Most people are somewhat familiar with the term “sex addiction”, particularly because they’ve heard about the occasional movie star or entertainer who seeks treatment for their compulsion. But, while sex addiction is recognized and there are rehab centers and support groups that can provide help, its polar opposite – sex avoidance – is hardly ever discussed. And yet, sex avoidance is just as shattering – perhaps even more so, because a person with sex avoidance shuns intimacy and the enjoyment that comes with having a sincere connection to a loving partner.

Additionally, while sexual avoidance can be troubling on its own, it is also often a side effect of having an anxiety disorder. Things like performance fears, being distressed and upset, and low libido can make people even more anxious and can lead to the avoidance of sex.

What is Sex Avoidance?

In general, the aversion toward sex is a defense mechanism. When thinking of intimacy or engaging in sex, the person with sexual avoidance feels emotional distress and physical symptoms, such as nausea and tensed muscles, or they may have panic attacks. They may also experience humiliation, shame, and low self-esteem for rejecting their partner.

As with any condition, there are people who fall on either end of the spectrum. Sex avoidance can come in the form of sexual anorexia, which happens when sex and intimacy are obsessively evaded in the same way anorexics shun food. In some cases, the sexual anorexic may enjoy physical intimacy once it has been initiated, but may not be able to instigate sex. Or, they may take it a step further and turn down their spouse or partner’s desire for physical closeness more often than not.

On the other extreme, the American Psychological Association has classified an actual disorder called Sexual Aversion Disorder. With this disorder, the individual actively seeks to avoid genital sexual contact with a sexual partner. Often, the person will even avoid genital contact related to a gynecological exam or procedure. Sexual Aversion Disorder can be so traumatic that the person won’t allow any physical touch or kissing.

Reasons for Sex Avoidance

There are various reasons for avoiding sex. The most obvious is the case of a person who has suffered childhood sexual abuse and now dodges anything that brings the trauma back up in their mind. However, not everyone who has been abused will avoid sex, just as not every person who shuns physical intimacy has been abused.

In some cases, people with anxiety disorders also shun sexual encounters. When a person has an anxiety disorder, they suffer physical effects along with their mental stress. Physically, the Mayo Clinic reports people with an anxiety disorder may experience the symptoms of:

  • Insomnia, trouble falling asleep or problems with staying asleep
  • Fatigue, particularly if they aren’t sleeping well
  • Heart palpitations
  • Headaches
  • Vomiting, nausea
  • Irritable bowel syndrome
  • May be easily startled
  • Muscles aches, tense or clenched muscles
  • Twitching or trembling
  • Sweating

But, why would these symptoms cause someone to avoid the comfort of a physical relationship? One reason is that the act of intimacy raises your heart rate, induces heavier breathing, and makes you sweat. These bodily reactions mimic the physical “fight or flight” responses people experience during a panic attack, so much so that some individuals will go to great lengths to avoid feeling them at all.

Additionally, people who already suffer anxiety may choose to forego sexual encounters so they don’t have to add more fears to their list of concerns. Engaging in sexual activity can bring up worries about their attractiveness, their ability to perform, or may increase feelings of shame or guilt.

Sex Avoidance Treatment

Depending on its root cause, sex avoidance can be effectively treated either on its own or as part of an anxiety disorder therapy.

  • Cognitive behavioral therapy and psychodynamic therapy can help reduce anxiety, fear, and negative emotions. These therapies can be conducted on a one to one basis, in group therapy, or online depending on the particular preference of the client.
  • Sexual function can often be improved with the use of certain medications. For example, SSRIs may have the side effect of delaying orgasm and can often help men who suffer from premature ejaculation.
  • If you are already on anxiety disorder medications, talk to your doctor about adjusting your medicine so it has less effect on or can help with your condition.

A Place to Turn for Help

If your anxiety disorders are leading to sex avoidance, turn to the professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida. For more information, contact us or call us today at 561-496-1094.

