Sex: What Can Go Wrong

Written by Pamela Rogers, MS, PhD | Published on July 21, 2014
Medically Reviewed by George Krucik, MD, MBA on July 21, 2014

What Can Go Wrong

Most people will experience some sort of sexual difficulty at some point in their lifetime. Luckily, various healthcare professionals, including sex therapists and counselors, are trained to help people with these issues. Although individual cases vary in their specifics, a few sexual concerns are quite common.

Top Sexual Concerns among Women

The top two sexual concerns for women are low desire or complete lack of sexual desire and being preorgasmic. Up to 40 percent of women report that they have little or no desire to have sex, even if they are in otherwise satisfying relationships. This sexual dysfunction becomes more common as women age. The second concern pertains to women who haven’t yet experienced an orgasm.

Low Desire or Lack of Sexual Desire

Low desire or lack of desire (hypoactive sexual desire disorder) is an increasing trend among women (and some men). Lack of desire is often accompanied by discussions about lack of time or energy for sex. Unfortunately, it can be a kind of “chicken and egg” situation. Lack of desire leads to lousy sex. And lousy sex makes you want sex even less.

The list of possible causes of low sexual desire is quite long. Numerous factors may play a role in low desire. Listed below are a few common causes:

Body Image Issues:

Not liking what you see in the mirror can make the thought of being naked in front of someone else unpleasant. Body image is tied to self-esteem, and low self-esteem is linked to low sexual desire.

Aging and Hormonal Changes:

Changes associated with menopause may conspire to reduce a woman’s interest in sex. Hot flashes, night sweats, and weight gain can all impact a woman’s feelings of desire and desirability. Additionally, declining estrogen or testosterone levels may affect sexual interest and arousal. Women who have undergone menopause may also experience decreased lubrication during sex, making it painful or unpleasant.

Relationship Conflicts:

Conflict with one’s partner over everyday issues, from money concerns to child-rearing, can reduce feelings of desire.

Unskilled Sexual Partners:

People who are experiencing unsatisfactory sex often lose desire. The more bad sex you have, the less you want (conversely, the more good sex you have, the more you want).

Medical Conditions:

Certain medical conditions may affect sexual desire. One of the symptoms of depression, for example, is a lack of interest in sex. Depression is often treated with a class of drugs known as selective serotonin-reuptake inhibitors (SSRIs). These drugs have been linked to sexual dysfunction in many patients. One common side effect is the inability to achieve orgasm. This side effect may occur in both men and women.

What You Can Do

First, you should work with your physician to rule out any physical reasons for low desire. Next, it is important to understand how your body responds to touch. Make time for self-pleasuring (masturbation) and explore your capacity to experience pleasure. In addition, seek educational resources that will help you communicate your sexual needs to your partner.

Being Preorgasmic

Women who are preorgasmic have not yet had the experience of reaching orgasm, either with a partner or alone. Possible causes of this condition include a sexually repressive upbringing, childhood sexual abuse, or general ignorance about the body and sex. Usually the best approach may be to see a sexologist or sex therapist to explore root causes and possible solutions.

Women who can reach orgasm alone, but not with a partner, should first explore the possibility that medications are playing a part. If not, other causes that relate to the relationship could be the root cause. Possible relationship issues include (but are not limited to): lack of trust, fear of intimacy, inability to “let go” in bed, a history of faking orgasms, an unskilled partner, or poor communication with a partner.

What You Can Do

Explore the causal factors that allow you to have an orgasm alone but not with a partner. For example, does your clitoris get a certain type of stimulation that is different in each situation? You need to know your own body in order to enjoy sex. Next, take responsibility for learning your sexual responses and then telling and showing your partner what kind of sexual stimulation you like. Remember, communication is key. Finally, you may need to seek professional help through couples counseling.

Top Sexual Concerns for Men

Men can also be affected by low desire or lack of sexual desire. Many of the causes and possible solutions are the same as for women (see above).

Early (premature) ejaculation is another primary concern among men. Premature ejaculation occurs when a man ejaculates sooner than he or his partner would like. It is the most common complaint among men under 40. Erectile dysfunction (ED) is also a common complaint among aging men. Often, ED can be treated with drugs. There are many reasons for premature orgasm. The most common:

Patter for Self-Pleasuring

Men may develop the habit of ejaculating quickly when seeking quick release during masturbation. When a man feels pressure to hurry during sex with a partner, he may default to this habit of reaching orgasm quickly.

If a man feels worried about pleasuring his partner, he may not be able to control his ejaculation. This can become doubly problematic if has had prior early ejaculation experience and is worried about it happening again.

What You Can Do

The best way to solve the problem of early ejaculation is to learn behavior control. By understanding what is happening in your head and body before ejaculation, you can learn to slow down and pay attention so you can last longer. Alternatively, your physician may prescribe a medication that helps delay orgasm.

For both men and women it is important to realize that sex is not necessarily about intercourse and having an orgasm. It is about touch, pleasure, and building an intimate connection with yourself and/or another person.

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