Key takeaways:
Women’s sexual health problems are common at any age.
Your sex life is affected by your physical and mental health, as well as your personal experiences.
If you’re having trouble in your sex life, there are many different treatments that can help.
If you’ve ever felt unhappy with your sex drive, your ability to get aroused, or your ability to enjoy sex, you’re not alone. A 2016 study found about 40% of premenopausal women worldwide had experienced challenges with their sex lives. And these women’s sexual health problems can also be a challenge during menopause and beyond.
When it comes to your sex life, what really matters is how you feel. But if your sex life causes you distress, sadness, worry, or harmful consequences for yourself or others, you may be dealing with a sexual health problem. Let’s take a closer look.
What are some common women’s sexual health problems?
Although there’s a lot of overlap, sex problems tend to fall into one of five categories:
Low libido (desire) problems: A low libido means you don’t have much of a sex drive. It’s a common sexual issue. People with a low libido often have less interest in sex and have fewer sexual thoughts or fantasies. It can also cause you to be less interested in masturbation or initiating sex with a partner.
Arousal problems: People with arousal problems have a harder time getting physically “turned on” before or during sex. You might struggle with lubrication (feeling wet) or feel less sensitivity in erogenous zones. You might also feel distracted during sex or find sex less exciting or pleasurable.
Trouble with orgasm: Orgasm problems are when you aren’t satisfied with the frequency or quality of your orgasms. You might have a hard time reaching orgasm, take longer (or shorter) than usual, or find that your orgasms are less pleasurable (or even painful) compared to before — even when you’re sexually aroused.
Pain or discomfort during or after sexual activity: Some women experience pain or discomfort with sex, genital contact, or other sexual touching. Pelvic floor muscle spasms or mobility problems can also make sexual penetration and positioning challenging.
Sexual problems caused by medications or illnesses: Many medications or chronic illnesses can cause sexual problems in all of the above categories (libido, arousal, orgasm, and pain).
What causes women’s sexual health problems?
Women’s sexual health problems are caused by a wide range of things. And it’s common for several different factors to interact with each other to influence how you think about and experience sex.
For example, your mental and physical health, emotions, and lifestyle can all contribute to sexual issues. And your sex life can be both positively and negatively influenced by things like your:
Past experiences
Cultural beliefs
Societal messages
Current and past relationships
Here are just some of the many different — and often interacting — factors that can affect your sex life.
Physical conditions
Your sexual health can be affected by your physical health. Here are some physical conditions that can cause sexual issues:
Heart and blood vessel disease
Neurological and psychological disorders
Hormonal changes (like pregnancy or menopause)
Chronic liver or kidney disease
Alcohol or substance abuse
Sexually transmitted infections
Gynecological conditions
Pelvic floor muscle dysfunction
Vulvar or vaginal scar tissue
Can depression or anxiety affect your sex life? Explore the link between mental health and sex.
Is it normal to stop having sex in a relationship? Learn about how much sex you “should” be having and common reasons couples stop having sex.
Can women use Viagra? Here’s what to know about using prescription medication to boost your sex life.
Psychological factors
Your mental health, thoughts, and emotions can impact your sexual function. For example, the following can lead to issues with sex:
Stress
Fear
Concern about sexual performance
Relationship problems
Guilt
Body image concerns
Past or current sexual trauma or abuse
Inexperience
Medications
Medications can have side effects that can impact your body and sexual health, including:
Hormones
Heart medications
High blood pressure medications
Psychiatric medications
Opioids
Cancer medications
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Social factors
Your social environment and familial expectations can also influence how you feel about sex, including:
Sexual identity conflicts
Sexual performance expectations
Religious beliefs or taboos
Cultural beliefs or taboos
How do sexual problems affect daily life?
Sexual challenges can impact not only your personal sexual satisfaction — they can also impact your relationships, self-esteem, and mental health. You may even find that problems with your sex life lead to feelings of shame or embarrassment.
In a 2015 FDA research discussion, women shared how problems with libido and arousal had affected their lives:
“[My partner] feels stupid at times when he keeps getting shut down. I know he feels rejected.”
“I lost a major relationship to this issue, and I never want to go back there.”
“[My condition] affects things like my self-confidence and how I approach the world.”
“I became so frustrated that any attempt to have [sex] would end up in me crying.”
“I find myself avoiding any situations where a sexual experience may occur... going to bed after my husband fell asleep or jumping out of bed in the morning before he got up.”
Could you be dealing with a sexual health disorder (female sexual dysfunction)?
If you feel sad, discouraged, or anxious about your sex life, you may have a sexual health disorder. These disorders are sometimes grouped under an umbrella diagnosis called female sexual dysfunction (FSD).
