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Updated: Jan 20, 2026

Reducing State Anxiety Using Working Memory Maintenance

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Published on: July 19, 2017

Sexual Performance Anxiety.

Robert E Pyke¹

¹Pykonsult, LLC, New Fairfield, CT.

Sexual Medicine Reviews

|August 27, 2019

Summary

Sexual performance anxiety (SPA) affects millions, contributing to sexual dysfunction. While treatments like CBT and certain medications show promise, further research is needed for effective SPA management.

Area of Science:

Psychology
Pharmacology
Sexual Medicine

Background:

Sexual performance anxiety (SPA) is a widespread sexual complaint lacking a formal diagnosis, leading to limited research and treatment options.
SPA affects a significant portion of the population, with prevalence estimates ranging from 9-25% in men and 6-16% in women.

Purpose of the Study:

To review the prevalence of SPA and its association with sexual dysfunctions and anxiety disorders.
To compare SPA with non-sexual performance anxiety and social anxiety (PA/SA).
To explore potential pharmacological and phytotherapeutic treatments for SPA based on existing drug properties.

Main Methods:

Literature review of SPA and PA/SA using PubMed searches from 2000 to 2018.
Prevalence data sourced from population-representative surveys.

Keywords:

Anxiety Disorders Erectile Dysfunction Hypoactive Sexual Desire Disorder Premature Ejaculation Sexual Arousal Disorder Sexual Performance Anxiety

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Prioritization of controlled clinical trials for treatment efficacy assessment.

Main Results:

SPA is linked to premature ejaculation and psychogenic erectile dysfunction (ED) in men, and severely inhibits sexual desire in women.
Cognitive behavior therapy (CBT) and mindfulness meditation are recommended for SPA, though controlled studies are limited.
Pharmacological options include PDE5 inhibitors for ED/PE, and serotonergic anxiolytics (e.g., buspirone, trazodone) with potential prosexual effects. Phytotherapies like sage and passionflower also show anxiolytic potential.

Conclusions:

SPA significantly contributes to common sexual dysfunctions, yet well-established treatments are lacking.
Cognitive behavior therapy, mindfulness, and specific serotonergic anxiolytics show therapeutic potential for SPA.
Phosphodiesterase type 5 inhibitors are effective for SPA-related ED and premature ejaculation, with several phytotherapies also warranting further investigation.