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Sexual Wellness

Sexual Performance and Mental Stress: What's the Connection?

Published on Aug 26, 2019


By Dr. Surya Bhagwati
Chief In- House Doctor
BAMS, DHA, DHHCM, DHBTC | 30+ Years of Experience

Sexual Performance and Mental Stress: What's the Connection?

Sexual intimacy is one of the most important components of a healthy relationship and it also regarded as fundamental social requirement by many. Couples with healthy and fulfilling sex lives report higher levels of satisfaction and happiness with their relationships. Unfortunately, mental stress has a huge impact on sexual performance and it’s one that is not widely recognized. Stress can affect both male and female sexual function in various ways, reducing sex drive and also causing impairments to sexual function. Understanding these risks and recognizing the role of stress is crucial to tackling the problem so that you can keep your sex life on track. After all, stress is pretty much unavoidable today, affecting all of us to different degrees.

 How Stress Affects Male Sexual Performance

While the occasional experience of stress poses no threat, frequent or prolonged exposure can result in chronic stress, which is problematic. Stress triggers the fight or flight response, which increases levels of the stress hormone cortisol and adrenalin. Chronic or excessive stress results in high levels of both hormones, while production of the sexual hormone testosterone is reduced. Low levels of testosterone can result in a lower sex drive in men and can also cause performance problems including erectile dysfunction or impotence.

 Another feature of stress and the fight or flight response is the elevation in blood rate for a quick energy boost. It’s a useful feature for survival when you’re in a dangerous situation and need to react quickly, but it becomes problematic when your body is constantly in this mode. Increased adrenalin causes an elevation in heart rate, while cortisol increases the release of glucose into your bloodstream.  Over time this causes a narrowing of the blood vessels, which impacts blood flow. Achieving and maintaining and erection depends largely on blood flow to the penis and reduced blood flow can hinder this function. Stress can therefore indirectly cause erectile disorders through its long term effect on blood vessels and blood flow.

Mental stress also affects male sexual performance through purely psychological mechanisms. Stress can overload the brain at a neurochemical level, with regions of the brain that regulate immediate survival being more active, while those that govern secondary functions are less active. Sexual performance would be a secondary function here. Stress also increases feelings of anxiety, making it harder to get aroused or to maintain an erection. The ability to perform sexually is also impaired as stress reduces your ability to focus on the moment, which means that you are more likely to be preoccupied with thoughts that cause stress. Chronic stress also increases the risk of panic attacks and clinical anxiety disorders or depression, which can further impair sexual performance.

 How Stress Affects Female Sexual Performance

In women too, stress affects sexual desire and satisfaction through very similar mechanisms. The biggest impact is felt through hormones. The rise in cortisol levels, associated with stress, has been shown to impede the function of oxytocin in the brain, adversely affecting libido levels. Elevated cortisol levels can also cause irregularities in menstruation. High stress levels also lead to lower levels of neurotransmitters in the brain, such as serotonin and dopamine. These chemicals don’t just affect your mood, but they also help to regulate libido. Of course, the impact on mood is also damaging to sexual performance as you are less likely to initiate, reciprocate, or enjoy sexual activity when you feel low or fatigued.

 The increase in adrenaline levels as a result of prolonged exposure to stress also makes you feel on edge constantly. Your body is unable to relax, increasing muscular tension and this makes it hard to experience sexual sensations or pleasure, which also reduces the likelihood of orgasms. For women, emotional wellbeing and intimacy are important to sexual arousal and satisfaction, but stress once again does damage here. It makes it harder to focus and enjoy the moment, as you are more likely to be distracted with thoughts that cause anxiety and stress.

For women, the effects of stress can also be indirect because stress hormones like cortisol also impact metabolic function. This can lead to fluctuations in body weight, which affects feelings of self-esteem and self-worth, making you less likely to engage in any kind of sexual activity. The risk of depression and anxiety disorders also increases significantly as a result of chronic stress and this is known to reduce sexual desire or libido levels.

 Overcoming Stress for Healthy Sexual Function

In many cases, even if your sex drive isn’t directly impacted by mental stress, it could suffer as a side effect of psychiatric medications used to treat stress, anxiety, and depression. Serotonin reuptake inhibitors, commonly used to treat stress, anxiety, and depression, are known to lower sex drive and can also make it harder if not impossible to reach a climax. They affect both men and women, which is why you should be aware of this side effect if you consider using conventional treatment. Natural stress reduction strategies including the use of behavioral therapy, exercise, yoga, and meditation should be your first resort instead. Ayurvedic medications for stress are also a good alternative as they are made from natural herbal ingredients that are effective at promoting relaxation, while they pose little to no risk of side effects.

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  • “Stress Hormone Blocks Testosterone's Effects, Study Shows.” UT News, The University of Texas at Austin, 7 Aug. 2018, news.utexas.edu/2010/09/27/stress-hormone-blocks-testosterones-effects-study-shows/.
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  • Hamilton, Lisa Dawn, and Cindy M Meston. “Chronic stress and sexual function in women.” The journal of sexual medicine vol. 10,10 (2013): 2443-54. doi:10.1111/jsm.12249
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  • Jing, Elizabeth, and Kristyn Straw-Wilson. “Sexual dysfunction in selective serotonin reuptake inhibitors (SSRIs) and potential solutions: A narrative literature review.” The mental health clinician vol. 6,4 191-196. 29 Jun. 2016, doi:10.9740/mhc.2016.07.191

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Dr. Surya Bhagwati
BAMS (Ayurveda), DHA (Hospital Admin), DHHCM (Health Management), DHBTC (Herbal Beauty and Cosmetology)

Dr. Surya Bhagwati is an established, well-known Ayurvedic expert with over 30 years of experience in treating and consulting in the field of Ayurveda. She is known for the timely, efficient, and patient-centred delivery of quality health care. The patients under her care receive a unique holistic treatment comprising not only medicinal treatment but also spiritual empowerment.

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