Sexual performance anxiety in cisgender men is, of course, a very real, upsetting, legitimate health issue. But let's take a second to think about how commonly male performance anxiety is discussed in our society, in comparison to female performance anxiety. Frankly, the difference between the two is that we don't really talk about what happens to women. I can remember being a grade schooler watching TV, and my parents uncomfortably changing the channel when commercials for male performance enhancement drugs popped up on the screen. So at that young of an age, the culture had already exposed me to the fact that men can have issues during sex, and that there is at least one option for treatment.
Why Don't We Talk About It More?
As Dr. Caudle and Morse both explain, performance anxiety is an issue faced by men and women, but it is hardly presented that way. Dr. Caudle tells Bustle, "This is something that happens to women of all ages. It is not the most common complaint [from my patients], but when they are comfortable, these things come out." One can't help but wonder how many more female patients would seek treatment if the issue wasn't as invisible. Dr. Caudle stresses that it can be a difficult, uncomfortable topic to breach for her patients of all genders, but certainly more so for women.
Because of all of the unnecessary and damaging "mystery" surrounding female sexual desire, performance anxiety for women is not often discussed because we don't really know how to discuss it.
First, let's look at what physically happens in a woman's body when she is experiencing performance anxiety. WebMD explains that anxiety "causes your body to launch a response called 'fight or flight.'" When sexual acts result in you feeling stressed or anxious, your body releases stress hormones — epinephrine and norepinephrine — that are actually meant to ready your body to hide from or face a threat. In this case, the threat to your body's well being is the fear of displeasing your partner (of if there is trauma involved, the fear of physical intimacy). A few different things can happen once these stress hormones take hold: 1) It is difficult to get wet enough for intercourse. 2) Vaginal muscles tense up, making penetration difficult or impossible. 3) You won't have any desire to engage in sex.
What Causes Performance Anxiety In Women?
While there are plenty of factors contributing to this problem, let's first explore the orgasm anxiety further. Dr. Caudle says, "Society has put pressure on women and men and everyone to orgasm all the time. And we already know that women often orgasm a lot less than men." The SKYN Condoms' 2015 Millennial Sex Survey states that 97 percent of men reported having an orgasm during sex, versus 89 percent of women reporting an orgasm. 75 percent of women are unable to achieve orgasm from penetration alone, according to research from Emory University. Some women can only orgasm from masturbation, Dr. Caudle explains. When explosive, loud, dramatic orgasm by women is what media and pornography teaches us to be the sign of "good sex," there is immense pressure on women to achieve that kind of orgasm — despite the fact, as Dr. Caudle emphatically reminds us, "Porn isn't real."
Morse elaborates on the disconnection that a woman can feel after the act. "She barely remembers what positions they did or how it felt because all she can think about it that bright shiny orgasm that she once again failed to achieve... A lot of women fall into this trap of believing that it is the man’s responsibility to bring home the orgasm. So when their partner is doing his various moves and nothing is happening for a woman down below, she immediately becomes anxious and starts to assign the blame to herself and her sexual response."
In addition to concerns over orgasms, as explained by the Huffington Post, "Body image issues, orgasm obstacles and STD woes are just a few of the concerns that can keep women from letting go and enjoying their time between the sheets." Anxiety over accidental pregnancies can also disrupt a woman's ability to perform. Women dealing with performance anxiety "are often worried about something," says Dr. Caudle. Women are already taught to be ashamed of any "flaw" on their body even when it's covered up by clothing. So, as Dr. Caudle explains, "Being naked feels extremely vulnerable." Women are socialized to fear and/or hate the appearance of their vulva and labia, and many grown women admit to being too anxious to have ever looked at it in the mirror. So imagine the anxiety that would accompany another person viewing their genitals. Dr. Caudle continues, "I definitely think the societal hype about sex makes it hard for so many people. Society tells us how to look, what is sexy and what is not, what is good sex, what is considered attractive or not. All these rules make it harder for people to be intimate in a way that makes sense for them."
Besides body image issues, says Dr. Caudle, "Difficulties in the relationship can cause anxiety. When you're not in tune with your partner from an emotional or psychological standpoint, intimacy and confidence can suffer."
What Can Help You Overcome It?
Dr. Caudle explains, "In order to get a hold of anxiety, it's important to understand where it's coming from. That could mean a heart to heart with yourself, with your partner, with your doctor, or with anyone you trust. Then you can reveal the underlying issue. Often, just feeling like you can communicate is the most important thing sometimes." For this reason, Dr. Caudle says that therapy can be very important as it allows you to confide in a third party. And once you have an understanding of the underlying issue — maybe it's body image issues or trauma — you can learn how to cope with the root of the anxiety. When you don't have clarity over the cause, it can create a cycle of panic attacks whenever sexual intimacy is present, and that only makes the situation worse.
And as Morse stresses, it is especially important to let yourself learn about your body, understand your sexuality, and discover what pleases you in order to rid yourself of that unfair orgasm anxiety. For one, Morse explains that just because you didn't achieve an orgasm doesn't mean the sex was bad or that you performed improperly — not even close. "Instead of putting all that pressure on yourself to perform, take a kinder approach, cut yourself some slack, and accept that it might not happen every single time. Learn to enjoy all aspects of sex. If you orgasm, great! If you don’t, you’re still enjoying the physical intimacy that comes with being with your partner." And the best way to learn what makes you orgasm is to find out for yourself. The confidence that you'll gain through taking ownership of your body and your pleasure will transfer into sex with your partner.
Morse also recommends speaking up and taking control! If throughout your self-exploration, for example, you realize that you enjoy vibrators or toys, suggest incorporating them into your sex life as a couple. If your partner makes you feel bad about wanting pleasure, they are in the wrong — not you.
So just remember, you have the right to pleasure (which can be achieved with or without a pornified orgasm), your anxiety is understandable and valid, and, with time and self-care, you can overcome it.
Images: Andrew Zaeh/Bustle; Giphy (4)