Performance anxiety, or fear of performance, is a common sexual problem in which anxiety about engaging in sexual activity becomes an overriding block to the spontaneous flow of sexual feelings and thoughts. The fear of sexual performance — or, more accurately, the fear of not performing sexually — can affect sexuality in a variety of ways. Performance anxiety can result in avoidance of sexual encounters, lowered self-esteem, relationship discord and sexual dysfunction.

Typically, an awareness of performance anxiety produces so much preoccupation with the anxiety itself that the person becomes less fully involved in the sexual interaction, bringing about the very failure that is feared.

In one common scenario, as the anxious person worries about how to be sexually responsive and spontaneous (how to be a "good lover"), he or she focuses on each detail of the lovemaking. The person may focus on how rapidly the partner is breathing, whether a shift in position is required, or how much lubrication or erection is present. The sexual interaction is dissected so deliberately that enjoyment is virtually impossible.

Sexual encounters that proceed in this fashion have a high probability of being unfulfilling for one or both partners. Anticipation of the next sexual encounter arouses the same anxiety coupled with the memory of the previous failure and often leads to avoidance of sexual activity altogether, or at least to minimizing the amount of sexual interaction that occurs.

This may result in one member of a couple mistakenly interpreting the situation as a form of rejection. The underlying avoidance, however, is usually not to reject one's partner, but to save face in a way that helps the person feel more in control and less guilty about being inadequate.