In general, FSD includes any persistent, recurrent sexual problem that strains your personal life or relationships. For a condition to be considered a sexual disorder, symptoms usually need to bother you for at least 6 months — and make you feel unhappy in some way.
Here are some examples of sexual disorders.
Female sexual interest/arousal disorder (FSIAD)
FSIAD is a disorder where you have a very low libido and/or difficulty getting sexually aroused. This can mean you struggle to get “turned on” or to even find interest in sex.
Some people have this condition for their whole lives. For others, it can be caused by a certain situation, like stress or pregnancy.
Hypersexual disorder (or sexual addiction)
Hypersexual disorder, or sexual addiction, involves being preoccupied with sex. If you have this condition, you may also have a hard time controlling your sexual behaviors — even when your actions have negative consequences.
Persistent genital arousal disorder (PGAD)
PGAD is a rare disorder where you frequently experience genital arousal — even if you’re not doing anything sexual. In other words, you get physically turned on (and can even have an orgasm) for no clear reason. People with PGAD usually find the arousal distressing rather than pleasurable. PGAD is also called persistent sexual arousal syndrome.
Female orgasmic disorder (FOD)
Women with female orgasmic disorder (FOD), or anorgasmia, are almost never able to have an orgasm, even when sexually aroused. In this condition, the problems with orgasm are ongoing and make you feel sad, worried, or anxious.
Female premature orgasm (FPO)
Women with female premature orgasm (FPO) regularly have orgasms too quickly when aroused, causing personal or relationship problems.
Genito-pelvic pain/penetration disorder (GPPD)
This condition involves ongoing pain and/or difficulty with vaginal penetration. It’s sometimes divided up into two separate conditions:
Dyspareunia (pain during sex)
Vaginismus (muscle spasms that interfere with sex)
When should I see a doctor for sexual issues?
It’s normal for your sex life to have ups and downs over time. But if you’re experiencing a problem that’s been hanging around for a while, or if it makes you feel sad, worried, or anxious, it might be worth talking to a healthcare professional. They can help you understand what might be contributing to your symptoms. They can also check to see whether any medications or underlying medical conditions could be playing a role in your sexual health.
If you already have a primary care provider or OB-GYN, they’re a great place to start. It’s OK to make an appointment just to talk about sex, or to bring up your concerns at your next well-woman exam (usually every 2 to 5 years). Even if it feels like everything’s going well with your sex life, talking with a healthcare professional about sex can help you create an open relationship where you feel safe bringing up concerns in the future.
Talking to your doctor about sex
If you feel shy or embarrassed about discussing your sex life with a healthcare professional, you’re not alone: Many women feel the same way.
But most healthcare professionals welcome the opportunity to talk about sex. From a medical perspective, sex is just another part of your overall health. Talking about sex with your healthcare team can help them understand what’s important to you so they can support you in having (or maintaining) a fulfilling sex life at any age.
During your appointment, your doctor may ask you some questions about your sex life. Though these questions may seem personal, they help your healthcare team to see the bigger picture of your health. Rest assured: Details about your sex life, like all medical information, are kept private by law.
As part of the interview, some healthcare professionals also use a special questionnaire called the Female Sexual Function Index (FSFI). Your healthcare professional may also suggest a physical exam (including a pelvic exam) and lab or urine tests. These will help rule out any physical problems that could be affecting your sex life.
Keep in mind: You deserve to feel good about the healthcare professional you’re working with. If you feel unsafe or uncomfortable for any reason, follow your instincts. It’s always OK to get a second opinion or switch to another doctor’s office.
What treatments can help with my sexual problems?
Dealing with problems in your sex life can be hard — both mentally and physically. Fortunately, there are many options that can help, including:
These treatments can be helpful for everything from mild and moderate symptoms to more severe sexual disorders.
Available treatments can potentially:
Boost or reduce sex drive, depending on your desired outcome
Improve your sexual arousal
Make sex more pleasurable
Encourage orgasm
Reduce pain during sex
Address physical challenges and mobility issues
Address physical and psychological trauma
Some treatments and therapies focus on just one or two of these areas. Others are more general. Since different parts of your sex life are interconnected, making a change in one area can help you in other areas as well.
Ideas to try at home
There’s a huge variety of things you can do to boost your sex life on your own. Here are some ideas to consider:
Educate yourself. Learning about sex can guide you to explore new techniques and better understand your body. Ultimately, it can improve libido, arousal, and orgasm. Consider reading books about sex or taking an online sex education class, like OMGyes or Bodysex (link includes explicit images).
