Do you ever get nervous before having sex? Sexual performance anxiety is a frequent issue that affects many males and is characterized by feelings of apprehension or unease before and during sexual activity. Men of all ages and backgrounds suffer from performance anxiety. It can influence your emotional state during sex and worsen common sexual problems including erectile dysfunction (ED) and premature ejaculation (PE). The good news is that sexual performance anxiety can nearly always be treated, usually with medication, therapy, healthy practices, or a mix of several treatments.