Can Therapy Really Help with Sexual Performance Anxiety?

Sex is supposed to be pleasurable, right?

But for many people, sex doesn’t feel free, confident, or connected; it feels pressured, stressful, and full of second-guessing. If you've ever found yourself overthinking your performance in the bedroom, worrying about how your body is responding, or feeling frozen in moments that are supposed to feel intimate, you’re not alone.

Sexual performance anxiety is incredibly common, but it’s rarely talked about even in therapy spaces. And unfortunately, the silence often makes things worse. The good news? Therapy can help, and not just in a surface-level way. It can address the deeper emotional and relational patterns that keep performance anxiety in place and help you (and your partner) move toward real, connected intimacy.

Let’s break it down.

What Is Sexual Performance Anxiety?

Sexual performance anxiety is a form of anxiety that shows up in sexual situations whether you're about to have sex, thinking about sex, or trying to be intimate with a partner. It can affect people of all genders, sexual orientations, and relationship types.

It often sounds like this:

• “What if I can’t keep it up?”

• “What if I don’t finish?”

• “What if I don’t feel anything?”

• “What if they think I’m bad in bed?”

• “What if my body doesn’t respond the way it’s supposed to?”

• “What if I disappoint them?”

For some, performance anxiety leads to avoidance (e.g., avoiding sex, closeness, or even conversations about intimacy). For others, it shows up during sex as intrusive thoughts, tension, or a sense of being disconnected from your body. This can be frustrating, isolating, and, let’s be honest, deeply painful, especially if it’s affecting your relationship.

Common Causes of Sexual Performance Anxiety

Sexual performance anxiety rarely shows up out of nowhere. It's often connected to one or more of the following:

1. Cultural or religious shame about sex

Messages you received growing up about sex being "bad," "dirty," or only for reproduction can linger in the body and mind, even years later. These messages about sex can lead us to think we are ‘wrong’ for wanting to be intimate or thinking about engaging in sex with our partners.

2. High pressure to perform

Especially for men, there's often pressure to “initiate,” “stay hard,” “last long,” or “satisfy your partner” all while being relaxed and confident. That's a lot of pressure for something that's supposed to be mutually enjoyable.

3. Body image concerns

If you're worried about how your body looks or functions during sex, it's hard to be present.

4. Past sexual trauma or negative experiences

Unresolved trauma or even one awkward, painful, or embarrassing sexual encounter can shape how you feel about intimacy moving forward.

5. Relationship issues

Ongoing conflict, lack of trust, or emotional disconnection can make sex feel like a performance instead of a shared experience.

6. Stress, anxiety, and mental health

Generalized anxiety, depression, and chronic stress (especially from work, parenting, or caregiving roles) can impact desire, arousal, and confidence.

So, Can Therapy Really Help?

Yes, and here’s how. At Embrace Sexual Wellness, we work with individuals and couples who are dealing with the emotional, relational, and physical challenges of sexual performance anxiety.

Therapy can help you:

1. Understand what’s really going on

Performance anxiety is rarely just about what’s happening in the moment. Therapy helps uncover what’s fueling the anxiety, whether it’s past experiences, shame, fear of failure, or relational dynamics. You get to explore your story in a safe, supportive space.

2. Interrupt the anxiety-thought cycle

In therapy, you’ll learn how to identify and challenge anxious thoughts before they spiral into shutdown or panic. This might involve CBT techniques, mindfulness practices, or somatic awareness, all aimed at helping you stay present and grounded during intimacy.

3. Reconnect with your body

Performance anxiety pulls you out of your body and into your head. Therapy helps you rebuild a relationship with your body that feels safe, attuned, and responsive, not judgmental or critical. This can be especially healing for people who’ve experienced dissociation or discomfort during sex.

4. Communicate with your partner more openly

If you're in a relationship, therapy can support both of you in having honest, shame-free conversations about sex. You’ll learn to express needs, set boundaries, and understand each other’s triggers so sex becomes a space of trust, not pressure.

5. Heal from past experiences

Whether you’ve been through trauma, rejection, or simply years of sexual avoidance, therapy offers a chance to heal. You don’t have to carry the weight of old experiences into every intimate moment.

6. Create a new sexual narrative

Instead of sex being about performance, pressure, or expectation, therapy helps you define what you want sex to mean. Perhaps it’s connection, pleasure, playfulness or safety or a combination. You get to rewrite the script.