Dr. Andrew Rosen PHD, ABPP, FAACP is a Board-Certified Psychologist and the Founder and Director of The Center for Treatment of Anxiety and Mood Disorders, as well as, the Founder of The Children’s Center for Psychiatry Psychology and Related Services.

50 Responses

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    2. I’m a 31 year old man. I was in a relationship with a narcissist woman who cheated. Who lied. She left me twice for two men in 8 years of being together. She created chaos. She cried Wolf to the police and had me arrested 3 times now. I avoid sex because of the trauma my ex put me through. I can’t get close because I have a fear of setting off a bomb. It’s like I’ve walked on egg shells for so long that it stuck and now I am filled with paranoia. That every woman is out to get me. I almost just want to commit suicide.

      1. Hi Kay,

        Please contact us through the contact page to learn more about the options and support available.

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  3. I can’t stop thinking about my girlfriend’s previous very active sex life in which she has shared as well I’ve imagined to the point of I can’t touch her or even ponder a sex life with her. The only way I know is to not have a relationship.please help

  4. My avoidance to sex has cost me my marriage. I waited way way to ling to address thus issue. I wish that I would have sought help much sooner. Now I am heart broken and my poor wife has been heart broken much longer than I. God bless her she stuck with me for so long.
    I love her so much but now she is gone and i can not blame her one bit.

    1. Better Sex through Mindfulness: How Women Can Cultivate Desire by Lori Brotto PhD. Worth the read.

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  6. I am a wife of a husband with severe anxiety and this describes him perfectly. I want him to get help to set him free and also, with the sexual avoidance that accompanies this, I feel so lonely and rejected. I read this to him a year ago and he said it was right. I have asked him to get help and he hasn’t. I asked about it tonight as gently as I could and he got angry and yelled at me and said I could love him how he is or don’t and make a decision! He was like a different human. He has had rage issues never directed towards me but still scary. I am so sad and I don’t know what to do. Anxiety effects all aspects of his life unless we are at home not doing anything out of his norm. I have gotten to a place where I feel shameful asking him and that he thinks I should be just fine without it. But he doesn’t even kiss me very much anymore and if snuggling seems too cozy like it might leed to something, he pushes me away. It is heartbreaking..

    1. I’m in pretty much the same boat although I finally told my husband that it’s incredibly selfish of him to hold me hostage in a relationship where he refuses to get help. That some of these issues in him are with within his reach of learning how to cope if he will just move forward and get some help. I told him firmly that you can’t call it love if only one person is doing all the sacricing in the relationship. He finally started therapy. Progress is extremely slow, but it’s there. We’ve been going for about 5 months and we’re building touch slowly back into our relationship- thank God! A good therapist I think will request to see each of you, which at first I didn’t think was necessary, but after years of dealing with stress and rejection, and loneliness- therapy is helping me close wounds too. Stay hopeful- keep trying. Keep pushing and don’t give up!

    2. I’m in pretty much the same boat as MK above, although I finally told my husband that it’s incredibly selfish of him to hold me hostage in a relationship where he refuses to get help. That some of these issues in him are with within his reach of learning how to cope if he will just move forward and get some help. I told him firmly that you can’t call it love if only one person is doing all the sacricing in the relationship. He finally started therapy. Progress is extremely slow, but it’s there. We’ve been going for about 5 months and we’re building touch slowly back into our relationship- thank God! A good therapist I think will request to see each of you, which at first I didn’t think was necessary, but after years of dealing with stress and rejection, and loneliness- therapy is helping me close wounds too. Stay hopeful- keep trying. Keep pushing and don’t give up!

      1. You’re both terrible people. How dare either of you wish to disregard your partners’ boundaries for consent for your selfish wants. If you truly loved them, you’d see them as the person you’ve grown with and made a life with, not as a broken sex toy. Neither of your husbands deserve to put up with you.

        1. But it’s not selfish that their partners won’t even try to get help?! Imagine being in a relationship or marriage with someone you love and they won’t even touch you. These women probably feel undesired and defeated. Sexual frustration is a very real thing and can cause problems, regardless of if you love the person or not. Human touch is very important. Their partners should also be trying to get over their anxiety, while the women also respect their boundaries. It should be a 2-way streak. It’s like they’re roommates instead of lovers.

