4 Signs You Might Have Sexual Dysfunction

They do a number on your sex life—and can point to even bigger health problems.

Medically reviewed in January 2020

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Sex isn't just fun—it's good for you. In fact, regular sex can relieve pain, help you sleep and boost pelvic floor strength, which improves bladder and bowel control. Still, The Cleveland Clinic estimates that 43 percent of women and 31 percent of men report having sexual difficulties—also known as sexual dysfunction— at some time or another.

In a nutshell, female sexual dysfunction is a problem causing you to avoid sex or have unsatisfying sex. It’s influenced by your biology and psychology, and can get worse with age, especially after 40. There are many different types; your symptoms can help your doctor determine your particular issues and get you back up and running.

Unsure whether you’re experiencing sexual dysfunction? Sexual health specialist Samantha Tojino, FNP-C, of Doctors Hospital of Augusta in Georgia shares signs to watch out for, and what you should know about getting diagnosed.

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You’re not feeling it—whatsoever

Low libido, or sexual desire, is often the first clue a patient has sexual dysfunction, says Tojino. “When a woman experiences a marked deficiency or absence of spontaneous or erotic thoughts and desire, this could mean something is off-balance.” This can be due to a hormonal or neurochemical imbalance. If you’re not interested in sex at all, your drive is weaker than it used to be or you consistently just aren’t into sex and it is causes you distress, it’s probably a result of a decreased libido, also known as hypoactive sexual desire disorder (HSDD).

It doesn’t mean you don’t love your significant other or find him or her unattractive, but rather there’s an underlying issue affecting your desire and drive. A non-existent or low sex drive could be caused by a variety of things, including:

  • Medical conditions like arthritis, cancer, diabetes, heart disease and neurological issues
  • Anti-depressants and anti-seizure medications
  • Alcohol and nicotine
  • Hormonal changes during stages of life like menopause and pregnancy =
  • Anxiety and depression
  • Negative sexual experiences in the past

Talk with your OBGYN or a sexual health specialist if you feel like your libido is waning. And make sure you’re communicating with your partner about these changes so they’re aware, too.

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You have pain during sex

If intercourse is causing you pain, the reason could be as simple as not using lubrication; a water-based lubricant can help, and ample stimulation through foreplay may also make penetration more comfortable. Hormonal changes related to menopause cause the vagina to become dry or irritated as well. In this case, your OBGYN or sexual health specialist may recommend hormone-based creams to assist lubrication.

However, painful sex could also indicate you have another issue that needs attention. Some medical conditions that may also cause this sexual dysfunction:

  • Bacterial vaginosis and herpes
  • Bladder infections
  • Yeast infections
  • Fibroids
  • Endometriosis
  • Contact dermatitis
  • Tearing during childbirth
  • Vulvar vestibulitis
  • You’ve recently gotten off birth control

Uncomfortable sex that you can’t take care of with at-home remedies means it’s time to see your sexual health provider or gyno. She can help you determine the cause and right treatment plan.

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You’re not getting what you need from your partner

Sexual problems can also be a result of what’s going on—or not going on—in the bedroom. “If your partner is finishing before you or is unable to achieve erection, this can leave you dissatisfied,” says Tojino. "This may also be an indicator of health issues with your partner."

So, make sure you’re communicating. Talk to your partner about what feels good and what doesn’t. Openly discuss things like when you’d like to have sex, how often you want to do it and new positions to explore. You may even consider a "fantasy box" with mutually agreed-upon fantasies or positions to try. Pull out a fantasy at the beginning of the week and you’ll have something to look forward to for the days ahead.

Still not feeling comfortable sharing your desires? Sex therapy can help you open up to your partner. Describe the problems you’re having—saying things like “I do not enjoy sex like I used to” or “I’m not interested in sex” can give your therapist a starting point.

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You’re irritable or stressed

Sex can boost your mood and reduce your stress levels. But, if you're stressed about work, money, your eating habits or your schedule, you’re probably going to have a hard time focusing on being intimate in the moment. And you may be less likely to want sex in the first place.

When anxiety or stress is affecting how often you want to have sex or your mindset when you do try to have sex, relaxation techniques can help. Here are some at-home exercises that may reduce stress:

And remember: if you’re having trouble managing your stress levels on your own, see your healthcare provider (HCP) to talk through some other things that can help.

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How sexual dysfunction is diagnosed

“When a patient first comes to me with sexual dysfunction symptoms, we typically go through a series of tests, surveys and screenings to diagnose what may be causing it,” says Tojino. These include a pelvic exam, female sexual function index, a sexual dysfunction screener and a menopausal questionnaire, which, when combined, help her understand symptoms a bit better. Your doctor may also suggest blood tests to measure hormone levels and check for diabetes or thyroid, kidney or liver problems. If you have any symptoms of sexual dysfunction, see your HCP so they can help you get to the root of the problem.

Tojino wants women—and men!—to know you don’t have to live with sexual dysfunction. Many treatments can significantly improve your symptoms so you can enjoy sex again.  

When it comes down to it, sexual dysfunction usually involves issues with desire, arousal, lubrication, pain, orgasm or overall satisfaction, says Tojino. Once you get to the bottom of these symptoms, and why you’re experiencing them, your treatment plan can help improve your sexual relationship with your partner.

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Expert sex tips to keep the fire alive

Once you’ve addressed any underlying health issues that may be interfering with sex, it’s time to make sex a priority (in whatever capacity you and your partner desire). Here are some ways to get started:

Set aside time for sex: In order to have sex, you have to make time for it. Put time on your calendar like you would do for a dinner reservation to ensure you and your partner have regular sex.

Communicate with your partner:  Ask your spouse how they like to be touched and what feels best to them—and have them do the same for you. Talk about any sexual desires, fantasies or role-playing scenarios either of you want to try, too.

Show affection outside the bedroom: A simple “I love you” text in the middle of the day, or a sticky note on the mirror that says “I’ll be thinking of you all day” is a romantic way to let you partner know they’re on your mind.

Arm yourself with lube: If you’re dealing with vaginal dryness or pain during sex, lube can help ease the discomfort. If you’re not dealing with such issues, adding lube can still make sex feel even better. Experiment with different gels and liquids until you find one that works for you and your partner. Water-based lubes are generally safe, even for those with sensitive skin.

Sex is an intimate part of any relationship, which means it’s individualized and personal. Your sex life may look different from another couple’s sex life—and that’s okay; it’s all about what you and your partner want and need.

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