Sexual distress in women tied to pain, satisfaction

Distress about low sexual function correlates positively with the severity of sexual pain and negatively with sexual satisfaction among women, reports a study. 

Moreover, women in relationships tend to be distressed when there is poor communication, lack of partner support, and when partners express sexual distress and dissatisfaction.

“Sexual satisfaction and relational factors influence whether women experience low sexual function as problematic,” the investigators said. 

“However, more research is needed to investigate sexual distress among women who are not in a heterosexual relationship, and those reporting low sexual functioning in domains of sexual arousal, desire, and orgasm,” they added.

In this systematic review, the investigators searched the databases of CINAHL, Psychology and Behavioural Sciences Collection, PubMed, Web of Science, PsycNET, and Scopus on 1 January 2025. They evaluated study quality using the Mixed Methods Appraisal Tool.

Nineteen studies met the eligibility criteria, and most of these included women in a heterosexual relationship. Many articles also focused on sexual pain disorders. [J Sex Med 2025;22:1827-1838]

Distress about low sexual function was significantly associated with sexual, psychological, relationship, and partner-related factors. Specifically, sexual distress correlated with the severity of low sexual function, depressive or anxiety symptoms, sexual dissatisfaction, poor relationship communication, low partner support, and partner’s sexual distress and dissatisfaction.

Anxiety, depression

Sexual distress among women experiencing sexual pain showed a positive association with both anxiety and depression. [Arch Sex Behav 2018;47:1649-1661; J Psychosom Res 2018;106:34-40; J Pain 2018;19:552-561; J Sex Med 2016;13:79-87; J Sex Med 2013;10:2255-2264]

"This likely reflects overlap between distress measures and symptoms of anxiety and depression,” the investigators said. “Further, this may indicate that distress is a result, or an indicator, of general poor psychological well-being, or, conversely, sexual distress may worsen depressive and anxiety symptoms.”

In earlier studies, researchers found a link between sexual distress and depression and anxiety. Moreover, women with depression and anxiety tend to have low sexual function. [Obstet Gynecol 2008;112:970-978; J Sex Med 2008;5:1681-1693; J Women’s Health 2011;20:1445-1451]

"Therefore, women in the included studies may have experienced higher levels of depressive and anxiety symptoms than those without low sexual function, but it remains unclear whether depressive and anxiety symptoms are a cause or consequence of low sexual function and distress,” the investigators said. 

A meta-analysis revealed a bidirectional relationship between sexual dysfunction and depression. However, most studies included in the analysis focused on men. [J Sex Med 2012;9:1497-1507]

“While the exact nature of the association remains unclear, depressive or anxiety symptoms were found to be positively associated with sexual distress among women with low sexual function in the studies included in this review,” the investigators said. 

“Although additional research is needed to further illuminate the nature of this association, it is recommended that mental health clinicians incorporate assessment of sexual well-being among clients who present with anxiety or depression,” they added.