Whether due to expectations or personal worries, it is common for men of all ages to experience performance anxiety and erectile dysfunction at some point.

Stress about sex can lead to performance anxiety. This, in turn, can lead to erectile dysfunction (ED), which is difficulty getting or keeping an erection.

Some simple coping methods may help men deal with ED related to performance anxiety.

What is the link between performance anxiety and ED?

couple sat on bed with performance anxiety and erectile dysfunction
Stress and anxiety can cause sexual dysfunction, which may lead to ED.

Performance anxiety and ED may be linked in several ways. Stress and anxiety about performing sexually or pleasing a partner can cause sexual dysfunction in both men and women.

When these personal sexual expectations are not met, it may lead to a downward spiral of feeling unworthy or incapable.

In men, these feelings of inadequacy and low self-esteem may turn into physical symptoms, such as ED.

Research notes that there is a clear link between a man’s state of mind and his ability to perform sexually.

Causes of performance anxiety

Performance anxiety is typically caused by negative thoughts about one’s ability to perform well during sexual activity. This may include feelings of sexual inadequacy or the inability to please a partner.

These feelings may be influenced by body image, penis size, or by perceptions about manliness or a man’s role. More generalized negative thoughts about one’s life may also contribute to performance anxiety.

Dealing with stress at work, in the family, or with money may also influence a man’s mental state and contribute to performance anxiety.

Causes of ED

Drinking may lead to performance anxiety and erectile dysfunction
Smoking, drug abuse, and alcohol may all contribute to ED.

ED is a symptom caused by a range of complex contributing factors. ED can occur when there is a disruption in any of the processes related to getting an erection, including the man’s mental state. ED can also be related to the nerves, hormones, or even circulation of blood.

In addition to performance anxiety, other things that may contribute to ED include:

  • depression
  • disinterest
  • stress
  • low testosterone levels
  • smoking
  • alcohol or drug abuse
  • chronic illnesses
  • kidney disorders
  • nerve damage from diabetes
  • stroke
  • injury
  • pelvic irradiation
  • recent surgery

Some medications may also cause ED, especially those that disrupt or alter the hormones, nerves, or circulation in the body. These include:

A doctor or pharmacist can help identify these potential side effects before a person starts a new medication.


Performance anxiety affects everyone differently, as everyone responds to stress and anxiety in different ways. In the body, this could produce various symptoms, such as premature ejaculation, inability to orgasm, or loss of interest in sex.

The physical symptoms of ED include trouble getting or keeping an erection and may also lead to a loss of sexual desire.

How to cope

There are many tips that can help people cope with performance anxiety and ED, and help them have positive sexual experiences.

Avoid the cycle

Many men can fall into a cycle of performance anxiety. Having a disappointing sexual experience from time to time is perfectly normal and occasional symptoms of ED are not usually a cause for concern.

However, men with performance anxiety may dwell on this event or consider it a failure. This may lead them to be anxious about sexual activity in the future, and this anxiety may cause the ED to continue.

Instead, it is essential that men understand that what they perceive as a sexual failure is a perfectly normal event.

Instead of focusing on the negative outcome, it may help to identify what stressor or worry influenced the symptoms of ED. The cause may be simple, such as an upcoming project at work or planning a family trip.

Shifting the focus to the cause, rather than the symptoms, may help a person reduce the pressure to perform well every time, especially during times of increased stress.

Focus on the senses

Many men with performance anxiety mentally relive their perceived sexual failures regularly. They may constantly worry about what their sexual partner is thinking or how they will be perceived during sexual activity. A tip to cope with this is to focus the mind on the senses instead.

During sexual activity, it may help for a man to focus on sensory experience rather than analyzing the event.

Focusing on what the hands are feeling or what the eyes are seeing can help a man block out anxious thoughts about performance. Using scented candles or romantic music might also add to the sensory experience and serve to lessen a man’s anxiety.


trail runner
Regular exercise a few times a week may help with ED.

Research has noted that getting little or no physical exercise has been linked to ED symptoms. A simple 20 to 30-minute exercise routine a few times a week may also reduce stress levels.

In addition to general exercise, specific exercises may also help symptoms. Pelvic exercises, such as Kegel exercises, may help strengthen the muscle responsible for pumping blood to the penis during erection. A man can do a Kegel exercise by clenching the muscles used to stop the stream of urine.

Other techniques

Many other techniques are used to treat performance anxiety and ED. These include things such as:

  • guided meditations, such as guided imagery therapy
  • couples counseling
  • sex therapy
  • sexual education
  • reducing stress

It may also help for a man to be open with any sexual partners about their performance anxiety. This can reduce stress, and their partner can help them find solutions to relieve their anxiety.

When to see a doctor

While taking personal steps to help performance anxiety and ED may help many men, there are some occasions when a doctor should get involved.

Anyone who continues to experience performance anxiety after they have taken steps to alleviate symptoms may want to speak to a doctor about their stress or anxiety levels,

Men who experience symptoms that get worse or appear more frequently over time should also see a doctor.

Doctors may do a physical exam or blood work to help identify any underlying physical causes of ED and may ask questions about the man’s mental health and stress levels.

Doctors may also have more tips on managing performance anxiety and ED. Working with a healthcare professional, many men can find a therapy or treatment that helps relieve their symptoms and encourage positive sexual experiences.