Sexual Distress

Sexual Distress- have you experienced it?

Sexual distress is a term used to describe any sexual concern relating to arousal, desire, orgasm or pain. In my practice, and in my research on female sexual dysfunction (FSD), I found that the term sexual distress described a plethora of issues, from experiencing sexual pain, to difficulty reaching orgasm.

This is problematic, because two people could present to me with ‘sexual distress’, but the reasons behind their concerns could differ completely. Health professionals tend to medicalise women’s sexual distress by attributing it to physiological issues like the lack or orgasm, desire, arousal or presence of sexual pain.

However, an interesting finding in my research was that sexual distress became an inferior issue compared to the impact FSD symptoms have on emotional intimacy in a relationship.

What this essentially means is; women are not only distressed by sexual dysfunction, but also by their partner’s negative responses to these issues. In private practice my conversations with women around sexual issues supports this finding. The emotional distress of FSD, and the pressure it puts on relationships is often reported as more upsetting than the physical distress of FSD symptoms.

An interesting finding that the research revealed was that women who experience sexual pain reported the highest levels of sexual distress. And this distress could be caused by both the physical pain, and the pressure that this places on intimacy with their partner.

The pressure to maintain a healthy, interesting and good sexual connection is affected by the woman’s sexual pain, and emotional distress comes from taking on the weight of her partner’s disappointment.

Women are not only distressed by potentially negative responses from their partners, they also worry about their own decreased physical pleasure, and decreased frequency of sex. A decreased frequency in sex isn’t just a representation of sexual dissatisfaction, but also a decrease in opportunity to emotionally connect with their partners.

Women who experience FSD symptoms became distress by their impaired functioning, their decreased ability to experience sexual pleasure, and decreased access to intimacy with a partner.

In keeping with my intersectional feminist lens on research, I also explored the difference between heterosexual and lesbian women’s experiences of sexual distress (there was no research including women of colour, trans women, or disabled women that explored this issue).

Once the researchers controlled for distress (or look beyond the distress to explore the underlying causes), they found that women, despite their sexual orientation, had the same concerns. Sexual pain was the most upsetting, followed by arousal issues, then orgasm difficulties, and lastly a lack of desire. This is interesting because past research has always assumed desire was the number one issue affecting women. I’ll discuss this in a separate article though.

The research indicated that lesbian women had better sexual functioning overall than their heterosexual sisters, including better orgasm function, higher arousal, and less sexual pain.

What was also interesting about this study was that lesbian women, despite reporting the same issues as distressing, experienced significantly less distress than heterosexual women. The researchers attributed this finding to lesbian women’s lovers having a deeper knowledge of how to stimulate the female body in a way that men eventually learn. And that lesbian women experience less pressure to perform penile-vaginal penetration, minimizing the chance of sexual pain.