Performance Anxiety
in Women

Performance anxiety has been used historically to refer to male sexual functioning. Women can have stress, fear, or worry around a number of sexual dynamics. Lauren discusses problems that manifest as a result of sexual anxiety and what can help.

By Lauren Campbell, LCSW, PLLC

The term “performance” creates a great deal of pressure in regards to sex and sexuality, regardless of
gender. What has been termed performance anxiety should actually be referred to as sexual anxiety.


Performance anxiety has been used historically to refer to male sexual functioning. Male sexuality is a topic at the forefront of our culture. Unfortunately, little focus is given to female sexual pleasure and sexual functioning.


This pattern has been shifting recently as women feel empowered to restore a healthy sense of sexual self. Despite this shift, challenges for women continue due to the historical prioritization of male sexuality.


Women can have stress, fear, or worry around a number of sexual dynamics.


For some women, even the thought of sexual intimacy can create anxious energy in the body. If over time, a woman has consistent feelings of sexual anxiety, she may withdraw both physically and emotionally to avoid potential sexual encounters. This overarching fear of uncertainty around the entire act of sex itself is incredibly common.

There is not a normal way to be when it comes to sexuality. Your happiness will be found when you learn what is best for you sexually no matter what anyone else is doing.

Not knowing how to initiate, what will happen during, and what the outcome will be can produce a stress response which can completely shut down our ability to even think about anything sexual.


Many women will intentionally avoid physical closeness or affection in fear that their partners will expect sexual intimacy.


For couples in long term relationships this sexual and emotional disconnect may grow and create unstable dynamics. For women who are looking to find a partner, this fear may lead to a decreased chance of forming a secure relationship.


Other problems that can manifest as a result of sexual anxiety are poor body image, low self-worth,
sexual pain issues, difficulty having orgasms, and dysfunctional relationships.


Body image has a significant impact on a woman’s self-esteem.


The way we perceive and view our physical selves has a profound effect on how we interact with others on a daily basis. Having a negative sense of our bodies and physical appearance continuously interferes with connection.


Low self-worth can develop over time as a result of sexual anxiety. The feeling of insecurity that can
develop from not having a healthy sense of our emotional selves will directly impact how we physically feel in our bodies.


Given the increase in social media usage in particular, women are comparing and judging their bodies
more than ever.


Media, in general, plays a major role in how we see ourselves. Women question their sexiness as they
compare themselves to the media portrayals of what is “desirable” in our culture.
Although efforts are being made in more recent years to shift the thinking around body image to a more
realistic and positive one, women still bear the brunt of decades of body shaming.

Sexual pain can be a complex and layered issue depending on the individual woman’s upbringing. Pain
can manifest as a result of a single traumatic event, or years of multiple negative developmental experiences.


These pain issues are typically not discussed in sex ed in school or at home and leave women feeling
embarrassed and alone.


There are also medical conditions and physiological issues that can cause or contribute to sexual pain.
This can be assessed through both medical and therapeutic support. Sexual pain can vary in regards to the specific area of female genitalia affected and the type of discomfort experienced. The type of
treatment received will depend upon the diagnosis and each individual’s needs.


Anorgasmia or difficulty having orgasms is also a common challenge that can result from sexual anxiety.


Anxiety itself creates a survival response that prevents a person from being completely present in their minds and bodies. The mind-body connection then becomes disconnected, making orgasm difficult or unachievable.


A better understanding of the anatomy and arousal cycle can help both women and their partners develop a more fulfilling sex life. It is important to note that a woman can very much enjoy her sexuality without having an orgasm.


Despite what we may see in movies and porn, orgasms can enhance a woman’s experience but are not
necessarily essential to great sexual experiences. Therapeutic support can help women who would like
to better understand their bodies and know more about what makes them feel good.


There are a number of other ways that sexual anxiety can impact women. There are solutions for any factors creating hurdles to feeling free in mind and body. Even when you think there is no hope or that too much time has passed, there are solutions.


There is not a normal way to be when it comes to sexuality. Your happiness will be found when you
learn what is best for you sexually no matter what anyone else is doing. Helping you find what works best for you and your needs is where it’s at. Finding a therapist who specializes in sex therapy and understands the connections impacting your sexuality is essential to finding a solution.

Lauren Campbell is a psychotherapist and licensed clinical social worker who specializes in sex therapy and relationship/couples counseling. She has a deep understanding of how people get stuck in different areas of their lives. She helps her clients get unstuck and learn productive and sustainable ways to improve their relationships. Lauren believes that the strength of any relationship derives from each individual’s abilities to balance togetherness with autonomy. To balance emotional intimacy with sexual intimacy. Lauren’s focus around sex and couples/relationship therapy stems from her training in family systems, attachment, psychodynamic, emotionally focused and mindfulness based approaches. She works with adolescents and families as well, helping improve parent-child and sibling dynamics. Lauren is one of the therapists at Relationship Restoration in Raleigh, NC.

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