From a global pandemic to political protests, we are living in extraordinarily stressful times. Stress can permeate many aspects of our lives. Stress is our body’s response to pressure — a bit of it can be tolerable or even helpful. But when there’s an imbalance between the demands we face and our ability to cope with them, it can become a problem. Overwhelming and prolonged stress can increase your risk of developing mental health illnesses such as anxiety or depression.
Stress, anxiety and depression can affect our sex lives in various ways.
Sex and stress
When we experience stress our sympathetic nervous system kicks into gear and our bodies get ready to either fight the challenge or run from it. However, once the stress or threat is gone, our parasympathetic nervous system takes over to help restore our body back to its normal state. When we are exposed to prolonged stress — be it a life event like the death of a loved one, major health concerns, or living in an unpredictable global pandemic — our sympathetic nervous system is activated for much longer than usual1,2. Normally when the sympathetic nervous system is activated, our bodies release cortisol, which helps with our fight or flight response. Prolonged release of cortisol can reduce testosterone production, which impacts sex drive3 and can exacerbate any pre-existing mental health issues such as anxiety, which can affect erectile performance2,3,4.
Think about how you feel when you’re stressed — irritable, grumpy, anxious, sad, or frightened. While these feelings are normal (especially in the aftermath of an unprecedented and prolonged event like COVID-19) they don’t often encourage desire, intimacy and romance. So how do you manage stress (and support a healthy sex life) while navigating your way out of a pandemic? Self-care is an important factor for resilience during difficult times.
Sometimes, we think of self-care as selfish or indulgent, but it helps us to persevere and to be better parents, partners, and lovers.
Movement is great not just for physical health, but also mental health, as exercise reduces levels of stress hormones, like cortisol, and stimulates the production of endorphins, promoting feelings of relaxation and optimism.
If you’re still working from home, you may be seeing a lot of your partner. However, creating quality time for romance and relationships is still important. Try to do something together each week, like making a special meal together, going for a walk or watching a movie.
If you’re having a bad day, rather than lashing out or projecting it onto your partner, communicate how you’re feeling. Often when couples are having issues (both in and out of the bedroom) one of the biggest factors is a lack of communication, which can lead to one or both partners feeling rejected or undesired.
Sex and anxiety
Anxiety can have a significant impact on erections and ejaculation. When we experience anxiety we get physiological symptoms, such as increased heart rate, gastrointestinal upset or sweaty palms, and anxious thoughts interrupt how your brain communicates with your penis. This can lead to a loss of erections5, which can create more anxiety. This cycle of erectile dysfunction (ED) can lead some people to withdraw from their partners both sexually and non-sexually out of fear that if they engage, it will lead to sexual activity that may lead to ED, disappointment and rejection.
It’s important to understand that sensuality and relaxation are important components of the sexual experience. Try practising what is called “wax and wane”, which is when you masturbate and allow yourself to go soft, then get hard again, and repeat. This exercise helps you to remain calm and not to panic when you do lose your erection, knowing it will come back6.
With your partner
Sex is so much more than just penetration and performance — it’s about pleasure. By its very nature, sexual performance is stressful, and this can become a major preoccupation for most men at some point in their life. This can include thoughts such as, ‘Are they enjoying it?’, ‘I can’t come too quick!’, ‘Why aren’t I like those porn stars?’, ‘Is my dick too small?’, ‘What do they think of me?’. It’s important that men work with their partners to increase their enjoyment of sensual pleasure, which includes all of the activities that are possible during sex, such as touch and affection as well as other sexual acts such as fellatio, cunnilingus, or anilingus. For us to experience truly heightened eroticism, we need to be relaxed and to appreciate and enjoy touch7.
Quiet your mind
Often it can be difficult to quiet your brain when you’re in the midst of sex. The following tools are circuit breakers that allow you to reduce the impact of anxious thoughts
and return to being present with your partner when pesky thoughts pop up.
- Activities: Use positive activities such as sex in the shower, going down on your partner, or using a toy
- Emotions: Before sex try things that change your emotional state, like watching funny online videos, or listening to upbeat music
- Push away: Use mindfulness techniques to push away anxious thoughts
- Thoughts: Actively engage in your mind to think about something else
- Sensations: Focus on sensations, such as the feeling of your partner’s skin under your hand, to ground your thoughts.
Sex and depression
Depression can be characterised by a marked decrease in activities that were previously a source of pleasure, such as sex.
Talk to your doctor about medication
There is a lot of stigma around using medication, however, using it may help you get your head above the waterline to engage
more effectively with psychological treatment. Some antidepressants can contribute to sexual dysfunction including delayed ejaculation. If this is a concern for you, talk to your prescribing doctor as there may be alternative medications available for you. Do not stop medication without seeking professional advice.
Small, simple pleasures
Set a daily goal of doing something you enjoy. When we do something enjoyable, we experience dopamine release which helps improve our mood. Often with depression, there is a lack of motivation to partake in pleasurable things, but once we get going it gets easier and more enjoyable. Sex may not be one of these things, so communication is important. Explain to your partner what you are experiencing, as well as what your capacity is at the present moment with regard to intimacy.
Young E, Korszun A. 2010. Sex, trauma, stress hormones and depression. Molecular psychiatry
Dana, D. 2018. The polyvagal theory in therapy: engaging the rhythm of regulation (First edition.). W.W. Norton & Company.
 King, R. 1998. Good Loving Great Sex: Finding Balance when Your Sex Drives Differ. Random House Australia.
 Van der Kolk, B. A. 2014. The body keeps the score: mind, brain and body in the transformation of trauma. Allen Lane, an imprint of Penguin Books.
 Andrews, G., Creamer, M., Crino, R., Page, A., Hunt, C., & Lampe, L. 2003. The treatment of anxiety disorders: Clinician guides and patient manuals. Cambridge University Press.
 McCarthy, B. W. 2001. Relapse Prevention Strategies and Techniques with Erectile Dysfunction. Journal of Sex & Marital Therapy
 Metz, M. E., & McCarthy, B. W. 2010. Male Sexuality and Couple Sexual Health: A Case Illustration. Journal of Family Psychotherapy