Sexual performance anxiety

What is ASFES?

Anxious Sexual Failure Expectation Syndrome or ASFES has appeared in the medical practice relatively recently. This is a pathology when a man is anxious before sex because he fears of failure during a sexual intercourse. This disorder is characterized by a vicious circle because fear leads to partial or complete loss of erection and a man becomes too focused on himself during sex not paying enough attention to his partner. Ultimately, because of his fear a man fails in sex and this only aggravates the pathology.


While the symptoms of sexual performance anxiety have purely psychological nature, etiological factors can be different. Man’s fears can be both motivated and groundless. The main factors leading to ASFES:

  • Fears of consequences after masturbation;
  • Unstable reproductive system;
  • Loss of erection caused by stress or alcohol;
  • Sex in unusual places (and sexual experiments);
  • Inadequate assessment of his won sexual abilities;
  • Woman dissatisfaction by the partner (even if his sexual performance is good);
  • Too long foreplay;
  • Organic causes of erectile dysfunction (signs of impotence);
  • Excessive physical loads;
  • Accentuations of personality traits and various personality disorders;
  • Psychoneurosis and depression.

Under the influence of these causes, Anxious Sexual Failure Expectation Syndrome can be developed in the following way:

  1. Pre-manifested stage of development. A man develops ASFES first and only then he notices genital system dysfunction.
  2. Manifested stage of development. The syndrome appears when a man changes his sex partner and has the first sexual intercourse with her. Each new sexual intercourse implies ASFES but later the syndrome disappears until a man finds a new sex partner.
  3. Post-manifested stage of development. A man already has some functional disorders which cause ASFES. The syndrome develops rather quickly, after one or two failures or very slowly – during several years.

Clinical picture of the disorder

ASFES symptoms imply not only fear or anxiety during an intercourse or before it. Clinical manifestations are varied but subjective. The main sign which confirms the diagnosis is fear of sex and all the other signs are just its consequences:

The symptoms of ASFES:

  • Anxiety and nervousness before a sexual intercourse;
  • A man is too focused on his own movements and on the opinion of his partner;
  • Weak erection (or its loss);
  • Premature ejaculation;
  • Reduced sexual attraction to the opposite sex (very rarely a complete asexuality can develop);
  • Hypoorgasmia (rarely occurs);
  • Lack of sensations during sex;
  • Tachycardia and chills (as the signs of neurosis, sometimes a man can have a chest pain);
  • Shortness of breath;
  • Excessive sweating;
  • Urge to urinate and defecate;
  • Depression and compulsive thoughts about his own inferiority.

As it is not easy to get rid of ASFES and only few men seek medical assistance, this disorder is progressing for a long time. Due to it, a man can change his behavior.

Possible deformation of the personality:

  • Restriction or complete avoidance of contacts with women (not only physical);
  • Excessive interest in hobbies, work or studies (efforts to distract himself);
  • Negative attitude to all women (efforts to justify himself);
  • Over-care for his partner to compensate his sexual defects;
  • Getting rid of bad habits to heal or, on the contrary, acquiring bad habits to relieve stress;
  • Depressed or aggressive behavior.

The situation is made worse because men with ASFES do not know where to seek help. Many men find it shameful to visit a psychiatrist or a sexual health specialist. The latter knows much about the problem and men should consult this specialist.

ASFES has several classifications and types. The syndrome can be constant and temporary. It can appear only in connection with one woman or with a certain type of women and this is a selective syndrome. Or the syndrome can appear towards all women and this is a total syndrome. Having ASFES a man can worry about himself, his emotions and feelings or about his partner. Usually, men’s worries are mixed.


Men prefer not to seek medical help when they have sexual disorders and help themselves using Viagra for sexual performance anxiety which is not always effective. A drug therapy is rarely indicated for this disorder and is usually aimed at eliminating a primary pathology which caused this psychological disorder. Most often auto-training and other psychological methods are used to treat ASFES.

To know how to fight ASFES, it is necessary to consult a sexual health specialist who will identify the cause of the disorder and choose the most optimal treatment.

In some cases, a man needs to visit a specialist just a couple of times to regain his lost confidence. However, the majority of men seek the way how to deal with ASFES themselves. For these patients, there is a simple but effective method consisting of 5 steps. The method is called Scenario Switching.

  1. Step One. Taking full advantage of his imagination and memory, a man should imagine his real failures. He should remember everything in details because he will have to divide them into two parts. A man imagines each failure as “before” and “after”. The point of recollection inactivation is the moment when something got wrong.
  2. Step Two. Then a man has to concentrate on the moment when he realized that he had a failure or that he was going to have problems during sex (this moment is a trigger). This understanding is always caused by something. It means that before realizing that he is going to have a failure in sex, a man feels something (it can be a sensation of a numb penis or something else) and a man has to find this moment. Then he should identify whether each moment was the same or not (usually, the moment is the same).
  3. Step Three. Finding out the trigger and making sure that it is the same for all the situations (and this is the sign that it will be easy to treat the syndrome), a man should take imaginary scissors and cut that moment between the trigger and failure. This moment is always there between some certain feeling, realization of the problem and a further model of behavior. That period when sex was going as planned and a moment of failure is very important for the training. All the rest should be discarded or completely forgotten. When you leave only this positive moment in your memory, you should think of continuation. What could you do to save the situation and even regain arousal?
  4. Step Four. Repeat the previous step three times for every situation. You should take a situation and create three models of behavior after the trigger. Each model should be fixed in your memory: you create the situation and play it over in your mind from the start to the end. But this time, you are not an observer but a participant. Play it over, at least, three times.
  5. Step Five. To make this method work in reality, you should play over your dating from the start to the end. There should be various situations: at home, in a café etc. Thus, your brain fixes the model of behavior and in a real situation the brain will generate it as the most optimal one.

This is a universal technique and in 80% cases it helps to overcome the syndrome. However, if you can not get rid of the pathology despite all the efforts, you should treat ASFES with the help of medical specialists.