Most men have had some type of sexual problem in their lives. The most common issues include performance anxiety and erectile dysfunction (ED). Performance anxiety happens when you feel stress about your body image or your ability to please your partner. It can lead to ED. Men dealing with ED have a hard time getting and keeping an erection.

Read on to learn more about the connection between performance anxiety and ED.

Some research has shown a link between performance anxiety and erectile dysfunction. A 2005 study found that performance anxiety can cause and maintain sexual dysfunction among both men and women. A more recent study from 2015 found a connection between depression and performance anxiety and noted that there may be a link between performance anxiety and ED. However, the study recommended more research be done.

Can stress and anxiety cause erectile dysfunction? »

Performance anxiety is caused primarily by negative thoughts. These thoughts can be related to sex or issues in your daily life. Men can feel pressured to please their partners or feel insecure about their ability to perform sexually. Fear and anxiety about penis size and body image could also play a role in performance anxiety. Other causes of performance anxiety may include stress about:

  • work
  • relationships
  • kids or other family members
  • finances

Learn more: What’s the average penis size? »

ED can be triggered by different physical and psychological factors, including performance anxiety. Other causes of ED can include:

  • blood vessel disorders
  • neurological disorders, such as multiple sclerosis
  • stroke or nerve damage from diabetes
  • stress
  • depression
  • lack of motivation
  • traumatic injury
  • low testosterone levels
  • chronic illness
  • prostate, bladder, and colon cancer surgeries
  • smoking
  • kidney problems
  • alcohol or substance abuse

Certain medications can also cause ED because of their effect on hormones, nerves, or blood circulation. ED is a common side effect of:

  • diuretics
  • high blood pressure medication
  • antihistamines
  • antidepressants
  • drugs for irregular heart action
  • Parkinson’s disease drugs
  • tranquilizers
  • muscle relaxers
  • hormones
  • chemotherapy drugs
  • prostate cancer drugs
  • antiseizure pills
  • anti-inflammatories

Performance anxiety affects men in different ways. In addition to ED, performance anxiety may lead to:

  • premature ejaculation
  • delayed or blocked ejaculation
  • loss of sexual interest

Erectile dysfunction has its own set of symptoms, including:

  • problems becoming erect
  • trouble keeping an erection
  • loss of sexual desire

Seek help if your performance anxiety persists or if it happens more frequently. The earlier you visit your doctor, the sooner you can learn techniques to deal with any negative thoughts, fear, and stress. You may also be able to rule out other conditions that could be affecting your ability to perform.

It’s important to visit your doctor if you have ED or sexual dysfunction. Your physician will ask you questions to figure out if the problem is physical, mental, or both. They’ll also do a general physical exam, including an examination of your penis and testicles. Your doctor may also want to run blood work and do other tests.

There are many ways you can manage performance anxiety. If your performance anxiety is causing ED, treating the performance anxiety may also help reduce ED.

Some options for managing performance anxiety include:

  • meditation
  • education about sex and sexual behaviors
  • talk therapy to manage stress, depression, and other life concerns
  • couples counseling to help with relationship problems
  • sex therapy to work through intimacy and performance issues
  • change in lifestyle, such as exercising more and eating better
  • being open about your anxiety and worries with your partner
  • clearing your head of negative thoughts
  • removing stressful factors from your life
  • not rushing sex
  • focusing on what you can do, not what you think you should do

Guided imagery

Guided imagery is another therapy technique that may help you to overcome performance anxiety. With guided imagery, you enter a light, trance-like state where you listen to a script describing a vivid scenario. The technique is meant to help your body overcome any mental or physical problems you’re dealing with by tapping into your unconscious mind. Research conducted by psychiatrist K. Kuruvilla in 1984 found that men who underwent guided imagery and sexual re-education were able to overcome ED caused by stress and anxiety.

You don’t need to visit a therapist to go through guided imagery. To do it at home, write and record a script that will allow you to visualize a successful sex session with your partner. When you listen to the script, focus on getting and staying hard and having an enjoyable sexual experience. The more you go through the process, the more your conscious mind will be able to overcome any performance issues.

Performance anxiety is a completely normal and treatable type of sexual dysfunction. If you also have ED, your performance anxiety may be the cause. It’s important to see your doctor if you’re having sexual dysfunction so that they can rule out underlying causes and help you manage your symptoms.