Introduction
Many women endure sexual difficulties in silence—sometimes for years—due to cultural taboos, shame, or the belief that “it’s just me.” But the reality is strikingly different: Female sexual dysfunction is highly common, affecting women of all ages, and is both understandable and treatable.
Recent research shows around 1 in 8 women in the UK reports a distressing sexual problem each year (Mitchell et al., 2013, Natsal-3), including loss of desire, arousal issues, pain, or difficulties with orgasm. Yet fewer than 20% seek help (Kingsberg et al., 2017). You deserve to know: sex should not be painful or distressing, and support is available.
This article breaks down the types, causes, and solutions for female sexual dysfunction, drawing from the latest studies and therapy practice, with actionable steps to support your journey towards confidence and pleasure.
Types of Female Sexual Dysfunction
The term “female sexual dysfunction” describes a range of persistent issues that interfere with sexual desire, arousal, orgasm, or comfort and persist for three months or longer. The main categories are:
- Low sexual desire (Hypoactive Sexual Desire Disorder): Marked by little or no interest in sex.
- Arousal disorders: Difficulty becoming physically aroused, loss of lubrication, or trouble maintaining arousal.
- Orgasmic disorders: Trouble reaching orgasm (anorgasmia), or orgasms that are less intense or satisfying.
- Sexual pain disorders: Pain during or after intercourse, including dyspareunia (painful intercourse) and vaginismus (involuntary tightening of vaginal muscles).
Clinical definition: Sexual difficulties become “dysfunction” when they cause personal distress or relationship challenges and last for at least three months (DSM-5, APA, 2013).
Prevalence in the UK
The Natsal-3 Study (Mitchell et al., 2013) revealed that:
- 34% of UK women (aged 16-74) had experienced at least one sexual problem in the last year.
- The most common were:
- Lack of interest in sex (34%)
- Trouble reaching orgasm (20%)
- Pain during sex (7.5%)
- No pleasure from sex (5%)
- About 1 in 8 considered their problem “distressing” and felt it lasted more than three months.
These numbers echo other international research, showing female sexual dysfunction is both common and often unspoken.
What Causes Female Sexual Dysfunction?
Most women’s difficulties are multifactorial, meaning they spring from combinations of physical, emotional, relationship, and sociocultural influences.
1. Physical and Medical Factors
- Hormonal changes: Pregnancy, postpartum, breastfeeding, menopause, and menstruation can reduce desire and change responses (Kingsberg et al., 2017).
- Medical conditions: Diabetes, thyroid disorders, endometriosis, pelvic surgery, and chronic pain conditions.
- Medications: Antidepressants (SSRIs), some contraceptives, blood pressure medications.
- Alcohol and drugs: Excessive use can numb sexual response.
2. Psychological Contributors
- Stress or anxiety: Preoccupation with life events can crowd out sexual feelings.
- Depression: Reduces energy, pleasure, and drive (Clayton et al., 2015).
- Low self-esteem or body image distress.
- Past trauma or negative sexual experiences.
3. Relationship and Social Circumstances
- Emotional intimacy: Lack of trust, emotional distance, conflict, or resentment.
- Communication: Not feeling safe or able to talk about needs and boundaries.
- Cultural and religious messages: Shame or guilt about sex, expectations about “good” sexuality.
Debunking Myths
Myth #1: “It’s All In My Head”
Reality: While emotional wellbeing is important, sexual function is biological, relational, and psychological. Hormones, health, and context all matter. Most women benefit from a combined approach to care.
Myth #2: “Sex Shouldn’t Change with Age or Life Events”
Reality: Fluctuations are normal—and pain, distress, or numbness are not things you “just have to live with.” Menopause, motherhood, or stress can cause change, but solutions exist at any age.
Myth #3: “If I Love My Partner, Sex Should Be Effortless”
Reality: Even in loving relationships, desire and satisfaction require honest communication and, sometimes, support from a professional.
Actionable Steps for Self-Empowerment
1. Track Patterns and Triggers
Maintain a simple sexual wellness journal for two to four weeks:
- Track mood, cycle, stressors, health, and sexual encounters.
- Note pleasure, pain, arousal, and satisfaction.
- Look for patterns: Is there more desire or pain during certain times of the month? What seems to help or hinder intimacy?
