Sexual Dysfunction and Social Anxiety Disorder

The Relationship Between Sexual Dysfunction and SAD

Couple with sexual issues in bed.
Social anxiety can cause sexual issues. Getty / Peter Cade

If you suffer with social anxiety disorder (SAD), you may also experience problems with sexual dysfunction.

Sexual dysfunction may include things such as avoiding sex, erectile dysfunction, and decreased enjoyment. In addition, some medications used in treating SAD, such as selective serotonin reuptake inhibitors (SSRIs) can sometimes cause sexual dysfunction.

Research is still in the early stages about the relationship between social anxiety disorder and sexual dysfunction.

This relationship makes sense when you think about the fact that people with SAD are afraid of performance and social situations: sex can draw out both of these fears.

However, while there is some evidence that social anxiety disorder and sexual dysfunction are both present in some people, studies do not show that this is always the case.

How Do Men and Women With SAD Experience Sex?

Initial small studies suggest that there may be a link between SAD and sex.

  • In a study of 40 people with social anxiety disorder and 40 without, men with the disorder were found to have moderate impairment in sexual arousal, orgasm, enjoyment and satisfaction.

    Women with SAD were found to have severe impairment in sexual desire, arousal, activity and satisfaction. In addition, men with social anxiety disorder were more likely to have paid for sex and women with SAD had fewer sexual partners.

  • Researchers compared 30 people with SAD and 28 people with panic disorder, and found that 75% of those with panic disorder, versus 33% of those with social anxiety disorder, had sexual problems. The most frequent problem in males with SAD was premature ejaculation.
  • In a study comparing 106 individuals with social anxiety disorder, 164 people with sexual dysfunction, and 111 normal controls, men with SAD were found to be less sexually active but just as satisfied as male normal controls. Women with social anxiety disorder were not found to differ from female normal controls.
  • In a 2015 study, a history of childhood sexual abuse or comorbid depression were predictive of problems with sexual functioning in those with social anxiety disorder.

What Does This Mean for You?

If you have been diagnosed with social anxiety disorder and are also experiencing problems with sexual functioning, it is important (although probably nerve-wracking) to tell your doctor or therapist. Remember that this person is a professional and has probably heard it all before.

Issues such as sexual performance anxiety can be treated along with SAD in therapy (after medical causes have been ruled out for problems such as erectile dysfunction), so it is important to talk about problems you are having.

In addition to addressing sexual problems in therapy, medications can be tailored to your particular situation. For example, SSRIs may be a good option if you suffer with premature ejaculation as they can help to delay orgasm.

Sources

Bodinger L, Hermesh H, Aizenberg D, et al. Sexual function and behavior in social phobia. Journal of Clinical Psychiatry. 2002;63(10):874-879.

Figueira I, Possidente E, Marques C, Hayes K. Sexual dysfunction: a neglected complication of panic disorder and social phobia. Archives of Sexual Behavior. 2001;30(4):369-377.

Munoz V, Stravynski A. Social phobia and sexual problems: A comparison of social phobic, sexually dysfunctional and normal individuals. British Journal of Clinical Psychology. 2010;49(1):53-66.

Tekin A, Meriç C, Sağbilge E et al. The relationship between childhood sexual/physical abuse and sexual dysfunction in patients with social anxiety disorder. Nord J Psychiatry. 2015 Jun 25:1-5. Epub ahead of print.

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