my sexual performance anxiety is driven by insecurity due to penis size. I have a slightly small penis than average. I keep thinking the girl I’m with has had sex with guys with huge penis and I feel I can not satisfy her. Even if I had a average size or slightly large size she probably has been with guys that are big. So I feel inadequate. Sometimes driving ED.

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