Get creative. The human brain is hardwired to like novelty (new things) — including when it comes to sex. In fact, there’s evidence that desire and arousal can decrease over time if you’re in a monogamous relationship. Consider introducing novelty by experimenting with new sexual positions or activities, reading or watching erotica, or experimenting with sex toys.
Use more lubricant. Water- or silicone-based lubricants can help with dryness. This can increase arousal and pleasure — and decrease pain — during sex.
Fantasize about sex. Thinking about sex can help with libido and arousal. It may also increase testosterone levels, a hormone that is related to sexual function and satisfaction.
Try masturbation. Not only is masturbation common — by some estimations, 3 out of every 4 women in the U.S. do it — it may help to improve sexual problems. It also increases blood flow to your genital area, which may help to keep vaginal tissue healthy — especially after menopause.
Try using a vibrator. Vibrators are sex toys that can be used on your body to help with sexual arousal or orgasm. They come in all shapes and sizes and are designed for all genders and body types. Certain vibrators can also be especially helpful for trans women or people with disabilities (link includes explicit images).
Use comfort or support devices. Positioners (link includes explicit images), spacers, and supports (link includes explicit images) can all help you control your body’s position and movements during sex. These can be especially helpful for people who experience pain during sex or who have a disability (link includes explicit images).
Limit alcohol. While one or two drinks can help with arousal, excessive alcohol use can get in the way of sexual arousal and orgasm.
Stop smoking. Cigarette smoking can decrease blood flow to your genitals and interfere with sexual arousal and orgasm.
Exercise regularly. Physical activity can reduce stress, increase stamina, and enhance well-being, all of which can help to improve your sex life. It may also directly help with sexual arousal, libido, and sexual side effects from antidepressants.
Frequently asked questions
A sex therapist is a trained mental health professional with knowledge about sex and relationships. They provide counseling designed to help you — and sometimes your partner — understand your thoughts and feelings about sex and to resolve issues in your sex life.
Sex therapy doesn’t involve any physical contact between you and your therapist. But they may suggest intimate activities for you to do at home, like sensate focus exercises.
A pelvic floor therapist is a licensed physical therapist who focuses on your pelvic floor muscles, ligaments, and tissues. All of these parts of your body work together to support your internal organs, control your bowels and bladder, and contribute to sexual arousal and orgasm. The therapist uses a combination of manual techniques to help ease pain and restore normal functioning. Though this is hands-on therapy, the touching is nonsexual.
Sexological bodywork is similar to pelvic floor physical therapy but with more of an integrative approach. In addition to hands-on physical techniques, sexological bodyworkers educate their clients about sex, arousal, and orgasm. Be aware that this type of therapy can sometimes involve sexual therapeutic touching.
An asexual person is someone who doesn’t feel sexual attraction toward other people. They’re generally not interested in being sexually intimate with others, though they may enjoy solo sexual activities like masturbation. People who are asexual may still be attracted to others and have romantic relationships. Asexuality is a totally normal sexual identity, just like being heterosexual, demisexual, or having other sexual orientations.
A sex therapist is a trained mental health professional with knowledge about sex and relationships. They provide counseling designed to help you — and sometimes your partner — understand your thoughts and feelings about sex and to resolve issues in your sex life.
Sex therapy doesn’t involve any physical contact between you and your therapist. But they may suggest intimate activities for you to do at home, like sensate focus exercises.
A pelvic floor therapist is a licensed physical therapist who focuses on your pelvic floor muscles, ligaments, and tissues. All of these parts of your body work together to support your internal organs, control your bowels and bladder, and contribute to sexual arousal and orgasm. The therapist uses a combination of manual techniques to help ease pain and restore normal functioning. Though this is hands-on therapy, the touching is nonsexual.
Sexological bodywork is similar to pelvic floor physical therapy but with more of an integrative approach. In addition to hands-on physical techniques, sexological bodyworkers educate their clients about sex, arousal, and orgasm. Be aware that this type of therapy can sometimes involve sexual therapeutic touching.
An asexual person is someone who doesn’t feel sexual attraction toward other people. They’re generally not interested in being sexually intimate with others, though they may enjoy solo sexual activities like masturbation. People who are asexual may still be attracted to others and have romantic relationships. Asexuality is a totally normal sexual identity, just like being heterosexual, demisexual, or having other sexual orientations.
The bottom line
When it comes to your sexual health, you deserve to feel confident, safe, and to experience pleasure — whatever that means to you. If you’re struggling with your sex life, think about reaching out for support. There are great options for getting help, no matter your concern.
Why trust our experts?
References
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Planned Parenthood. (n.d.). Sexual orientation.
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Tenga. (2018). World’s largest masturbation survey uncovers how traditional views of masculinity prevent men from having fulfilling sex lives and relationships. PR Newswire.
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