Many people experience worries about sex. It’s common to be nervous, for instance, before losing your virginity or having sex for the first time after a long-term relationship ends. Some people have qualms that stem from a negative body image, or they simply feel a bit apprehensive about being vulnerable with another human.
But for some people, the fear of sex is more than just a low level of anxiety or a general aversion. The fear is intense and all-consuming, and interferes with their lives in meaningful ways.
In some cases, it comes down to a specific phobia such as genophobia (a fear of the act of sexual intercourse) or erotophobia (includes fears about any aspect of sex—including the physical, emotional, and psychological parts). For others, fear of sex can be linked to a different mental health condition such as obsessive-compulsive disorder (OCD) or post-traumatic stress disorder (PTSD).
If you’re struggling to tell the difference between everyday worries about sex and a legitimate fear that warrants professional help—and perhaps a diagnosis—consider this advice from Tracie Zinman-Ibrahim, LMFT, CST, a therapist at NOCD. Ask yourself: “Are you going through great lengths to avoid sex, or not think about it, or do something to mitigate the fear?” These are all signs that your worries are more than fleeting—and that support from a professional would be beneficial.
If the fear of sex is affecting your mental health, it’s time to talk to a professional. Book a free call.
When is fear of sex an actual phobia?
According to the DSM-5, a Specific Phobia is a “marked fear or anxiety about a specific object or situation.” There are many sex-related phobias—and sometimes they occur together. These include:
- Genophobia, also known as coitophobia, is the fear of sexual intercourse specifically.
- Erotophobia refers more generally to a fear of any type of sexual activity, contact, or even sexual content or themes.
(Erotophobia and Genophobia differ slightly, but the terms will sometimes be used interchangeably.) - Nosophobia is the fear of contracting a disease or virus.
- Gymnophobia is the fear of nudity (being seen naked yourself or seeing others naked).
- Haphephobia is the fear of being touched and touching others.
- Philematophobia is the fear of kissing.
- Tocophobia is the fear of pregnancy or childbirth.
How can fear of sex affect you?
Often, someone with a sex-related phobia such as Erotophobia and Genophobia will go to great lengths to avoid sex. They may alienate their sexual partners, make excuses to avoid sex, and even sabotage their relationship because of their fear.
Given the intensity of the fear, it’s not surprising that phobias are often accompanied by debilitating symptoms.
Symptoms of a sex-related phobia include:
- Panic attacks
- Avoidance
- Nausea
- Sweating
- Tension
- Headache
- Dizziness
- Having a hard time concentrating
Is fear of sex the same as asexuality?
No. Genophobia and Erotophobia are different from asexuality. Those who identify as asexual, also known as Aces, have a general disinterest in sexual intercourse—not a fear of it. (It’s important to note that asexuality is a spectrum; some Aces might still occasionally experience sexual desire, whereas others may never feel it.)
What’s more, asexuality is not a mental health condition or a sexual dysfunction. Instead, research suggests that asexuality can be viewed as a sexual orientation.
Causes of genophobia (and other sex-related phobias)
There’s not one factor that leads to Specific Phobias. It’s thought that genetics, brain chemistry and life experiences may all play a part.
When it comes to genophobia, physical and emotional factors may include:
- Vaginismus: a condition where the vagina’s muscles involuntarily clench up when penetration is attempted. This makes intercourse painful or even impossible.
- Body dysmorphia: Shame around how your body looks or how others perceive it
- Erectile dysfunction: a highly treatable condition where it’s difficult to get or maintain an erection.
- A history of sexual assault and/or abuse
- PTSD
Diagnosing a specific phobia
For a fear of sex to constitute a phobia, certain criteria must be met. Here’s what’s needed for a diagnosis:
- Your fear is excessive or out of proportion
- Your fear leads to intense distress, anxiety, or panic
- Your fear of sex (or avoidance of sex) interferes with your life
- You’ve had the fear for at least six months
- Your fear is not a result of another mental disorder, such as OCD
What does the fear of sex have to do with OCD?
First, it’s important to understand that OCD is a serious mental health disorder—not a personality quirk. OCD is characterized by two key symptoms. There are obsessions, which are repeated thoughts, urges, feelings, sensations and/or mental images that are intrusive, unwanted, and lead to distress. Then there are compulsions, which are repetitive physical and/or mental behaviors a person feels the urge to do in response to an obsession.
While they all fall under the umbrella of a general OCD diagnosis, there are actually many OCD themes—or subjects around which the person’s anxieties or intrusive thoughts revolve. And sex is an incredibly common theme.
Here are some examples:
- Someone with Contamination OCD—an OCD subtype characterized by the fear of germs and illness—may develop a fear of sex that’s related to STDs or just the disgust with bodily fluids.
- Someone with Sexual OCD may have, among other fears, an extreme fear of becoming violent during sex.
