The most common overall reasons given by women were stress and anxiety, reported by 58 percent; lack of enough arousal or stimulation by nearly 48 percent; and not enough time by 40 percent. Moderately common issues were negative body image, reported by 28 percent; pain or irritation during sex from 25 percent; insufficient lubrication by 24 percent; and medication-related problems by almost 17 percent. The other factors were less commonly reported, by less than 10 percent of respondents.
Some of these factors go together. For example, a lack of arousal was associated with stress and anxiety, not enough time for sex, lubrication issues, and genital pain or irritation. Women with a negative body image tended to also report stress and anxiety. A lack of lubrication, unsurprisingly, was associated with a lack of time and genital discomfort.
When distressed women were compared to non-distressed women, researchers learned that more distressed women experienced anxiety and stress around sex and believed their partners did not like having sex with them. More distressed women, when asked to identify the single most important contribution to decreased orgasm, reported anxiety and stress, while non-distressed women reported less interest in sex and not having enough time to reach orgasm during actual sexual encounters.
Many of these factors are seemingly straightforward to remedy and are likely reflective of relationship quality and partner inattentiveness, among other reasons. There are simple ways to improve the frequency and quality of orgasm via changes in technique and specific communication strategies, which improve overall sexual and relationship satisfaction. While many of these approaches to improving orgasmic and sexual satisfaction sound like common sense, barriers such as poor relationship quality, inadequate or dysfunctional communication styles, unaddressed individual issues, such as depression, anxiety, trauma, and sexual and medical disorders, are often difficult to actually address.
Sexuality remains infused with pressure and shame for many people, in spite of greater positive and open attitudes. On personal and couple levels, people often rely on avoidant coping to deal with the anxiety and shame surrounding sex and sexual problems, solidifying pessimistic views, confirming negative self-image and amplifying low self-esteem, and reducing belief in their ability to make positive changes. Fortunately, by providing "esteem support," partners can help one another with self-esteem and self-efficacy, making it easy to tackle challenges.
In some cases, as with medications and medical conditions, making changes that would improve sexuality is more complicated. Nevertheless, quite often there are ways of modifying medications and treating medical conditions which can improve or restore sexual enjoyment. Even modest improvements in sexual satisfaction over time can greatly improve quality of life and are worth pursuing.In therapy and through self-help, individuals and couples can address psychological and emotional issues, improve communication and relationship difficulties, and thereby directly work on intimate behaviors to achieve better sex for both partners. Restoring self-esteem and self-efficacy, practicing more adaptive, active coping, cultivating realistic optimism, and modifying relationship behaviors provides relief of underlying issues and improves overall relationship quality and sexual enjoyment. Rather than setting unrealistic short-term goals, which leads to chronic failure and hopelessness, approaching challenges with investment in compassion for oneself and others, gratitude, curiosity, and patience paves the way for long-term gains.
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