Sexual Problems

About sexual-problems

What it is, why it happens and what helps. Contents:

• What sexual problems are
• How common they are
• Understanding desire
• Accelerators and brakes
• Common experiences for women
• Common experiences for men
• Stress, mood and sex
• Mindfulness and sex
• Your pelvic floor
• Exercise and lifestyle
• Sensate focus
• Talking with your partner
• Keeping desire alive in long relationships
• Sex through the stages of life
• Sexual well-being around the world
• Sex therapy and other support
• How self-help methods fit in
• FAQs

What sexual problems are

A sexual problem is anything that gets in the way of you enjoying sex as much as you would like. It might be about desire (how much you want sex), arousal (how your body responds), orgasm (reaching it, or reaching it sooner or later than you would like), comfort, or connection with a partner. Sexual problems can affect anyone, at any age and in any kind of relationship, and they often come and go with life events such as stress, a new baby, illness, ageing or changes in a relationship. They are nothing to be embarrassed about, and there is a great deal you can do. You can explore related topics in our Health hub.

How common they are

If you are experiencing a sexual problem, you are far from alone. In a large national survey in the United States, 43 per cent of women and 31 per cent of men reported a sexual difficulty. [6] In Britain’s third National Survey of Sexual Attitudes and Lifestyles, about 42 per cent of men and 51 per cent of women who had been sexually active in the past year reported at least one problem with sexual function lasting three months or more. [7] The most common were lack of interest in sex for women and finishing too quickly for men. Knowing how common these experiences are can be a relief in itself.

Understanding desire

Many people assume that desire should arrive out of the blue, but that is only one kind. Researchers describe two styles. Spontaneous desire appears seemingly on its own, while responsive desire emerges in response to touch, closeness or arousal. Many people, especially in long-term relationships, experience mostly responsive desire, and that is completely normal. Sex educator Emily Nagoski, author of Come As You Are, explains this in her talks in Videos. If you rarely feel like sex out of nowhere but enjoy it once you start, you may simply have a responsive style, and creating the right context can make a big difference.

Accelerators and brakes

A helpful way to think about arousal comes from the dual control model developed at the Kinsey Institute. Your sexual response has an accelerator, which notices things that turn you on, and brakes, which notice reasons not to be turned on, such as stress, worry, tiredness or feeling self-conscious. Many sexual problems are less about too little accelerator and more about too much brake. So, alongside adding more of what turns you on, it helps to remove what is pressing the brakes: a stressful week, a to-do list running in your head, worries about how you look, or a lack of privacy. Emily Nagoski has popularised this model, and many people find it transforms how they see their sex life.

Common experiences for women

The most common sexual concerns for women include low desire, difficulty becoming aroused, difficulty reaching orgasm and discomfort during sex. Desire often changes with life stages, such as pregnancy, breastfeeding, perimenopause and menopause, and with stress, tiredness and relationship changes. The NHS lists many causes of loss of libido, including stress, tiredness, relationship issues and hormonal changes, and many of them respond well to simple changes. [8] Mindfulness, pelvic floor exercises, lubricants, more time for arousal and open conversation with a partner can all help. Women with stronger pelvic floor muscles tend to report better arousal and orgasm. [9]

Common experiences for men

The most common sexual concerns for men are finishing sooner than they would like, erection problems and low desire. Erection problems are very common, especially as men get older, and the NHS notes that they are often linked to stress, tiredness, anxiety or drinking alcohol, as well as to physical health. [10] Performance worries can create a loop: one difficult experience leads to worry, which presses the brakes next time. Pelvic floor exercises, regular aerobic exercise, cutting down on alcohol, stopping smoking, reducing stress and taking the pressure off with practices such as sensate focus all help. Doctors can also offer treatments such as tablets for erection problems. [10]

Stress, mood and sex

Stress is one of the most powerful brakes on sexual desire and response. When you are stressed, your body prioritises getting through the day, and sex often drops down the list. Low mood, anxiety and poor sleep can do the same. That is why many of the most effective approaches to sexual problems are really about calming the nervous system: getting enough sleep, moving your body, taking time to relax and finding ways to switch off from work and worries. Our guides to stress management, anxiety and sleep have many ideas.