- With Relationship OCD, a fear of sex may arise because of intrusive thoughts such as: “Maybe the sex with my partner isn’t ‘good enough’; could it be a sign I’m in the wrong relationship?”
- Someone with Scrupulosity (a.k.a Religious) OCD may have a fear of sex that has to do with their moral beliefs, with intrusive thoughts such as “Sex is shameful” or “I’ll be punished if I have sex before marriage.”
- With Harm OCD, someone may have intrusive thoughts about hurting their partner during sex.
Manage your fear of sex while getting your life back from OCD
Common obsessions related to the OCD fear of sex
As mentioned earlier, obsessions are unwanted thoughts that keep coming back, or urges, sensations, or images that are intrusive and cause distress or anxiety. When a fear of sex is present in someone with OCD, the obsessions can be about anything. Here are some examples:
- Intrusive and repulsive sexual images, whether during sexual situations or otherwise
- Fear of being harmed during sexual intimacy
- Fear of sexual performance failure
- Unwanted sexual fantasies
- Fear of unwanted attraction (toward children, animals, family members, inanimate objects)
- Fear of becoming violent during sex
- Fear of having a groinal response in response to unwanted stimuli or thoughts
- Fear of rejection or ridicule
- Fear of unwanted outcomes, such as accidental impregnation
- Fear of contracting sexually transmitted illness
Common compulsions related to the OCD fear of sex
As a result of their obsessions, people with OCD engage in compulsive behaviors in an attempt to reduce their distress and anxiety or to avoid an unwanted outcome. Compulsions may include:
- Avoidance of sex
- Seeking reassurance about fears from a partner
- Sabotaging relationships on purpose
- Making yourself unavailable for sexual relationships
- Distracting yourself during sexual encounters
- Thought replacement during sex/trying to push unwanted urges or images away
- Avoidance of media or other content involving sexual themes
OCD vs. Phobias
Intrusive thoughts are not necessary for the diagnosis of a Specific Phobia. On the other hand, OCD will always present with intrusive thoughts, urges, or images. Likewise, when people with OCD experience obsessions that cause anxiety, they feel a strong urge to engage in compulsions to feel better.
Another difference is that OCD symptoms often come and go, and switch themes. This means that you may only spend a finite amount of time consumed by obsessions and compulsions about the fear of sex—after which your intrusive thoughts and compulsive behavior are about something else entirely. If you have a Specific Phobia, your fears and behaviors usually remain consistent in the absence of treatment.
Ultimately, the best way to know if OCD could explain your symptoms is to consult an OCD specialist specifically. Sadly, many mental health professionals claim false specialty in OCD, which can lead to the disorder going undiagnosed for too long.
How to overcome the fear of sex
If you’ve identified an underlying cause of your Specific Phobia that needs treatment, it’s best to start with that. Some physical and emotional causes for Genophobia include:
The fear of sex can be debilitating, but the good news is that there’s a lot you can do to overcome it.
4 tips for when your fear of sex is related to a Specific Phobia such as Genophobia:
- Understand if a physical issue is causing it. Take vaginismus or erectile dysfunction, for example. When these issues are present, getting medical help to resolve the underlying problem will be key to addressing the fear of sex or intimacy.
- Work through past sexual traumas. If you experienced sexual abuse or trauma that’s impacting the way you view sex and intimate relationships, it will be important to work with a therapist.
- Acknowledge if you’re holding yourself back due to impossible standards. When body image is at play, or you’re worried you’re not “good enough” in bed, addressing these issues of self-esteem can help you move past the fear of sex.
- Consider therapy. Treatment for phobias typically includes psychotherapy, such as cognitive behavioral therapy (CBT). CBT can teach you new ways of thinking about your fear of sex while also learning techniques to address physical reactions to the trigger.
Specific Phobias also respond well to Exposure and Response Prevention (ERP) therapy. ERP is the gold standard for all forms of OCD, but this evidence-based treatment has shown to be highly effective in allowing people to manage either condition.
How to overcome an OCD-related fear of sex
Unfortunately, without ERP specifically, the tips above won’t work if your fear of sex has to do with OCD. This specialized treatment is unlike traditional talk therapy or general cognitive behavioral therapy (CBT). And without practicing ERP specifically, it’s very likely that your OCD will get worse, not better.
ERP works by gradually exposing you to your triggers, and teaching you response prevention techniques to cope with your distress—things that don’t involve compulsions. You will never be forced into anything before you’re ready, but you will be encouraged to do exposures that move you toward recovery.
For instance, your ERP therapist may encourage you to start with an exposure that simply asks you to write down the worst-case scenario of your fears becoming true. Your therapist will guide you in resisting the urge to respond to fear and anxiety by doing compulsions. Over time, this allows you to tolerate anxiety and distress better than you thought you could—which helps break the cycle of obsessions and compulsions.
The takeaway? Whether your fears about sex result from OCD, a Specific Phobia, or another condition, they can be treated effectively so you can have the life (and sex life) you want and deserve.