Sexual Health and Dysfunction

Sex is often a fun and satisfying part of life for all consenting partners, and it’s important to remember that a wide variety of sexual desires, preferences, and behaviors are considered normal and part of a healthy sex life.  

However, sex can also become stressful, confusing, or worrisome. Many people face challenges around sexual desire disorders, arousal, satisfaction, and intimacy with partners. These physical and mental health struggles can come up for individuals of any sexual orientation or gender identity.

When difficulties like these become a recurring source of worry or interfere with day-to-day life, therapy — including, but not limited to, sex therapy — is one way to work toward resolving them.

Common conditions that may relate to or arise from sexual dysfunction might include: anxiety, depression, or trauma.  

Because most challenges related to sexual dysfunction are not diagnosed mental health conditions, it’s difficult to know exactly how prevalent they are.

However, some sources suggest that sexual dissatisfaction is fairly common. For example, a large global survey found that only 44% of individuals reported being happy with their sex lives. Challenges around sexual desire and arousal are also common, with the Cleveland Clinic reporting that 43% of women and 31% of men experience sexual dysfunction of some kind.

Sex therapists and therapists versed in sexual dysfunction can provide support around a wide variety of topics. When a sexual dysfunction impacts daily life, it may have developed into a sexual disorder. These are often classified as arousal and desire disorders, orgasm disorders, and pain disorders. For further differentiation, these disorders can be organized by their level of recurrence; acquired, lifelong, situational, and generalized. Some of the most common scenarios include:

  • Lack of desire or mismatched desires: You or your partner(s) may not feel as much sexual desire as you want to, or you may not experience the same amount or frequency of desire.
  • Sexual arousal disorder: You might have difficulty feeling sexually aroused or having a favorable sexual response. Erectile dysfunction is part of this category.
  • Hypoactive Sexual Desire Disorder: HSDD is a condition where individuals experience a lack of sexual fantasies and desire for sexual activity. This condition can cause significant personal distress and difficulties in relationships.
  • Orgasmic disorder: This can affect all people achieving orgasm. Sexual dysfunction in men can be finishing sooner than you want to. Premature ejaculation falls under this category, or on the other end of the spectrum, delayed ejaculation. Female sexual dysfunction can be evident by vaginal dryness, decreased sexual response, and inability to reach orgasm (female orgasmic disorder).
  • Issues relating to sexual trauma: Individuals who have been victims of trauma or sexual abuse often experience ongoing challenges around sexual activity and sexuality.
  • Challenges relating to sexual orientation or gender identity: If you’re struggling with any aspect of your sexual orientation or gender identity (coming out or facing discrimination, for example), these challenges may affect your sexual desire and other sexual problems in your life as well.
  • Painful intercourse: Though it can be caused by underlying medical issues, sexual pain disorder or painful intercourse can sometimes be related to stress or anxiety around sex. Though more apparent in women, anyone can experience sexual pain disorders.
  • Paraphilic disorders: The DSM-5 — the current guide used by mental health professionals to diagnose clinical conditions — includes several specific sexual disorders, called paraphilic disorders. These include exhibitionistic disorder, voyeuristic disorder, fetishism, and pedophilia among others.

Mental health symptoms with roots in sex-related concerns vary widely, but a few of the most common ones include:

  • Anxiety or worry: You may be preoccupied with your worries about sexual activity or performance, and find that your anxiety in this area interferes with some aspect of sex.
  • Sadness or depression: Stressful, traumatic, or simply an unsatisfying sexual relationship can lead to feeling sad, hopeless, or depressed.
  • Self-esteem issues: Especially in a culture that places a high value on sex appeal, issues around sex can challenge an individual’s sense of self-worth.
  • Conflicts with partners: Sexual difficulties often lead to conflicts between partners in intimate relationships.

If you’re experiencing any sexual problems, consider one or more of these options:

  • Therapy. Find a therapist who can help you understand your challenges and find strategies for improving your related symptoms. You might work with a therapist on your own, or you and your partner(s) might choose to attend therapy together. (See more tips below on selecting a therapist.)
  • Check-ups: Because sexual functions can be related to medical conditions, it’s important to stay up-to-date with your medical appointments. Scheduling a physical exam or check-up with your primary care doctor can help you rule out physical conditions that may contribute to your symptoms around sexual stimulation, arousal disorders, or erectile dysfunction.
  • Exercise: Some studies show that regular physical activity can decrease stress, which may increase your sex drive.
  • Hotlines: If you’re having thoughts of suicide or need immediate support, you can always call the National Suicide Prevention Hotline at 1-800-273-8255. If you have experienced any kind of sexual trauma, the RAINN National Sexual Assault Hotline can also provide support and resources at 1-800-656-4673.

How to find a therapist for sexual dysfunction

Therapists differ in their approaches to treating sexual dysfunctions. Some have training specifically in sex therapy, while others may use more general approaches to mental and behavioral health concerns. Sexual dysfunction in people can often be treated and everyone can benefit from therapy, some popular options include:

New to therapy? Learn about how to find a therapist here.