What to Expect in Sex Therapy

You don’t have to show up with all the answers. You don’t need to be in crisis. You just need to be willing to be curious and honest with yourself and your therapist.

We’ll create a space that’s affirming, nonjudgmental, and tailored to you. Some clients come for individual therapy; others come as a couple. Either way, therapy is always consent-based, collaborative, and deeply respectful of where you are in your journey.

We often hear clients say things like:

“I wish I’d started this sooner.”

“I am so relieved I found you to help us.”

“I thought I was broken, but I just needed someone to help me understand what was really going on.”

You’re not broken. You’re human. And you don’t have to figure this out alone.

Sex Therapy in Chicago

At Embrace Sexual Wellness, we offer specialized comprehensive care in sex therapy that targets your goals. While we are based in Chicago, Illinois, we’re also licensed to support clients in Idaho, Indiana, Kansas, and Louisiana. Whether you're local or working with us virtually, you’ll receive compassionate, expert care grounded in science and rooted in human connection.

TLDR

Sexual performance anxiety can make intimacy feel like a test you’re always failing, but it doesn’t have to stay that way. Therapy can help you understand your anxiety, shift your mindset, reconnect with your body, and build a sex life that actually feels good for you and your partner. You don’t need to power through, shut down, or pretend everything’s fine. You can talk about it. You can work on it and find new strategies to approach intimacy with more ease.

How Can I Talk to My Partner About Our Sexual Problems Without Fighting?

How to Talk About Sexual Problems Without It Leading to A Fight

Sexual issues in a long-term relationship don’t show up overnight and they don’t fix themselves overnight either. Whether you’re dealing with low libido, performance anxiety, or a sense that you’ve become “just roommates,” bringing up these concerns with your partner can feel overwhelming.

You may worry that you’ll hurt their feelings, trigger a fight, or get shut down completely. So instead, many couples avoid the topic altogether… until the silence becomes its own kind of problem.

The good news? You can talk about sexual problems in a way that leads to understanding instead of defensiveness. It takes intention, patience, and a few key tools, but it’s possible.

Here’s how to start…

Know That You’re Not Alone and You’re Not Failing

Let’s normalize this: many couples struggle with sex at some point. This could be due to stress, parenting demands, medical or hormonal shifts, emotional disconnection, past trauma, or simply different libidos. It’s not a sign that your relationship is broken; it’s a sign that something needs your attention.

What often turns discomfort into conflict is the way we bring it up, especially when it’s been simmering for a while. That’s why laying the emotional groundwork matters.

Get Clear on What You’re Feeling Before You Bring It Up

Before you talk to your partner, take time to get curious about your own experience. Are you feeling rejected? Embarrassed? Lonely? Anxious about initiating? Pressured when they do?

Write it down. Speak it out loud. Journal, talk to a friend, or even try rehearsing what you’d want to say in therapy.

Clarity helps you approach the conversation with more compassion and less reactivity.

Choose the Right Time (Hint: Not in the Bedroom)

Don’t bring it up in the middle of intimacy or right after a failed attempt at connection. Emotions are raw in those moments, and it’s easy for both people to feel blamed or shut down.

Instead, choose a neutral, low-stress time to talk, maybe on a walk, over coffee, or during a planned check-in. A simple way to begin might be:

“I’ve been thinking a lot about how we’ve been feeling disconnected physically, and I’d really love to talk about it, not because I want to fight, but because I want us to feel closer.”

Framing the conversation as a bid for connection rather than a criticism sets the tone for collaboration.

Use “I” Statements, Not “You Never…” or “You Always…”

Statements like “You never want sex anymore” or “You always turn me down” immediately put your partner on the defensive.

Instead, focus on your experience:

• “I’ve been feeling distant lately, and I miss feeling close to you.”

• “I’m craving more intimacy, and I’m not sure how to talk about it without feeling nervous.”

• “I’m starting to feel anxious about our sex life, and I want us to figure it out together.”

This subtle shift invites understanding instead of blame.

Be Curious, Not Just Correct

Remember, there are two people in this dynamic and both of you bring feelings, fears, and expectations to the table. If your partner seems withdrawn sexually, there’s likely something underneath: stress, insecurity, pressure, shame, or even past rejection.

