Difficulties with sexual performance or erectile functioning are far more common than most people realise. Yet they’re also among the least talked about concerns — often accompanied by embarrassment, frustration, or a sense that something is “wrong” on a very personal level.

Many men who experience these issues are otherwise functioning well in their lives. They may be successful at work, physically healthy, and in stable relationships — which can make the problem even harder to understand or accept.

The reality is that sexual functioning is closely linked to the mind, emotions, attention, and nervous system. When anxiety enters the picture, performance often suffers.

Understanding Sexual Performance Anxiety

Sexual performance anxiety occurs when attention shifts away from connection and experience, and toward monitoring, pressure, and self-evaluation.

Instead of being present, the mind becomes focused on questions such as:

• “Will this work?”

• “What if it happens again?”

• “What does this say about me?”

This internal monitoring activates the body’s threat system — the same system designed to respond to danger. When that system is active, arousal naturally decreases.

In other words, anxiety and sexual arousal work against each other.

Why Erectile Difficulties Often Have a Psychological Component

Erectile difficulties are often multifactorial. While medical factors should always be considered and ruled out where appropriate, many cases involve a strong psychological component — particularly when difficulties fluctuate, occur in specific situations, or worsen after an initial episode.

Common psychological influences include:

• performance pressure or fear of failure

• anticipatory anxiety after a previous difficulty

• relationship tension or communication difficulties

• shame, avoidance, or self-criticism

Once the issue occurs, it’s common for anxiety to attach to future sexual situations — creating a self-reinforcing cycle.

The Cycle That Keeps the Problem Going

Sexual performance difficulties often persist due to a predictable cycle:

1. A difficulty occurs (often during stress or distraction)

2. The experience is interpreted as a personal failure

3. Anxiety increases during future sexual encounters

4. Increased monitoring and “trying” disrupts arousal

5. Avoidance, tension, or reassurance-seeking follows

Over time, confidence erodes — even if sexual function was previously reliable.

Breaking this cycle involves understanding it, rather than fighting it..

Masculinity and Expectations

Many men quietly hold beliefs that sexual performance should be automatic, reliable, and unaffected by stress or emotion. These expectations can worsen anxiety when reality doesn’t match them.

Therapy often helps clients:

• challenge rigid or unhelpful expectations

• separate sexual functioning from self-worth

• approach intimacy with more flexibility and presence

• rebuild trust in their body and responses

Change tends to happen not through pressure, but through understanding and decreased threat.

When It’s Worth Getting Support

It may be worth seeking professional support if:

• performance concerns persist or worsen over time

• anxiety is present before or during sexual encounters

• avoidance or tension is developing

• the issue affects confidence, mood, or relationships

• medical causes have been ruled out but difficulties remain

How I Help With Performance Anxiety

My approach in therapy to assist clients experiencing sexual performance anxiety and erectile difficulties, focuses on evidence-based principles and draws from various psychological interventions that I tailor to your specific needs and goals.

This generally involves:

• understanding how anxiety, attention, and arousal interact

• identifying performance pressure, beliefs, or assumptions that increase threat

• working with avoidance or safety behaviours

• building emotional awareness and nervous system regulation

• reducing self-monitoring and excessive control

• addressing broader stress, burnout, or relationship factors

Rather than chasing certainty or control, the aim is to help the body feel safe enough for normal functioning to return.

If you’d like to arrange a session to discuss your specific situation and see what I can do to help, please get in touch using the form below

Telehealth sessions are available Australia-wide.