Mindfulness and sex

Mindfulness means paying attention to the present moment, without judging it. During sex, many people find their mind drifts to worries, to-do lists or how they look, which pulls them out of the experience. Mindfulness helps bring attention back to sensation. Psychologist Lori Brotto at the University of British Columbia has studied this extensively. In one study, women with low desire and arousal who took part in group mindfulness-based therapy had improved desire, arousal and sexual satisfaction. [1] Brotto explains her work in Videos, and her book Better Sex Through Mindfulness is in Books. A simple practice is a daily body scan, gently noticing sensations in each part of your body.

Your pelvic floor

Your pelvic floor is a hammock of muscles at the base of your pelvis, and it plays a big part in sexual function for everyone. In a trial of men with erection problems, pelvic floor exercises combined with lifestyle advice led to about three-quarters of men improving, with many regaining normal function. [2] In women, stronger pelvic floor muscles are linked with better arousal and orgasm. [9] Some people need to strengthen these muscles, while others need to learn to relax them, which can help with comfort during sex. There are guided pelvic floor sessions for both women and men in Videos, and a pelvic health physiotherapist can give you a personal programme.

Exercise and lifestyle

What is good for your heart is good for your sex life. A systematic review found that regular aerobic exercise improved erectile function, especially at around 40 minutes of moderate to vigorous activity four times a week. [3] Exercise also lifts mood, reduces stress and helps you feel good in your body, which supports desire for everyone. Other lifestyle changes that help include cutting down on alcohol, stopping smoking, eating well and sleeping enough. Our guides to cutting down on alcohol, quitting smoking and energy and fatigue can help.

Sensate focus

Sensate focus is one of the most widely used techniques in sex therapy. It was developed by the researchers William Masters and Virginia Johnson in the United States, and it has been used in many countries since. [4] Partners take turns touching each other in a series of stages, starting with non-sexual touch and gradually moving on, with the focus on noticing sensation rather than on arousal or orgasm. Taking the goal away removes pressure, which is often exactly what helps. Sex therapist Amanda Pasciucco explains the steps in Videos.

Talking with your partner

Talking about sex can feel awkward, but it is one of the most powerful things you can do. Choose a relaxed moment outside the bedroom, start with what you enjoy and appreciate, and use “I” statements, such as “I’d love more time to warm up” or “I feel closer when we kiss more”. Listen with curiosity rather than defensiveness. Betty Martin’s Wheel of Consent, in Videos, offers a playful framework for exploring what you each like to give and receive. Our guide to improving communication in relationships has more tips.

Keeping desire alive in long relationships

Desire often changes over the course of a long relationship. Psychotherapist Esther Perel, author of Mating in Captivity, suggests that desire thrives on a little space, mystery and novelty, while love thrives on closeness and security. Seeing your partner doing something they are passionate about, trying new experiences together and keeping a sense of play can all help. Emily Nagoski’s research with couples who sustain a strong sexual connection found that what matters most is not frequency but prioritising pleasure and the friendship between partners. Both talks are in Videos. Our guide to marriage and long-term partnership has more ideas.

Sex through the stages of life

Sex naturally changes across a lifetime, and many people find it becomes deeper and more relaxed with age and experience. After a new baby, many couples need time, rest and patience before desire returns. Around perimenopause and menopause, lubricants, more time for arousal and pelvic floor care can make sex comfortable and enjoyable. As men get older, erections may need more direct touch and more time, which many couples come to enjoy. Long-term illness, medication and changes in your body can all affect sex, and a little creativity, open conversation and a focus on pleasure rather than performance can keep intimacy alive at every age.

Sexual well-being around the world

Cultures around the world have explored sexual well-being for thousands of years. In India, the Kama Sutra treated pleasure as one of the aims of a good life. In China, Taoist teachings described sexual energy as part of overall health. Tantra, from India and Tibet, brings breath, awareness and presence into intimacy. In the 20th century, researchers such as Alfred Kinsey and Masters and Johnson in the United States opened up the scientific study of sex. Today, sex therapy is available in many countries, through organisations such as AASECT in the United States and COSRT in the UK, and many therapists offer sessions online so you can find support wherever you live.