Instead of jumping to conclusions, try asking:

• “How do you feel about our sex life lately?”

• “Are there things that make it hard for you to feel connected or in the mood?”

• “Is there something I’m doing (or not doing) that you haven’t shared with me yet?”

These questions require vulnerability, yes, and they also open the door to honesty.

Don’t Try to Solve Everything in One Conversation

Big sexual issues are rarely resolved in one sitting. And putting that kind of pressure on a single conversation can make both partners tense or overwhelmed.

Instead, think of this as the start of an ongoing dialogue. Your goal is progress, not perfection.

If it helps, say it out loud:

“We don’t have to solve this all today. I just want us to start talking about it, and keep talking about it.”

Recognize the Role of Shame and Push Back Gently

For many people, especially those raised with little sex education or lots of sexual shame, conversations about intimacy can bring up feelings of inadequacy or guilt.

If your partner gets quiet or defensive, consider what might be happening under the surface. They may not know how to talk about sex without feeling like they’ve failed you, or themselves.

Let them know you’re not looking for blame. You’re looking for closeness.

Sometimes it helps to say:

“This isn’t about who’s right or wrong. I just want us to feel good together again, emotionally and physically.”

Consider Professional Support If You’re Feeling Stuck

Sometimes the communication tools just aren’t enough, not because you’re doing it wrong, but because the issues go deeper than what you can unpack alone.

Couples often come to sex therapy after months or even years of avoidance, frustration, or hurt feelings. Therapy offers a space to name the patterns, uncover what’s really going on, and build new ways to reconnect both emotionally and sexually.

Whether it’s low libido, mismatched desire, painful sex, performance anxiety, or the “we’re just roommates now” dynamic, there’s help. And there’s hope.

TLDR

Talking about sex is vulnerable, but it’s also one of the most powerful things you can do for your relationship. It’s not about perfection or frequency or performance. It’s about feeling seen, desired, and emotionally safe with your partner.

You don’t need to fight to be heard. You just need the right tools, the right timing, and the willingness to show up gently and honestly.

Ready to Take the Next Step?

At Embrace Sexual Wellness, we help couples navigate sexual disconnection, low libido, and performance anxiety in a supportive, nonjudgmental space. Our team of sex and relationship therapists are licensed in Illinois, Idaho, Indiana, Kansas & Louisiana. Book a free intro consult call with us today!

Closing the Orgasm Gap: Building Mutual Pleasure Through Communication, Curiosity, and Care

In relationships, sexual intimacy can be one of the most meaningful and vulnerable forms of connection. Yet for many couples, there’s a consistent and often unspoken disconnect in how pleasure is experienced is commonly referred to as the orgasm gap.

The orgasm gap refers to the measurable disparity in orgasm frequency between partners, especially between men and women in heterosexual relationships. Research shows that men report climaxing during sex far more often than their female partners. But this gap doesn’t have to persist—nor is it inevitable.

With the right tools, open communication, and an intentional shift in focus, couples can move toward more equitable, mutually pleasurable experiences.

What Causes the Orgasm Gap?

Understanding the root of the orgasm gap is essential to closing it. Some common contributing factors include:

Limited Focus on Clitoral Stimulation

Many people are unaware that the majority of women do not climax from vaginal penetration alone. The clitoris is often overlooked in popular depictions of sex, and it is a key center of sexual pleasure and deserves more attention.

Cultural Scripts and Misinformation

Media, movies, and even sex ed often present sex as ending when the male partner orgasms. This “one-size-fits-all” script overlooks the nuanced needs of many people, especially women and nonbinary individuals.

Poor Communication

Many couples never learn how to talk about sex openly. Embarrassment, fear of hurting a partner’s feelings, or simply not having the language to express desires can keep people silent.

Performance Pressure

Feeling rushed to climax or pressure to perform can shut down arousal and reduce sexual satisfaction for both partners.

Lack of Education

Most people receive little to no pleasure-based education around sex. Understanding sexual anatomy, arousal patterns, and what feels good takes time and exploration.

Tips for Closing the Orgasm Gap in Your Relationship

Turn-Taking During Sex

Rather than making sex a simultaneous experience, try taking turns focusing solely on one partner at a time. This helps eliminate performance pressure and ensures that both people have space to receive and explore pleasure at their own pace.

