When people hear the term “sexual dysfunction,” most think of men and little blue pills. But it can happen to women, too, and it includes things like painful sex, an inability to orgasm, trouble getting aroused, or having zero interest in even trying.
There are a ton of reasons why this might be happening: Stress, medications, relationship issues, or conditions like HSDD (hypoactive sexual desire disorder).
If any of those symptoms sound familiar, you’re among friends. In a recent survey* of 1,686 women ages 25 to 49, almost two-thirds of respondents said they’ve experienced at least one sexual dysfunction symptom.
It’s totally normal for your sex life to ebb and flow, and it’s also very normal to experience sexual dysfunction. But! “If it’s interfering with your sense of well-being or you’re distressed or troubled by it, and it’s a consistent thing, that’s how you know it’s an issue worth addressing,” says Tari Mack, Ph.D., a couples therapist in Evanston, Illinois.
In that case, consider telling your partner what’s up. Yes, you might feel self-conscious, bummed out, or awkward AF (91 percent of the surveyed women who experienced symptoms felt some sort of negative emotion about them). And it’s no shocker that a heart-to-heart with your S.O. might not sound like the most fun ever—only about a quarter of women surveyed talked to their partner about it. But, if you stay tight-lipped, you could be setting yourself up for more issues.
“Anything you don’t talk about in a relationship can play out in other ways and cause problems in other areas,” Dr. Mack says. Your partner may even start making their own (probably false) assumptions. “It’s human nature for us to make meaning out of experiences, so your partner might think, ‘Oh, she’s cheating on me,’ or, ‘She doesn’t find me attractive anymore,’ even if the issue has nothing to do with them,” says Marianne Brandon, Ph.D., a couples and sex therapist in Wellesley Hills, Massachusetts, and a former consultant for Vyleesi, a medical treatment for HSDD.
On the flip side, research shows that communicating about your sex life makes both sex and your relationship better. So let’s get it on. Here are seven step-by-step expert tips that’ll make talking about sexual dysfunction as not-weird and helpful as possible.
1. Talk to yourself first.
Be honest about what might be at the root of your issue. Basically, anything can put your sex drive in the slow lane, but stress is a biggie—43 percent of survey respondents cited this as their main reason—as are self-esteem issues and fatigue (reported 41 and 37 percent of respondents, respectively). Other common causes include anxiety, medications, relationship or partner troubles…the list goes on. It’s also A-okay to not have a clue what’s hindering your sex drive.
Either way, consider what steps you might take to address it. Should you see your gyno or internist? Could a therapist or couples’ counselor help? Is this another sign that you need to ditch your stress-ball job or practice more #selfcare? Pinpointing the cause of your less-than-eager feelings toward sex can seriously help get to the root of the issue.
It could potentially help your relationship, too. “You don’t need a set plan in place, but having some ideas to bring to the conversation helps show your partner you’re serious about working on it and finding a solution,” says Kelley Kitley, a couples therapist in Chicago and author of MY Self: An Autobiography of Survival.
2. Find an opening—or create one.
If your partner tries to initiate sexy time and you’re all, ‘No, thanks,’ it’s a good opportunity to say something like, “You know, let’s talk about this.” The convo has to happen sometime.
“Rather than bringing up the topic out of the blue, it organically opens up the conversation,” says Kitley. If it’s not a good time in the moment (i.e., you turned down a quickie before heading to your cousin’s wedding), you could say, “Let’s plan to talk tomorrow.” Or whenever. Just name an exact time so you don’t put it off.
And if a good opening doesn’t appear, crack that damn door open yourself. Say something like, “There’s something I’ve been wanting to talk to you about. When is a good time?” Then, schedule the conversation for when you can be alone and neither of you are rushed or exhausted.
3. Say how you’re feeling and ask for what you need.
When you do talk, Dr. Mack suggests letting your partner know straight away that it’s a tough conversation for you. Doing so will help you feel more open and will elicit compassion from your partner from the get-go. Try something like, “I’m scared/anxious/feel awkward about bringing this up.” Then explain why you’re bringing it up anyway, with something along the lines of, “Sex is important to our relationship, and I want to work on getting back to a place where we both feel fulfilled.”
Also, tell your partner what you hope to get from them during this talk. Your S.O. isn’t a mind reader, so this will make you more likely to have the conversation you want, Dr. Mack says. For example, say, “I just need you to listen and hear me out,” or, “I need some reassurance or patience from you,” or “I want your help working on this.”
4. Get down to the nitty-gritty.
Give your partner as many details as you can—they deserve it, and you deserve to unload the weight of it. “Sharing gives you someone on your side; otherwise, you can feel really isolated and alone,” Dr. Brandon says. Try to explain exactly what’s going on, including whatever you don’t know. Do you feel like you never want sex and you don’t know why? Do you have trouble feeling turned on by the same things you used to? Are you unable to orgasm?
Also, be clear about your partner’s role. If they’re an innocent bystander, state it loud and clear: “This is my issue—I think because X or Y—but know that I still find you attractive and sexy, and I still love you.” Or try, “You haven’t done anything wrong,” or, “I really like and want to have sex with you, but I need to figure out/fix why I’m not ever in the mood.”
On the other hand, if you think the relationship or your partner plays even a bit part, be honest about that, too. Just explain it by how you feel, Dr. Mack says. That means starting sentences with “I,” such as, “I’ve been feeling lonely or disconnected from you lately,” or, “I don’t feel like I’m a priority.” Dr. Mack advises, “It’s better than saying, ‘You never make me a priority,’ or, ‘You don’t…’ whatever, which puts your partner on the defensive.”
5. Then make it about “we.”
If you need your partner to be a part of the plan, ask for their help and be specific. Maybe it’s: “Can we try going to therapy?” or, “How about we have more date nights?” And, of course, if you know there are certain sex or foreplay-related things that might help, speak up about that, too, Kitley says. You can say something like, “I think I might really get turned on when X or Y. Can we do more of that?”
This is also a time when women benefit from extra (nonsexual) physical affection and emotional closeness, Dr. Mack says. Because, when sex declines, so do other kinds of touch. Be clear about what feels good and what you want or need. For example, “Can we cuddle or hold hands more often?”
If nothing else, ask your partner for patience and understanding, and promise to be open with each other.
6. Stand your ground.
Sometimes, partners can personalize the issue, play the victim card, or blame themselves. Or, they can make you feel guilty, like you’ve done something wrong, says Dr. Mack.
In those cases, speak your truth. Say, “No; I think the problem is…” Then, take a breath. “Be clear and repeat yourself if you have to. Don’t let them drag you into a different narrative or feel shame around what you’re experiencing,” she says.
7. Plan a follow-up.
“You won’t solve the issue overnight; this is not a one-and-done thing,” says Dr. Brandon. “Don’t expect a resolution. Instead, agree to have a follow-up conversation in a week or two after you both have had a chance to think about everything.”
If all goes well, you and your partner could end up feeling closer than ever. For now, hug it out, then cuddle up for a movie night.
*Survey was conducted by Women’s Health & Cosmopolitan, in partnership with a pharmaceutical company that sells a drug to treat hypoactive sexual desire disorder (HSDD).