Sexual Performance Anxiety.
I think anxiety about performing is the main thing going wrong for me rather than a physical problem — how would you assess that, given there isn't a formal diagnosis for it?
Weak or heavily disputed. Treat as a question, not an answer. how we score evidence
Caveat on this rating: This is a single-author narrative review with no systematic search protocol and no pooled analysis; the author's affiliation is his own consultancy, Pykonsult LLC, and no funding or conflict-of-interest statement was accessible. Its treatment section is explicitly hypothesis-generating — it applies "pharmacologic principles" to drugs and phytotherapies including buspirone, trazodone, yohimbine, l-citrulline, and bitter orange that have not been tested for sexual performance anxiety. Treat the prevalence range as the usable part and the supplement suggestions as untested.
This review estimates from population-representative surveys that sexual performance anxiety affects 9-25% of men — contributing to premature ejaculation and psychogenic erectile dysfunction — and 6-16% of women, where it severely inhibits desire. Its central finding is an absence: there is no recognised diagnosis for sexual performance anxiety in either sex, and consequently, in the author's words, "research into treatment has been minimal." Cognitive behavioural therapy and mindfulness training are recommended by extrapolation from non-sexual performance and social anxiety, because controlled studies in sexual performance anxiety are lacking.
Worth asking
I think anxiety about performing is the main thing going wrong for me rather than a physical problem — how would you assess that, given there isn't a formal diagnosis for it?
What to watch for
Evidence quality tells you whether to trust the finding — not whether the treatment is safe. These are the risks this research reports.
- Sexual side effects
Source
Sexual Performance Anxiety. — Pyke RE. (2020)
Reputable peer-reviewed journal
Read the source: https://doi.org/10.1016/j.sxmr.2019.07.001
DOI: 10.1016/j.sxmr.2019.07.001
How this was scored
- Study design
- Narrative review
- Funding
- Funding not disclosed
- Published in
- Reputable peer-reviewed journal
- Sample size
- not recorded
- Preregistered
- No
- Conflicts disclosed
- No
- Independent of proponent
- not recorded
- Retracted
- No
Read the full scoring rubric, including what it can't tell you.
Published August 19, 2026.
Where we put this study in context
Questions
How strong is the evidence behind this?
Resolv rates this source "contested". Weak or heavily disputed. Treat as a question, not an answer. It scores 33 out of 100 on our published rubric. One caveat travels with that badge: This is a single-author narrative review with no systematic search protocol and no pooled analysis; the author's affiliation is his own consultancy, Pykonsult LLC, and no funding or conflict-of-interest statement was accessible. Its treatment section is explicitly hypothesis-generating — it applies "pharmacologic principles" to drugs and phytotherapies including buspirone, trazodone, yohimbine, l-citrulline, and bitter orange that have not been tested for sexual performance anxiety. Treat the prevalence range as the usable part and the supplement suggestions as untested. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
Sexual Performance Anxiety. — Pyke RE. (2020). Published in: Reputable peer-reviewed journal. DOI: 10.1016/j.sxmr.2019.07.001. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Narrative review. Funding: Funding not disclosed. Independence from the proponent is not recorded. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.