  7. My wife is so afraid she shakes and trembles like a leaf vomits curls up in a little ball feels like she’s going to die. I love her but I can’t save her from this I don’t know what to do and my son doesn’t understand either.

    1. I am a woman,who has the same problems,and worse also,my whole life and my kids life have been destroyed by my anxiety,s I’ve never been able to talk about it,but I just leave,and stay broken,I’ve loved my kids dad,all my life and have kept him at a distance,destroying all our lives,n it’s almost pushed me to so a lone n I hate it,n I hate myself for all the pain .I just want to be loved n love .

  8. Hi, me and my girlfriend are almoste 3 years together and we are trying to have sex for about 2 years now. But every time I want to go in she begins to panic. We are both still virgins so I dont want to push her. But I was wondering if you could help us?

  9. I am okay having male friends. Not jerks. The moment they try to touch me or kiss me or start pawing me I feel disgusted and just want them to leave me alone and never want to see or talk to them. If I suspect their intentions are sexual in nature. I ghost. Even in my marriages I dreaded sex. I am warm and funny and okay with hugs and holding hands but sexual touching grosses me out. I feel like I am being raped. I had an abuse childhood. PTSD, molestation, rape, CPTSD, violent alcoholic parents, pimped out to my mother’s pedophile father, mother had NPD. I’ve never felt good or safe about sex. I would just rather not. I am older now. Kids grown. It has been over 7 years since I have been sexually active. I can please myself but the thought of someone having sex with me makes me ill. Always did. Is this sexual or touch aversion?

    1. I know this exact feeling. I was abused as a child and in my marriage, raped. I went on a sexual binge after I got divorced, before I was diagnosed with bipolar. I’m well medicated now, but the thought of sex makes me gag. I don’t like to be touched, especially in a sexual way. Hugging, holding hands, that’s fine. But if I think anything sexual is going to happen, I’m out. You’re dead to me. And if I think they’re thinking anything sexual? I also ghost. I can’t help it. I can handle myself fine, it’s the thought of anyone else… I just can’t.

  10. As far as the physical side effects of anxiety go it should be mentioned that sexual dysfunction, especially in males can make sex unpleasant and heighten anxiety even more. Problems like the inability to ejaculate and/or being unable to get and hold an erection can be a fundamental reason for sexless marriages. Fixing these anxiety based dysfunctions in therapy is extremely difficult and for me, having gone to a number of therapists over the years with no luck, both cognitive behavioral therapy and sex therapy “homework” assignments actually made the situation worse. My 30 year sexless marriage is a testament to the failure of Sex Therapy when dealing with sexual dysfunction caused by anxiety.

  11. I have no anticipatory anxiety when having sex with someone the first time. Desire carries the day the first one or two times I have a sexual encounter with the same woman. After that however I suddenly lose desire for the person and my body shuts down sexually and I can no longer perform. I have seen a few Sex Therapists but anxiety as a cause of my sexual dysfunctions was never mentioned. Indeed I was treated with Cognitive Behavioral Therapy which they used to try and deal with the symptoms rather than the cause. Also the Sex Therapy “Homework” we were given actually made the situation worse causing my wife to finally give up therapy out of shame and frustration.

  12. I struggle so much with this situation. Whenever my girlfriend and I try to do something, I always end up ruining it by getting anxious and losing my erection. This is obviously a turn off for her as well. I need help.

  13. I’ve had this problem for a long time, but only with intercourse, not any other type of forplay. But because forplay almost leads to expectations of “more”, I avoid that too. I had been prematurely exposed to sex, through porn, and was molested as a young child. Plus my mom said some things to me when I was 10, warning me of getting a girl pregnant, after excitedly getting her that there was a girl I liked and had kissed… I wasn’t even thinking about that at that time and it gave me nightmares even though i wasn’t sexually active. When I’ve been with women, the fear of unwanted pregnancy scares me to the point that i can’t perform, so now i just avoid it altogether. This is especially now bothering me because I’m in my late 30’s and I’d like to someday have a family before its too late, but since my anxiety overwhelms me and I feel completely hopeless 🙁

  14. I can completely relate to it, very useful information. I haven’t thought in this direction. I always thought sex is an enjoyable experience which is good for body, mind n soul. How can anybody avoid it!! But now I know for people with anxiety it completely make sense. But the fact is it takes a severe troll on your marriage and you are helpless. I think one should avoid marriage with this condition. It’s very unfair on the partner. My husband of 10yrs is doing this all the time to me. God only knows how much I have been suffering.

