How Stress Influences Sex
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How Stress Influences Sex

The standard message is that stress is everywhere and it can ruin your health. But a closer look reveals that although stress may be ubiquitous, it is not always bad, nor do we all respond to it the same way. And perhaps even more important, men and women can have very different responses to stress—differences that can also influence what does or does not happen between the sheets.

You already know intuitively that being keyed up or worried all the time can lead to trouble. Stress is bad for you; it can bring on an ulcer, a heart attack, or a stroke . Stress also can interfere with your work, your ability to concentrate, and even your ability to have fun.

Moreover, stress comes in many forms: work stress, family stress, money stress, and relationship stress. So it is no surprise that stress can interfere with your sex life, too. Worry and depression, for example, are just two of the stressful states that can turn a potential sizzlin' interlude into a dismal flop.

But if stress is so bad, why is it so difficult to avoid? It seems that no matter how well you manage things and how hard you try to go with the flow, sooner or later, you get stressed out.

And what about those people who seem to crave stress—the adrenalin junkies, like no-rope rock climbers and high-tech day traders? As it turns out, this is a very complex question. The answer lies in the way you define stress, in the way you respond to it, and to some degree, whether you're male or female.

The Meaning of Stress

In their book, Handbook of Stress Medicine , Drs. John Hubbard and Edward Workman point out that, although the subject of stress has become familiar to most of us, we don't all mean the same thing when we talk about stress.

The authors provide three different meanings for the word "stress":

  • As a reference to things that create stress (also called stressors), like danger, work, or illness
  • As a reference to internal negative feelings caused by stress, such as worry, depression, and tension
  • As a reference to the numerous biologic changes that stress can bring about, such as increased heart and respiratory rates and alterations in hormone secretions

In addition, your personal responses to stress are influenced by numerous factors, including your personal history, genetic make-up, and social, psychological, and biological status. Last, but not least, gender also plays a role.

Stress Myths

A first step toward coping with the stress in your life—and your bedroom—is to be aware of what stress is not . Many people believe, incorrectly, that stress is an all-or-nothing response and that it's always a bad thing.

These misconceptions come from a valid observation made about stress in the early part of the 20th century. Researchers studying behavior found that animals, including humans, generally reacted to stress, such as threats of attack, in one of two ways: they either ran away or they stayed and defended themselves—the "flight-or-fight" response.

There is a tendency to generalize this response to all situations and declare that fight and/or flight are the only responses to stress. In reality, however, humans and animals have a wide range of responses to stress. Fighting and fleeing are just more visible. But long before you actually fight or flee, you go through a series of more subtle physical and mental preparations, such as alterations in hormone secretion, blood thickness, digestive activity, and changes in mood and mental focus.

Nor do these responses occur only in response to an attack. You experience many of these more subtle changes during positive experiences too, including sexual encounters.

The Balancing Act

As Hubbard and Workman explain, "Stress is a continuum, which at appropriate levels, keeps people engaged in the world. Boredom occurs if stress is too low, and emotional and physical damage can occur if stress is too high."

Your body and your mind generally try to stay in balance. Stress alters this balance. Furthermore, stressors come in all shapes and sizes—physical and emotional (from one source or many) and from the past, the present, or the future. Stress also can be short-term or long-term and conscious or unconscious. You cannot—and, fortunately, do not—respond to all these variations of stress the same way. So it makes sense that you use different strategies to keep or regain your balance in response to different stressors.

Stress and Gender Differences

Your individuality and the particular stressor are not the only factors that determine your response; the other factor is gender.

Woman or man, you may spend your weekends parachuting or at chess tournaments. You also may sweat off pounds at the prospect of speaking in public or giving blood. Different stressors for different strokes, if you will.

Still, until recently, it was assumed that men and women responded to stress similarly. But new evidence is suggesting that this assumption is subject to the same flaw as the fight-or-flight notion—our responses to stress are not that simple.

A recent study conducted at the University of California at Los Angeles found that women respond to stress with a strategy called "tend and befriend," rather than fight-or-flight. Women using this strategy are more likely to protect their children and get help from other females. These investigators speculate that this response to stress could be due to hormonal differences. The hormone oxytocin has a calming effect on both men and women; however, the female sex hormone estrogen increases this effect, while the male sex hormone androgen decreases it.

The One-Track Mind

Gender-based differences in response to stress also influence sexual response. For instance, in a study of the effects of anger and anxiety on sexual desire, college students listened to three different versions of scripted audiotapes of a sexual encounter.

During the tape, the couple involved became increasingly more intimate. All the students reported increases in sexual desire when they listened to a version of the encounter that did not include negative stressors (anger or anxiety). All the students reported decreases in desire when anxiety-provoking material was added to the tapes.

However, in the version of the tape that included material meant to produce anger, there was a clear difference. Initially, both the male and female students reported decreases in their sexual desire. But as the encounters became more intimate, the males reported their sexual desire returned, despite the anger. In contrast, the females reported their desire decreased and having remained low, despite the increasing sexual intimacy. The authors speculated that the difference is due to males focusing on sexual content and ignoring negative "interactional features" of the encounter and women focusing on the negative emotions of the situation rather than the sexual content.

Good Stress

So, the point is not to avoid all stress, but to recognize it and respond appropriately. If the stress is an attacker, you need to get away or defend yourself. But if the stressor is a challenge at work or lover who throws you off "balance" for a bit, that can be a good thing. As Hubbard and Workman put it, "In everyday life, personal growth seldom occurs without some discomfort." And remember, you can respond in more than one way.


Anxiety Disorders Association of America

Mental Health America


Canadian Psychiatric Association

Canadian Psychological Association


Beck JG, Bozman AW. Gender differences in sexual desire: the effects of anger and anxiety. Archives of Sexual Behavior 1995;24:595-611.

Bradford A, Meston CM. The impact of anxiety on sexual arousal in women. Behav Res Ther. 2006;44:1067-1077. [Epub ahead of print]

Kuffel SW, Heiman JR. Effects of depressive symptoms and experimentally adopted schemas on sexual arousal and affect in sexually healthy women. Arch Sex Behav. 2006;35:163-77. [Epub ahead of print]

Last reviewed June 2008 by Marcin Chwistek, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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