top of page

How Does Anxiety Affect Sex?

Suffering from a general anxiety disorder can crank up your stress levels, hold back your career and create problems in social settings so it makes sense that when it come to your libido, it can also make a huge dent between the sheets.

How Does Anxiety Affect Sex?

Anxiety affects sex in different ways. In many cases, the exact connection is complex.

The key issue to understand is that the mental and physical changes that come from dealing with regular anxiety make it difficult to maintain a healthy libido.

Here’s a simplified explanation of some of the main connections.

General levels of distress

Anxiety tends to cause the mind to be distracted by various anxiety-related thoughts.

Those distractions make it much harder to feel the moment, so during times when you would normally experience sexual desire, your mind is elsewhere focused on other things.

Sexual desire is a happy feeling; anxiety is a negative feeling. It is far more difficult to experience enjoyable emotions like sexual desire when you are overwhelmed, feeling shame, fearful, sad, worried, have panic attacks or feeling distressed as a result of your anxiety.

Anxiety causes the mind to focus more on the negative and makes overcoming it with positive emotions seem impossible. That’s why it also makes it impossible to be present in the moment and indulge in sexual intimacy.

Hormone changes

Panic, worry and incessant thought patterns have a physical effect on your body by ramping up the stress hormones: cortisol and adrenaline. This leads to you feeling jittery and on edge.

Where sex is concerned, these stress hormones aren’t a good thing because they impact on your whole physical health including the libido.

Focusing on the anxiety, and the stress that accompanies it, kick starts the fight-or-flight mechanism which leads to a sustained exposure to cortisol.

This, in turn, decreases the immune system as the body uses its resources to fight perceived threats.

If the body is on fight–or-flight mode for any length of time it can cause a domino effect by shifting the balances in your brain and body. The knock on effect negatively impacts on your sex hormones: testosterone and oestrogen.

The good news is that the reverse is true. Once you get a handle on the root cause of your anxiety, and begin to bring down the accompanying symptoms, hormone balance will return and your sex drive will increase.

Emotional intimacy

Anxious feelings can sink the closeness with your partner in several ways.

Emotional intimacy requires trust, tenderness, patience and vulnerability.

People who suffer from anxiety have these in bucket loads, because they are highly sensitive creatures, and give generously to the relationship. If anxiety kicks in, however, it can quickly erode them.

Anxiety steals the magic

It’s the specific symptoms of anxiety – intense worry, insecurities, paranoia and fear – that steal the magic and loosen the connection between two people who belong together.

If you are an anxiety sufferer you might be super sensitive to the needs of others and give generously to your relationship. However, anxiety can drain resources from the relationship just as quickly as you invest them.

You may feel reluctant to ‘burden’ your partner with your concerns and tend to dismiss them which means you could do yourself out of the opportunity to feel nurtured and supported by your partner because there’s nothing more healing than the warmth of the person you love.

How anxiety creeps in

By the same token, anxiety has a way of creeping into everything unobserved. Left unchecked it can make you doubt the things that are actually OK – like your relationship.

It’s very normal to ask your partner for reassurance but too much and it could become ‘anxiety neediness’. Over time, too much of this can smother the magic.

One way that anxiety creeps in is through the need for constant reassurance. This causes sufferers to hold in the accompanying thoughts and feelings in order to protect themselves from possible heartache by not allowing themselves to be vulnerable.

How to stop anxiety ruining the intimacy

Being open to another is a beautiful thing and is the essence of a successful, healthy relationships. The problem with holding back too much is that it can invite the very rejection you’re trying to protect against.

Part of being intimate is letting someone in closer than you let anyone else and trusting that person with seeing the fragile, wild and messy part of you.

These parts can be beautiful because allowing them to see your real self builds trust that whatever happens, when you open yourself up to being loved and loving them, it will be OK.

Anxiety and the naked, critical voice

Getting naked in front of someone can make you feel intensely self-conscious when you suffer from anxiety. This can have a direct effect on your libido.

The anxious and critical voice might obsess about so-called body flaws. Self-consciousness about body shape, the way you smell, taste or perhaps move is heightened when you have anxiety.

This shuts down the ability to be fully present emotionally and physically during sex, which inhibits fully being able to give and receive sexual pleasure.

Anxiety can stop the climax

The anxiety can be so great it causes the body to shut down so that you're unable to experience enough arousal to tip over the edge to a climax.

The symptoms of anxiety during sex might be:

Shallow breathing

Clenched muscles

Goose bumps

Mind racing

All of these are part of the fight-or-flight stance and will block you from letting go and reaching climax. They put the brakes on the body working to achieve satisfaction.

For men this can play out as a loss of his erection or suffer premature ejaculation and for women it can put the brakes on lubrication and make the vaginal muscles so tense and contracted that penetration is impossible.

Anxiety also keeps you from asking for what you want and makes it ten times harder for close partners to share their preferences and fantasies than for those who don’t suffer.

Become transparent

Being highly anxious masks the reality that whatever you want in bed is 100% normal and okay. You will have a better relationship when you feel that you can be completely transparent with your partner.

Trying to hide anxiety and overcome it, all without your partner’s knowledge, causes further stress because you'll find that you will be overcompensating by trying too hard to get aroused.


Loss of libido is so common in people affected by anxiety disorders that this is often a first reason for consulting a professional.

However, ‘sexual aversion’ is another type of problem that is also prevalent in people who are prone to anxiety.

One study[i] suggests the reason for this particular problem was that both men and women feared having a panic attack during sex.


Because arousal is a reflex function, and not something you can force, so the more you try to force it, the harder it gets.

By sharing your anxieties about getting naked and the ensuing insecurities, you may find that being open about the problem takes some of the stress off you. This, in turn, will lower that critical voice that sits in your head just waiting to tell you how rubbish you are!

Anxiety medication can affect sex drive

It can come as quite a surprise when you go to your doctor for anxiety problems that the prescribed medication pulls the plug on your sex drive.

Then you're left wondering: would you rather have an erection when you’re in the mood or the assurance that you won’t have a panic attack in the middle of a work presentation?

An orgasm or the ability to do your job?

The types of medications that are prescribed for anxiety include the group of selective serotonin reuptake inhibitors (SSRI's.) They can help deal with anxiety symptoms but there are some side effects

These include making it difficult to become aroused, sustain arousal, and reach orgasm. Some people taking SSRIs aren't able to have an orgasm at all. Anxiety symptoms can then dramatically increase as a direct result.

Aside from changing medication (which is something you should discuss with your doctor) the best thing you can do is regular and vigorous exercise.

It’s been proved[ii] that vigorous exercise will combat the sexual side effects of these medications. It will also benefit your mental health in general. It’s always challenging to start an exercise regimen and this is a powerful motivator.

How to overcome anxiety related sex problems

Because everything we’ve discussed here is about how anxiety causes you to experience sex problems, of course the big challenge is to cure your anxiety.

If anxiety is affecting your sex life then eliminating anxiety is the way towards re-booting your libido. However, eradicating anxiety is a long-term process, and not something that can be achieved overnight.

Having a long-term plan to reduce anxiety symptoms plus: eating well, exercising regularly and talking to your lover about your challenges, are all ways to rejuvenate your sex drive.

If having sex isn't physically possible, at the very least spend time being romantic and having fun in an intimate way to keep alive that part of your life.


[i] Figueira I, Possidente E, Marques C, Hayes K. Sexual dysfunction: a neglected complication of panic disorder and social phobia. Arch Sex Behav. 2001;30: 369-376



bottom of page