Is it normal to be anxious about sex?
I’ll let you into a secret: you’re not the only one whose sex life isn’t perfect all the time. “Sexual problems are way more common than people think and even the numbers we do have are likely to be much lower than in reality, because cases are under-reported due to embarrassment,” says Kate Moyle, a sexual and relationship psychotherapist.
However, it’s key we don’t let shame hold us back from seeking help, adds Ms Moyle. “The longer sexual problems go on for, the more prominent they can become because of a cycle of anxiety: the more anxious we get, the more prevalent the problem,” she points out.
The best thing to do is go and see a pharmacist or GP, and the good news is there will be zero embarrassment involved. “Medical professionals are just that – professionals,” says Ms Moyle. “To them, it’s just another health problem, just another body part.”
So here’s how to start addressing those common sex anxieties…
Anxiety 1: ‘I have erection problems’
Struggling to get – or keep – an erection? You’re not alone: 4.3 million men in the UK are affected. There’s a whole raft of potential causes, from the physical (such as high blood pressure or the effects of medication) to psychological (such as stress, anxiety or depression). If it’s a recurrent problem, see your pharmacist or GP – the latter can rule out health conditions and discuss potential treatments, from medication to therapy.
“Men can feel under immense performance pressure,” explains Ms Moyle. “There’s a sense the responsibility for sex is on them, because once you have an erection you can have penetrative sex. So as a couple it can help to take the emphasis away from penetrative sex – literally ‘banning’ it for now – and instead focus on foreplay and intimacy. This allows you to enjoy the sensations and you might find you become naturally aroused.”
Anxiety 2: ‘I’m never in the mood’
According to Ms Moyle, there is no “normal” level of sexual desire or amount of sex to have. But if your normal has shifted, potential causes include anxiety, depression, relationship problems, hormonal changes (such as during menopause), and side effects of medication. Her advice to is have a chat with your GP if it’s worrying you.
“It can help to remember sexual desire is usually responsive,” she continues. “You might not be in the mood for sex but if you were to read or watch something that aroused you, or your partner started kissing you, you might respond.
“There’s a lot of miseducation that we should be spontaneously aroused and that’s not really how it works. So try making more opportunities for arousal to happen. And remove other distractions. Often people are struggling with an inability to switch off – so turn everything off around you to get turned on.”
Anxiety 3: ‘Sex is painful for me’
For men, common causes of painful sex include infection, inflammation and a tight foreskin. For women, infection, vaginal dryness, lack of arousal and vaginismus (a condition where muscles in or around the vagina shut tightly) are some typical causes. Again, the advice from Ms Moyle is to get it checked out by a GP.
“If you experience pain during sex, the positives like anticipation and excitement are replaced with fear, anxiety or tension,” she says. “So you might start to avoid sex or, for women, it can become a vicious circle where you tense up and that causes sex to be painful.
“While you’re working out what’s wrong, don’t force it or you’ll reinforce sex as something negative,” adds Ms Moyle. “You need a ‘partner pact’ where it’s OK for you to say when you’re uncomfortable having sex.”
Anxiety 4: ‘I come too soon’
There’s no “correct” amount of time for sex to last. So the speed at which you orgasm is only a problem if it’s a problem to you. However, premature ejaculation in men can be caused by a whole host of things, including prostate problems, thyroid problems and depression, so if you’ve noticed a change, see your GP.
“Men can feel under pressure because there’s this idea that when they climax the sex is over,” says Ms Moyle. “But sex doesn’t have to be linear where the end goal is intercourse. Non-penetrative sex isn’t just a route to penetrative sex, it’s sex in itself. So even if a man has ejaculated he can still engage in that with his partner.”
The same goes if the woman comes first in a hetrosexual couple – she might not feel comfortable carrying on with penetrative sex. But, as Ms Moyle notes, “The focus should be on mutual pleasure.”
Anxiety 5: ‘I’m not confident in the bedroom’
Worried about a lack of experience? Know this: it counts for nothing. “There’s no objective measure of being ‘good at sex’,” says Ms Moyle. “Because you had good sex with someone doesn’t mean the next time you have great sex with someone it will be the same kind of sex.”
But what if it’s body insecurities that are getting you down? “When it comes to body confidence, it doesn’t really matter what your partner thinks about you – it’s about what you think about yourself,” she says. “As much of a buzz-phrase as self-care is, looking after yourself is important so you learn to value yourself.”
For you as an individual, that might mean exercise, a warm bath, therapy or simply spending more alone time.
Anxiety 6: ‘I can’t orgasm’
“Exploring what you like with your partner or through masturbation can make a real difference,” suggests Ms Moyle. However, there can be other issues that play into an inability to orgasm for men (including stress, depression, diabetes and effects of certain medication, and for women (depression, relationship problems and previous traumatic sexual experience are among the potential causes), so seek advice from your GP if you’re concerned.
Removing reaching orgasm as a goal can really help, too. “Having a goal means pressure to succeed,” says Ms Moyle. “If we’re preoccupied with that we’re in our heads, and then we can’t really be in our bodies.
“But it’s the bodily sensations we experience that are going to lead to orgasm. So it’s about trying to be mindful – bringing your focus back to your senses and experiences every time your mind wanders.”
Finding a way forward
This series of Telegraph articles, brought to you by VIAGRA Connect, addresses the myths and misconceptions around erectile problems and helps men find the right treatment
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 Prevalence based on men reporting occasional and frequent difficulty getting or maintaining an erection [ref. Kantar TNS Omnibus Survey Dec 2010 – in a survey of 1,033 men]