Question: How does anxiety impact erections?

What is performance anxiety generally?

Performance anxiety in the bedroom plagues at least 25% of the cis-male population. It’s time to give you some concrete ways to work on it so that you can have a more fulfilling sex life. Sexual performance anxiety (SPA) is the overpowering worry that you won’t be able to deliver sexually. This pervasive negative thought spiral stops you from engaging the way you truly want to in intimate situations.

What causes performance anxiety in a sexual context?

It can stem from many things, but it is usually connected to a fear of ‘underperforming’. Common factors that contribute to sexual performance anxiety are: anxiety/stress in general, negative body image, penis shame, fear around sexual performance, or embarrassment about sexual dysfunction (E.D., premature ejaculation, etc.).

It turns out that when it comes to successfully achieving and maintaining erections, mental health might play as big of a role as physical health. During sexual activity, anxiety, fear and worry can be about as helpful to a penis-owner’s privates as a dive into a chilly swimming pool.

Unfortunately, many remain unaware of this fact. 

Those who struggle with erectile dysfunction (ED) may think they’re just broken and unfixable, their self esteem devastated. 

In a sex-negative world, we’re not encouraged to explore or learn about sexuality in an empowered way, but being better informed is a starting point for people who want to break disruptive, harmful cycles of thought and behavior that a person with ED might be stuck in. 

Let’s talk about how erections happen.

In order to better understand ED, we need to learn how erections come about. They’re actually not the simple, straightforward occurrences that they may appear to be.

Erections happen when penis owners start to become sexually aroused and blood begins to circulate into the erectile structures throughout the body, causing them to expand and enlarge. The blood vessels constrict, keeping the penis erect.

This whole process is possible because the brain sends a signal to the genitals that it is time to begin the sexual response cycle. The brain and body send messages back and forth all the time, so this messaging system needs to stay open and reciprocal for a penis to stay erect and reach ejaculation. It’s a complex biological and psychological process. 

When our nervous system is in a relaxed state, these messages can travel freely and effectively. But should the nervous system become activated, trouble could turn up. 

Anxiety and erections.

When we experience nervous system dysregulation, we often experience anxiety. Anxiety happens when we our nervous systems can’t cope in dealing with a an occurrence in our environment, whether real or not. 

In sex, this can look like getting into your head and worrying you might lose your erection, worrying you won’t last long enough, or feeling generally self-conscious.

Nervous system activation is a survival response to perceived danger, something that was forged at some point in our evolution so that we knew to run away quickly from, like, lion attacks and other threats. When this happens, our bodies basically shut down, putting all the resources we have into dealing with the “threat.”

When we’re anxious during sexual activity, the blood vessels contract and constrict the flow of blood throughout the body. When this happens in erections, they go down.

Your brain begins churning out stress hormones, too. We start releasing cortisol which raises the heart rate.

Your brain is now screaming to your boner that this is not a safe situation, you are in danger, and it is time to put that erection down. So, the erection withers away, and your blood flow is sent to your extremities so you can run like hell from that (probably make-believe) lion.

Legit, who is going to keep an erection under these circumstances?

How ongoing anxiety can make for ongoing erection problems.

The mind-body relationship is incredibly important to erections. 

When penis owners are anxious a lot, especially about our erections, ED can become a self-fulfilling prophecy. You’re anxious, so you have erection problems — which leads you to be anxious about your erections — which causes erections not to happen, and so on. 

This is the anxiety cycle that perpetuates ED.

Anxiety-induced ED may not always be about the erections themselves, but born out of other stressors that we have trouble letting go of during sex. It could be relationship issues, mental health problems etc.

All in all: It’s hella complicated.

5 ways to manage anxiety for more reliable erections.

1. Work on your breathing.

Before we can calm anxiety and start to return the nervous system to a state of relaxation, we have to learn how to breathe. Breathing is a simple way to jumpstart your sympathetic nervous system and calm you down.

Try breathing in for a count of four, holding it for a count of four, and then releasing it for another count of four. This may require you to take a break during sex in order to feel calm again. Communicate with your partner when necessary.

2. Take the idea of ‘performance’ off the table.

When any of us think that successful sex is dependent upon whether or not we can “perform,” we really do ourselves a disservice. When we let go of performance and focus on pleasure, we can have more expansive and fulfilling sex — without all the pressure. 

This can also mean expanding your definition of “sex” to include elements that are, say, not strictly tied to intercourse. 

3. Speak to your healthcare professional about possibly trying Viagra.

If you’re curious about medical options, you can look into drug options such as a prescription to Viagra or a similar drug. It’s important to note that these types of drugs can help maintain erections, but they don’t automatically give you one. 

With that being said, having them as one of your tools can be very reassuring — which lessens anxiety.

4. Tap into your senses.

Being too “in our heads” during sex robs us of enjoyment and can lead to ED. To remedy this and get you back into your body, sex therapists use sensate focus. It’s about bringing attention to what is happening with your senses — your smell, taste, sight, hearing etc. When we’re this in-tune with our senses, we don’t stay trapped in the cycle of self-doubt.

5. Get yourself a therapist.

A qualified sex therapist can be a wonderful support system when you’re coping with ED. You can work with them to manage your anxiety responses and come to feel better equipped to deal with perceived threats.

There is nothing wrong with needing a little assistance.

You deserve a beautiful, thriving sex life. Enough said.

XOXO GIGI

Part of this blog originally appeared as an interview with AskMen.