Sex therapy and other support

Sex therapists are trained to help with desire, arousal, orgasm, pain, performance worries and intimacy, either on your own or as a couple. Sessions are talking only, and many offer online appointments. A review of psychological treatments for sexual problems found them effective, especially for low desire and orgasm difficulties in women. [5] Pelvic health physiotherapists help with pelvic floor strength and relaxation for all genders. Doctors can check for physical causes and offer treatments, such as tablets for erection problems. [10] Directories in several countries are listed in Get help & sources.

How self-help methods fit in

Many self-help methods support a healthier, happier sex life. Mindfulness and meditation help you stay present. Yoga builds body awareness and pelvic strength. Hypnosis and EFT tapping can ease performance worries. Inner child healing can help you let go of old feelings about your body and sex. For your relationship, our guides to self-love, rebuilding trust and conflict resolution have more ideas, and our guide to self-esteem can help you feel more confident in your body. Directories for several countries are in Get help & sources.

Frequently asked questions

How common are sexual problems?

Very common. In Britain, about 42 per cent of men and 51 per cent of women reported at least one problem lasting three months or more in the past year. [7]

Why have I lost interest in sex?

Common reasons include stress, tiredness, relationship issues, low mood and hormonal changes, and many respond well to simple changes. [8]

What is responsive desire?

Desire that emerges in response to touch, closeness or arousal, rather than appearing out of the blue. It is common and completely normal.

Can exercise help with erection problems?

Yes. A review found regular aerobic exercise improved erectile function, [3] and pelvic floor exercises helped about three-quarters of men in one trial. [2]

Does mindfulness help with low desire?

In a study of women with low desire and arousal, group mindfulness improved desire, arousal and satisfaction. [1]

What is sensate focus?

A step-by-step touch programme for couples, developed by Masters and Johnson, that focuses on sensation rather than performance. [4]

What does a sex therapist do?

They help with desire, arousal, orgasm, pain and intimacy, through talking only, on your own or as a couple. Psychological approaches are effective. [5]

The best videos on sexual-problems

Hand-picked and checked one by one: sex educators, a psychologist, a psychotherapist, sex therapists and pelvic health specialists.

Desire and pleasure

Mindfulness, touch and consent

Pelvic floor

Books on sexual-problems

Free resources

Experts to follow

Get help

If a problem started suddenly or comes with pain, a doctor can check for physical causes.

Find a therapist or counsellor

• US and Canada: Psychology Today (US) and (Canada) directories.
• UK: BACP therapist directory.
• Australia: APS Find a Psychologist, and Relationships Australia for couple and family services.
• Elsewhere, including Europe and India: ask your doctor or local health service for a referral, and check that anyone you see is registered or accredited where you live.

This hub is for information, not a substitute for medical or psychological care.

Sources

1. Brotto & Basson (2014), Group mindfulness-based therapy significantly improves sexual desire in women, Behaviour Research and Therapy 57:43-54
2. Dorey et al. (2005), Pelvic floor exercises for erectile dysfunction, BJU International 96(4):595-597
3. Gerbild et al. (2018), Physical activity to improve erectile function: a systematic review of intervention studies, Sexual Medicine 6(2):75-89
4. Weiner & Avery-Clark (2014), Sensate focus: clarifying the Masters and Johnson’s model, Sexual and Relationship Therapy 29(3):307-319
5. Frühauf et al. (2013), Efficacy of psychological interventions for sexual dysfunction: a systematic review and meta-analysis, Archives of Sexual Behavior 42(6):915-933
6. Laumann, Paik & Rosen (1999), Sexual dysfunction in the United States: prevalence and predictors, JAMA 281(6):537-544
7. Mitchell et al. (2013), Sexual function in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3), The Lancet 382(9907):1817-1829
8. NHS, Loss of libido (loss of sex drive)
9. Lowenstein et al. (2010), Can stronger pelvic muscle floor improve sexual function?, International Urogynecology Journal 21(5):553-556
10. NHS, Erection problems (erectile dysfunction)

Written by Saj Ali. Last updated 31 October 2026. Spotted an error? Tell us and we will fix it.