How to try turn-taking:

• Set aside a dedicated time for intimacy.

• Decide beforehand who will go first.

• The giving partner focuses entirely on the receiver's experience—without rushing or multitasking.

• Switch roles when it feels right, or in a subsequent session.

This practice allows each partner to feel prioritized and fully present, deepening trust and communication in the process.

Use Sex Toys to Enhance (Not Replace) Connection

Toys are powerful tools that can help close the orgasm gap especially for partners who benefit from clitoral stimulation or consistent stimulation.

Benefits of toys in partnered play:

• Promote more diverse stimulation and stronger orgasms.

• Reduce strain on hands or mouths.

• Help facilitate orgasms during intercourse.

• Normalize mutual exploration and novelty.

Getting started:

• Shop together either online or in person.

• Start with simple toys (e.g., bullet vibrators, vibrating rings, wands).

• Use toys externally during intercourse or turn-taking sessions.

• Check in regularly: “Do you want more pressure?” or “Would you like to try a different speed?”

Using toys should feel collaborative, not competitive, and can actually boost intimacy, fun, and satisfaction for both partners.

Show and Tell: Teaching Your Partner What Feels Good

A foundational but often skipped skill in closing the orgasm gap is physically showing your partner how you like to be touched.

This “show and tell” approach removes the guesswork and builds confidence—while encouraging vulnerability and deeper communication.

Here’s how to practice:

• During a relaxed moment, guide your partner’s hand to mimic your touch.

• Offer simple, positive feedback like “right there” or “a little lighter.”

• Masturbate in front of your partner (if comfortable) to demonstrate rhythm, location, and pressure.

• Reverse roles and ask them to show you what they like.

Over time, partners become fluent in each other’s preferences, increasing the likelihood of mutually satisfying experiences.

Slow Down and Extend Foreplay

Foreplay isn’t just a warm-up; it’s an essential part of many people’s arousal cycle. Skipping it can mean one partner is ready before the other even gets started.

Ideas to extend foreplay:

• Non-sexual touch (massages, cuddling, gentle stroking)

• Eye contact, breathwork, or synced breathing

• Kissing slowly, sustained, and exploratory

• Sensual use of scented oils or warming lubricants

Building arousal slowly increases blood flow, emotional attunement, and physical readiness, which can lead to stronger, more pleasurable orgasms, especially for those who require more time to get there.

Communicate Before, During, and After Sex

Sexual communication is not a one-time conversation—it’s a continuous practice. Cultivating an open and nonjudgmental space for feedback is one of the most effective ways to bridge the orgasm gap.

How to foster communication:

• Use positive reinforcement: “I loved when you did that thing with your fingers.”

• Ask questions like, “Was there anything you really enjoyed last time?” or “Would you like more of something?”

• After intimacy, check in: “How was that for you?” or “Anything you’d like more of next time?”

You don’t have to overanalyze every encounter, but normalizing open dialogue can help partners feel seen, heard, and satisfied.

When to Seek Support from a Sex Therapist

While these strategies are powerful, some couples still benefit from professional guidance. A certified sex therapist or couples counselor can help uncover emotional blocks, resolve longstanding communication issues, and create personalized strategies for increasing mutual pleasure.

Whether you’re exploring this topic for the first time or have been navigating the orgasm gap for years, therapy can offer a safe and supportive space to deepen intimacy, emotional connection, and sexual satisfaction.

For individuals or couples searching for sex therapy or couples counseling in Chicago or elsewhere, working with a trained professional can make all the difference. Many therapy practices offer virtual sessions, expanding access to care beyond your immediate location.

TLDR

The orgasm gap is not just about technique. It’s about equity, care, and communication. Pleasure should not be one-sided or dependent on old sexual scripts. With curiosity, openness, and a willingness to experiment, couples can co-create intimate experiences that feel good for both partners.

Whether you’re just beginning to explore this topic or already working to improve your sex life, remember: the journey toward mutual pleasure is one worth prioritizing.

Looking for support?

If you’re ready to go deeper and explore personalized tools for building sexual and emotional intimacy, working with a sex-positive therapist can help. Whether you're based in Chicago or accessing services remotely, compassionate and tailored support is available.

Explore more insights on relationships and intimacy on our blog, or contact us to take the next step toward closing the orgasm gap, together.