Your sexual response and experiences can be shaped by many different factors. Sexual difficulties can be caused by physical, relationship, and mental health factors. They could also be shaped by cultural or religious beliefs, body image, a history of sexual assault or other types of trauma, to name a few. Understanding the root cause(s) of your sexual concerns is the first step in addressing them. 

Mental Health. Pleasurable sex isn’t just about your physical health – your mental health also plays an important role. Low self-esteem, depression, anxiety, stress, and other factors can translate into sexual concerns. Speaking with a trained mental health professional can not only help you improve your sex life, but also your overall mental health and well-being.

Relationship Problems. Relationship or marital problems can cause stress and strain in your sex life. Along with talking more openly with your partner(s), you might want to work with a therapist specializing in marriage or relationship counseling who can help address your concerns.

Being a Parent. Having children can be wonderful, but it can also put stress and strain on your sex life and relationship(s).  Finding time for you and your partner(s) – that’s not interrupted by children during the day or night – can be a challenge.  Lack of sleep, especially with newborns and toddlers, or even with teens who worry you, can take a toll.  Also, demanding jobs and conflicting work schedules can mean less time together. To help keep your sex life and relationship on track, visit “Resources to Learn More” and the section: “Resources for Parenting & Sex.” 

Health Factors. A variety of physical and medical conditions, along with some medications and treatments, can affect your sex life and cause sexual difficulties, including:

  • Alcoholism or Drug Abuse
  • Diabetes
  • Cancer and cancer treatments
  • Chronic Diseases
  • Gynecological Conditions 
  • Heart and Vascular Diseases
  • High blood pressure
  • Hormonal Imbalances
  • Menopause
  • Neurological Diseases
  • Obesity
  • Physical, Intellectual, and Developmental Disabilities
  • Surgery

A health care provider can help diagnose and treat sexual difficulties related to these conditions. If something doesn’t feel right to you, seeking help from a provider can help you address undiagnosed conditions you may have, along with any related sexual concerns.

Side effects from medications used to treat chronic conditions, such as high blood pressure, or mental health conditions, such as depression, can sometimes affect your sexual functioning. While sexual concerns can be a frustrating side effect of your health condition and/or medication(s), your health care provider should be able to help you manage them.  

Lifestyle factors, such as stress, using alcohol or drugs, and lack of exercise, might also cause sexual difficulties. While moderate alcohol use might increase sexual desires and confidence, excessive use could put a damper on your sex life. In fact, it could reduce sexual desire and affect the ability to have or keep an erection, or to reach orgasm. So, moderation is key to a good sex life. 

Natural Aging Process. Aging can bring physical changes in people of all genders, which can sometimes affect sexual function. For people with a vagina, menopause can affect sexual desire, increase vaginal dryness, and change the shape of the vagina; these factors could make sex uncomfortable or painful. For people with a penis, erectile dysfunction (ED) – when you can’t have or keep an erection – becomes more common. But ED isn’t just linked to age; in fact, it often results from a chronic medical problem. 

Also, as people grow older, they are more likely to have illnesses, disabilities, or surgeries, or to take medicines that affect their ability to have and enjoy sex. However, there are strategies and treatments available to help overcome the difficulties caused by these conditions and by the natural aging process. For more information, visit “Resources to Learn More,” and the section “Resources for Aging and Sexuality.”

Past and/or Present Experiences of Sexual Violence, Abuse, or Trauma. Experiencing any type of sexual trauma or abuse – in the past or present – can have a big impact on your emotional and physical health, along with your sex life. It can cause depression, anxiety, anger, and chronic physical pain. Trauma can also affect sexual desire, arousal and the ability to orgasm. What is sexual abuse? It’s when you are pressured or forced into having any type of unwanted sexual contact. This could include kissing, touching, any kind of sexual intercourse, and even digital abuse like forced sexting. 

Sexual abuse violates your trust and feelings of safety, and it’s a crime. Partner abuse comes in many other forms, too – it can be emotional, verbal, physical, digital, or even financial. Any type of trauma can be hard to discuss, but speaking with a mental health professional – who is trained in addressing trauma – can help you address these issues. Many survivors can still enjoy pleasurable sex lives, especially if they get counseling. For more information, visit “Resources to Learn More, “ and the section “Resources for Survivors of Trauma and Abuse.”

If you have experienced past or present trauma and/or are currently experiencing abuse, there are resources available for you. The Rape Abuse and Incest National Network (RAIIN) or the National Coalition Against Domestic Violence (NCADV) can connect you with free local resources. If you are in immediate danger, please call 9-1-1.

Religious, Social, or Cultural Causes. If you are surrounded by negative messages about sex, it can be hard to have a healthy sex life. Guilt or embarrassment, religious upbringing, and social norms regarding sex can shape your sexual experiences. However, remember that your sex life is yours, and you should be able to make decisions about your personal sex life and what appeals to you. Also, counseling might help you tackle some of the barriers that stand in your way.