This information can be invaluable for therapy conversations or GP visits.
2. Honest, Gentle Communication
Share your experience with your partner, using “I” statements:
“I’ve noticed that I sometimes feel disconnected during sex, and I’d like us to talk about it together.”
Be specific about what feels good, what doesn’t, and what might help.
3. Prioritise Emotional and Physical Self-Care
- Rest, balanced nutrition, and exercise.
- Mindfulness and body-positive practices.
- Set boundaries around time, energy, and emotional labour—say “no” when you need.
4. Explore Non-Penetrative Intimacy
Pressure to have penetrative sex can reduce arousal and increase anxiety. Experiment with:
- Sensual touch, massage, mutual masturbation, cuddling.
- Removing orgasm as the goal, focusing instead on connection and pleasure in the moment.
5. Address Pain Openly
Sex should never hurt. If you experience pain, see your GP to rule out medical causes (such as infections, endometriosis, or lichen sclerosus). Pelvic pain is not normal, and there are specialists who can help.
Evidence-Based Solutions
1. Medical Interventions
- Vaginal moisturisers and lubricants (water-based, silicone, or oil-based, depending on needs).
- Hormonal therapies for menopause-related symptoms (after consultation with your GP).
- Adjustments to medications, if possible.
2. Psychosexual Counselling/Therapy
What to expect: Your therapist will never judge your desires or experiences. Sessions may explore:
- Relationship patterns and emotional factors.
- Past trauma or negative beliefs.
- Communication skills.
- Mindfulness and body awareness exercises (see Brotto et al., 2012).
Therapy is confidential, paced according to your needs, and can include sessions alone or with your partner.
3. Pelvic Floor Physiotherapy
For pain or arousal difficulties, specialists can guide you in simple exercises to restore muscle strength and control.
4. Mindfulness-Based Interventions
A growing body of research (Brotto et al., 2016) demonstrates that mindfulness training can:
- Increase awareness of sensations and pleasure.
- Reduce distraction and negative self-talk.
- Improve desire and satisfaction.
Local NHS trusts and online platforms (e.g., MindfulnessUK) often provide resources.
When to Seek Professional Help
Consider seeking support if:
- Sexual difficulties persist for over three months
- Problems cause distress or avoidance
- Sex has become painful or unenjoyable
- Communication with your partner feels impossible
- You want a more fulfilling sexual relationship
Find a therapist: Seek BACP, COSRT, or UKCP-accredited professionals. Many women begin with their GP for medical checks—this is a valid and positive first step.
Real Stories, Real Change
Sophie, 39:
After two children and major career changes, Sophie noticed both pain and loss of desire. Therapy helped her discover new ways to connect with her body and rebuild intimacy with her partner, leading to greater satisfaction than ever before.
Jade, 25:
Jade experienced severe anxiety and pain due to vaginismus. Over six sessions of sex therapy, she learned relaxation and self-compassion techniques and moved towards pain-free, enjoyable intimacy.
Further Support
- NHS Sexual Problems in Women
- British Association for Counselling and Psychotherapy, Find a Therapist
- Relate’s Advice
Books:
- Come as You Are by Emily Nagoski
- Better Sex Through Mindfulness by Lori A. Brotto
Conclusion
Sexual wellbeing is a fundamental part of overall health and happiness. If you’re struggling with desire, arousal, pain, or orgasm, you are not alone, and you are never “broken.”
With self-compassion, gentle communication, and—if needed—professional support, sexual confidence and pleasure are truly within reach.
References
- Mitchell KR, Mercer CH, Ploubidis GB, et al. (2013). Sexual function in Britain: findings from Natsal-3. The Lancet, 382(9907), 1817–1829.
- Kingsberg SA, et al. (2017). Hypoactive sexual desire disorder in women: Treatment strategies. BMJ, 356:j1353.
- Brotto LA, Basson R, et al. (2016). Mindfulness and sexual disorders in women. Journal of Consulting and Clinical Psychology, 84(1), 61–66.
- Clayton AH, Kingsberg SA, et al. (2015). Depression and sexual function in women. Sexual Medicine Reviews, 3(2): 102–108.
- NICE (2021). Sexual dysfunction: Management for men and women.
- BACP. (2022). Sexual issues and therapy guidance.
- APA. (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
