There is clear indication that anxiety about sexual performance or experience can have an immediate and profound effect on sexual functioning. Many studies show that a woman’s sexual excitement and pleasure is tied to feelings of relaxation. Fear of vaginal dryness, pain, or lack of response can immediately dampen a woman’s sexual arousal. Likewise in men, fear of erectile dysfunction can create a vicious circle, in which anxiety about impotence can cause men to lose their erection, which in turn reinforces their anxiety.