Anxiety and Sex: What to Do About Sexual Anxiety

I wish everyone knew how much anxiety most people carry inside themselves about sex.

Knowing you aren’t the only experiencing sexual anxiety can help you get just a little curious about why it’s happening.

At the root of the worry is always the question, “Am I enough?”

  • This worry gets disguised into lots of different sub-worries like:

  • “Did I last long enough?”

  • “Am I as sexy as his last girlfriend?”

  • “Is my penis big enough?”

  • “Are my breasts big enough?”

  • “If I don’t come will he think I’m broken…am I broken?”

  • “I am the only one that doesn’t know how to orgasm so that means I am defective.” (Ok that was a declarative statement but still a worry!)

  • “Can I make her multi-orgasmic like her last partner did?”

Can you see how all of these thoughts tie back to the question of being enough?

It’s crazy that the whole population is asking themselves this same question and what’s crazier is that it’s infiltrating your bedroom and relationship and creating a narrative that just isn’t true.

What happens if someone continues to hold this worry? It creates a disruption to the mind-body connection.

What the heck is the mind-body connection anyway?

In short, it is the miracle of being human.

It is the intricately woven relationship between how we feel emotionally and how we feel physically.

Our thoughts, feelings and attitudes influence how we feel physically.

I had a recent experience of this with my own appearance. After canceling a hair appointment and having to wait a very long time to get another, my hair looked shapeless- but I was kind of used to it and continued styling it as I usually did.

After arriving to the appointment finally, I suggested to my stylist to cut it with more of an angle and with more layers. My hair looked fabulous! I felt more attractive and began to wonder where I could take my new hair cut out to show it off. I decided to take a selfie and posted it to social media.

The feedback that came back to me wasn’t about my new hair it was about the “radiance” my smile had in the photo. Someone commented how I had “really come into my own”. (Whaaaat!!!!!!!)

I was shocked initially, but then sat with the photo and saw a genuinely happy smile that typically posted selfies I’ve shared didn’t contain.

My feelings about my hair shape-shifted my attitude and it came beaming through my smile.

That my friends is the mind-body connection.

Anxiety and sex often go hand in hand and you might be wondering what to do about sexual anxiety? These are 5 facts to help you challenge you fears around being worthy or good enough in bed.

Can you imagine your sexual relationship holding that kind of energy instead of the worried thoughts that preoccupy your mind as you are going through the motions of sex by trying to please your partner or making sure you look “normal” or at least not “broken”?

What makes this even more challenging is that most people try to hide their worries from their partner.

They worry if they knew the real thoughts and feelings they were having they would find them less attractive.

This thought then involves not only having to contain the worries but it also adds another layer of defense where you having to hide the worry.

Talk about a block to pleasure! It’s a double whammy!

How on earth could you even have the space to focus on pleasure or feel the connection that sex is meant to bring to two people?

What people don’t realize is that this becomes a self-fullfilling phrophesy.

The actual worry of not being enough to create pleasure or connection manifests in a sexual experience with your partner that is cloaked in worry, agitation, and disconnection. You create the very thing you have been worried about! To read about relationship repair, head here!

Your sexual energy gets dulled and impaired either through trying so hard it creates stress, or by not being able to pay enough attention due to the anxious thoughts in your head that you can’t get into the erotic space, can’t feel your feelings, and can’t track sensation in your body.

This is not what sex is meant to be.

Getting caught in anxiety spirals about and during sex, you are moving away from your birthright of pleasure and connection.

Worst of all it’s just one huge miscommunication between you and your partner. You know how it goes… you both walk away disappointed and worried that something is wrong with themselves and the relationship.

What a waste of time, energy, relationship and opportunity!

What is true is this: You are Enough.

Here are some thoughts I’d like to offer you to challenge your fears of worthiness.

  1. Physically attractive people come in all kinds of outside packaging. There are many varies of beauty and handsomeness. Just look at the celebrities- you can find variety in every sort of body part, hair color, height, and size.

  2. Sexual pleasure is not tied to size of any body part. It’s not how big someone’s penis is that gives pleasure - just ask a woman with a smaller vagina. Pleasure can be delivered in a multitude of ways. What it is actually tied to is the ability to feel worthy of pleasure, attention, and being seen inside and out. It’s about the ability to welcome pleasure.

  3. Anxiety around sex is often tied to the meaning people make out of sex. Is sex had kept on a scorecard? If sex doesn’t happen frequently enough does a bad mood set in? Does it mean something more than just connection and pleasure? Is it a way to measure one’s masculinity? Does it mean you are desirable? Is there the fear that someone will have an affair if sex isn’t good enough? Is it the ruler being used to mean you are loved? These are all problematic thoughts that change the experience of sex.

  4. Sex needs to be a flexible experience and seen on a continuum. It can’t be graded each time and held to a standard that creates perfectionism. Sometimes you can have hanging- off -the- chandelier-sex and at other times body parts just won’t cooperate, and maybe sex that day is a good make out session and back rub. If it’s expected to always contain penetrative sex every.single.time. you are heading for troubles because perfectionism is at play.

  5. Your emotional relationship health ties to your sexual relationship’s health. If you feel unseen or unheard by your partner why would you want to be make yourself vulnerable to opening up to them? Removing the obstacles to closeness can help people create more intimacy sexually.

If you find yourself stuck in any of these scenarios I want to let you know there is help to be had.

I, for one, have helped people repair some of their individually and relationally held attitudes about worthiness as it relates to self and have helped them create new sexual narratives about themselves and their partner.

They’ve created a magical sexual connection again with each other by engaging in therapy and learning to explore themselves and their ideas about worthiness.

Jan Carey provides sex therapy for people experiencing anxiety about sex. Working with a sex therapist near me can help you understand and heal from sexual anxiety.

I’m a sex therapist in Maryland and Pennsylvania.

I’m passionate about helping people understand anxiety and sex, and move through sexual anxiety and experience the desire, pleasure and connection they deserve.

Book a free consultation to learn more about how online sex therapy or sex therapy in my Ellicott City office can support you.

I’m here to walk with as you challenge your limiting ideas about yourself, so you too can reclaim your right to pleasure and connection.


I’m a couples counselor and sex therapy in Ellicott City, MD who provides in person and online sex therapy in Pennsylvania and Maryland.

I specialize in couples counseling, sex therapy for couples, affair recovery, out of control sexual behaviors and therapy for men.