Psychosexual: How Anxiety Effects Sexual Function

When we are feeling stressed or anxious, this can have a direct impact on the way the body responds during sexual arousal.

The physical process of arousal is controlled by the Parasympathetic Nervous System (PNS). This is an involuntary system that is activated when we feel aroused. It is also responsible for helping us feel relaxed, content and calm.  It does this by releasing particular hormones in the brain that help to create physical and psychological changes to allow our bodies to respond sexually.

These include bloodflow changes in the body that allow:

• For people with penises, to help gain an erection, increasing pleasure and allowing for penetration (if desired).
• For people with vulvas, your clitoris and labia may swell (outside), and your vaginal canal (inside) may become wider and wetter (lubrication). This all allows for more pleasurable and comfortable sexual contact and penetration (if desired).

The activation of this system can also help everyone

• Gain a sense of control over arousal and help the process of ejaculation/ orgasm to build and reach a peak over time within a sexual experience
• Allow for us to relax, and create a focus on sex; experiencing pleasure and become motivated by the reward of a sexual situation.

However, there is another nervous system that operates in our bodies, and is activated when we feel stressed, anxious or in danger. This is called the Sympathetic Nervous System (SNS).  This  system is responsible for our ‘fight or flight’ response and helps to prepare the body to protect itself from danger.  It causes our heart rate to increase, sends blood to the muscles in order to get ready to fight or run away. It’s not usually that useful to feel horny when we are about to fight something or run away, so we find that when this system switches on, different hormones are released that disrupt sexual function and the ways our bodies work in sex.

This process would be useful if there was real threat or danger ( e.g. You were having sex and all of a sudden a fire broke out). However, these kinds of emergency situations during sex are not that common. Instead, our ‘fight or flight’ response is activated by sex related worries like:

• what if I come too quickly?
• I am not a good in bed as other men
• they look bored, they mustn’t like this
• I hope I don’t get syphilis again
• I probably should have used a condom
• they’re not that into me
• what if I can’t perform like my partner is expecting?

Stress related to sex impacts our bodies in the same way stress about anything would. This can be frustrating during sex, as our bodies will often respond as if there is a threat present, just at the point we want to feel relaxed and for our bodies to work sexually. This means that our bodies may then not work in the way we want, which reinforces the idea that there is something to worry about, and therefore increasing stress and worry next time we try to have sex.

So, if you are feeling stressed or anxious (about sex, or anything else), your SNS is probably in control. This will make getting an erection, or experiencing the above changes in your vagina and vulva, very difficult. It can also disrupt the ways in which we come, making it more likely we may come early, or take longer than usual to reach orgasm. Over time, if our brain learns to associate sex with pain, embarrassment, or stress, then it will continue to react as if sex is a dangerous event. This leads to a vicious cycle:

There is another aspect to this that is also important. When we feel worried in sex, our attention moves away from sex and what we are enjoying with our partners. We tend to focus on what might go wrong, or what the other person might be thinking of us. Sometimes this means that we rush sex, or try hard to stop thinking sexual thoughts to slow down our feelings of being turned on.

This shift in our attention often means have less opportunities to focus on aspects of sex that might relax us or bring different types of pleasure. Focussing on our worries in sex also increases feelings of stress and tension which in turn again makes it much harder for our bodies to control when we come.