  15. Hi,

    I’m 32 years old female, and I’m still a virgin. I have no problems with being friends with guys, but once they express and form of sexual interest, I avoid them. I would really like to find a way to learn to cope with my anxieties, as I truly do want to have a partner and to start a family.

  16. My fiancée has had this issue for awhile. I always had a feeling it was due to anxiety, but this just proves it. I realize I may have been trying to talk to him about it all wrong. I don’t try to be hurtful, but I think I may have been…Now I’m afraid I can’t discuss this with him for at least half a year, or else it could make things worse.

    He doesn’t want to go to therapy. That, I know. Why? Because it gives him anxiety. I wish there was some way I could to to help him. Maybe even help him become at ease enough to seek out professional help. The issue is, his anxiety causes him to become angry and defensive, so he pushes me away. Any help or even a link to reference would be appreciated.

  17. I’ve always known I’ve had this but didn’t know the word. Thank you!

    I’m 21 and I have sex but I’m never into it. Never have been. Didn’t feel pleasure for a long time. I’ve only had good sex a few times and that was only because I forced my brain to want it. My boyfriend is highly sexual and into some fetishes that I’m not really into, but being kinda forced to make him happy in that way killed the vibe more. I grew up with a mom who hated alcohol, hated sex, hated drugs, to the point where she did none of those things herself. I don’t know what to do.

  18. My wife has been struggling with sexual anxiety since before she met me. When the relationship started the sex was great, as soon as we grew close it all just stopped. Now I can’t even bring up the idea of having sex without her having a panic attack and crying. I can’t live like this and I don’t want to leave her. It’s been 12 years and I’m giving up hope. She’s tried therapy and exercise and taking it slow but she just gives up every time. I feel like she’s just not interested in me anymore. How can you have love and passion without sex? How is this different from having a roommate? I feel trapped. I’ve gone from angry to hurt to just disillusioned. This is the second time in my life this has happened in a long relationship. I don’t think I can trust women after this anymore. I feel like it’s all a trick.

    1. I feel your story man cos I have been there it hurt like hell man.. I have to live like that for almost 5 years and I was really going nuts. We did everything but nothing changes I was try all ways but nothing happened until in ready a story online of a guy who had similar problem and he got help by using the other methods of herbs and spell. So I talked to the guy he explained to me and gave me the guys contact which I did trust me today I am so fucking enjoying sex with my wife. Let me shock you a little i have been able to achieve my sex fantasy of 3some with my wife and she is so loving it. Some times I sit back and ask my self is this really happening or am I dreaming. If you truly love her and want to keep the marriage I advice you give it a try, he is a honest man and will tell you exactly what to do. It took him a couple of weeks before he finally finished and it been over a year now i t seem I am in honeymoon lol. If you are interested these are his contact or 503-773-9114. Am Donald from Atlanta

  19. I am 25 and have had a few sexual partners. I have been with my current boy friend for almost 3 years. He is still a virgin and in the beginning he wasnt sure about sex and now cares for me enough that he wants to and now I dont. I know I’ve always had anxiety but anxiety about sex didnt start till my first long term relationship. Since then and the emotional abuse I went through in that relationship it has been so hard for me to be able to relax enough to enjoy sex. There has only been a few times I’ve been able to enjoy it. Now I am to the point where I start the intimacy I am okay for a while but not long after I just start shutting down. I loose all feeling and just feel sad and dont want to be touched. My anxiety gets so bad that my throat will feel like its closing up on me and I start to gag. I have been going to therapy and we are going to start working on this part of my anxiety. Reading this article and the comments made me realize I am not the only one with sex avoidance anxiety and was helpful in better understanding my feelings.

  20. Great article. I used to be sexually active..very sexually active. A few months into my marriage my husband wasn’t interested in sex. After 12 years of him rejecting me and refusing to have sex with me he finally told me that it was because he started watching pornography videos online. I felt so rejected! We were separated but he got professional help. Turns out he also had anxiety and other mental issues. Now that we’re together again, I can’t initiate sex anymore. I get anxiety attacks and extremely emotional just by thinking of initiating sex because I don’t think I can handle anymore rejections. I feel so broken. Recently I finally got the guts to initiate and he flat out refused me. I got a panic attack and cried for several hours. I am so tired of this. Emotionally and mentally I can’t go on. Our 17th anniversary is coming up and we’ve only had sex once in the past 12 months. I have completely lost my sex drive. Just the thought makes me cringe and your article explains why so I can rest knowing the reason why I feel this way.

  21. I’m 21 and spent most of my teenage years struggling with depression and anxiety. I managed to get through that, but now that I’m feeling better and finally starting to give dating a try, I have a problem with this. I can’t even kiss anyone for long without just cringing so hard I have to laugh. I was victim to online predators from the ages of 8-11, saw things I wasn’t ready to see. I just had my first kiss since the age of 17 yesterday and a sleepless night afterwards. I wasn’t ready to be kissed on that 2nd date (not sure I ever will be, and of course the same can be said about sex), and made it awkward. I know really well the kind of disappointment on a guy’s face when he realizes he’s making no progress with me, and feels rejected, and it makes me feel guilty.

  22. I appreciate, cause I discovered just what I used to be taking a
    look for. You’ve ended my four day long hunt! God Bless you man. Have a nice day.

  23. What if I have a very high libido and sexual anxiety. I constantly think and desire it but I rarely meet a man I want to have sex with. When I do I get SO excited it has turned 3 men off, even though they were initially attracted to me, they end up pulling away before anything happens leaving me hurt and more sexually frustrated. It’s been almost 3 years since I even kissed a man. I feel so much longing it hurts but my anxiety is repelling the men I want to be around. I feel like I could die of a broken heart, although I want and need emotional intimacy to have sex, it is really only the sexual that I really need. My hormones are driving more crazy now than when I hit puberty! I think it’s my body was ting to have babies partly.

  24. I am curious if it is always a sexual aversion or an aversion to your partner. After 16 years of sexual coercion, shaming and other issues I do not want him to touch me or look at me sexually. The thought of other partners doesn’t elicit this response just him.

  25. My partner has recently developed new feelings about me. Before they were all about having fun, playing games, watching movies and the like, just to be together. Recently he has liked me in a sexual manner as well, which intrigues me even though the thought of sex is something I don’t enjoy. I like that I can turn him on, but I don’t want to go any further. For some reason, when we go into what I would consider in-depth conversations (over text) where I try to arouse him, my whole body starts to shake uncontrollably. Could there be any other cause other than sexual avoidance?

  26. Thank you for this page. I’ve been feeling a lot of anxiety around sex recently and avoiding sexual contact. It’s been upsetting and distressing for both me and my partner because I used to love sex and love sex with him. I feel so guilty about turning him down and I explain to him that it’s not about him but I know it still makes him feel insecure. Feeling like this makes me feel broken, even more so when I had no idea what it was or why it was happening. This article explained everything I was feeling and tells me that I’m not alone in feeling that too. I’m not sure what started it but my anxiety has been bad recently and I guess it’s just now extended to sex. Thank you, I think I need to talk to a therapist about my anxiety.

  27. It’s crazy to me to hear people say they actually suffer from sex avoidance but they have children? I’ve always wanted children but my sex avoidance is so bad I’m still a virgin. I’m 32 and I was molested in childhood. I think I actually do have this sex avoidance thing.

    1. Hi Elisabeth,

      Please contact us through the page to learn more about the options and support available.

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