Talking about sexual problems can feel awkward or intimidating. Many women struggle in silence for years before speaking to a professional. Others turn to friends or the internet, only to find confusing or conflicting advice. With so much information and misinformation available, it’s no surprise that sexual worries often grow into anxiety.
Myths, social media & unrealistic expectations
Social media has a powerful influence on how women see themselves, their relationships, and their bodies. Couples often present picture-perfect relationships online, making it seem like everyone else has a flawless partner or soulmate. This pressure can make women feel alone or inadequate when their own relationships look, well… normal.
Media and pornography add another layer of unrealistic expectations. Images of women’s bodies, especially vulvas, are often edited, staged, or selected to look a certain way. There is no single “normal” appearance. Vulvas come in countless shapes, sizes, and colours, and all are valid.
There’s also widespread misunderstanding about what sex “should” look like. Many women believe they should climax through penetration alone, but only about one-third do. Others think sex isn’t “real sex” unless it involves a penis and vagina. This simply isn’t true. Any consensual sexual activity that feels pleasurable counts. And while some women want to have penetrative sex for pleasure, closeness, or conception others are unable to because of pain or muscle tightening.
Understanding vaginismus & dyspareunia
Vaginismus
Occurs when the vaginal muscles tighten involuntarily, making penetration difficult or impossible. For some women, this affects only sex; others struggle to insert tampons or undergo medical exams such as smear tests. The severity varies, and it can be situational.
Dyspareunia
Refers specifically to pain during penetration. Some women feel pain at the entrance of the vagina, while others feel it deeper inside. Vaginismus and dyspareunia often overlap, pain can trigger muscle tightening, and tightening can cause pain.
Both conditions can stem from physical causes, such as:
- urinary or yeast infections
- STIs
- endometriosis
- pelvic inflammatory disease
- skin conditions (eczema, psoriasis, lichen sclerosis/planus)
- childbirth trauma
- prolapse
- hormonal changes and vaginal dryness
They can also have psychological roots, including:
- fear of pain or injury
- fear of pregnancy
- performance anxiety
- trauma (sexual, medical, or childbirth-related)
- negative early messages about sex
If you’re experiencing either condition, it can be helpful to see a gynaecologist to rule out physical causes and a psychosexual therapist to explore psychological ones. Even when the cause is purely physical, the emotional impact on relationships and self-confidence can be significant and worth addressing.
Good questions to ask yourself include:
- Is this affecting my relationship or making me avoid intimacy?
- Does it cause anxiety, fear, or distress?
Vulvodynia: when pain has no clear cause
Vulvodynia is chronic pain, burning, or irritation in the vulva without an obvious medical explanation. The vulva may look completely normal, though some women experience redness, inflammation, or itching. Pain can be constant or come and go, and it may be triggered by touching, sex, tight clothing, exercise, soaps, chemicals like chlorine, or even sitting for long periods.
Possible contributing factors include:
- nerve irritation
- muscle spasms
- hormone changes
- sensitivity to yeast
- allergic reactions
- overuse of antibiotics
- past trauma, infection, or inflammation
It’s a complex condition, but there is help available through gynaecologists, specialist clinics, and psychosexual therapists.
Desire, arousal & difficulty reaching climax
Arousal and orgasm depend on the body’s blood flow, nerves, hormones, and emotional state. Physical factors that may affect desire or climax include:
- reduced blood flow
- nerve damage
- thinning or dryness of vaginal tissue
- hormonal changes (menopause, pregnancy, contraception)
- certain antidepressants or medical treatments
- chronic conditions like diabetes
Psychological factors are equally important. Relationship tension, stress, body image issues, anxiety, low mood, or past trauma can all reduce desire or make arousal difficult. Sometimes, the issue is simply lack of sexual education, unrealistic expectations, or poor communication with a partner.
Does it matter who initiates sex?
Many heterosexual couples worry because the man often initiates sex more than the woman. Women often feel “abnormal” for not initiating as much. Biologically, women’s desire naturally fluctuates and may peak around ovulation. Men, on the other hand, can biologically reproduce at any time, so their desire is less cyclical.
Ultimately, it’s not about who initiates, but about creating the right context for intimacy. Factors like stress, conflict, lack of privacy, parenting demands, trust, communication, and emotional closeness all play a huge role.
How often should couples have sex?
There is no normal frequency. Couples may be intimate several times a week, a few times a year, or anywhere in between. The key is open communication and mutual satisfaction, not comparison to others.
When couples struggle with sexual problems, they often begin to avoid not only sex, but all physical affection, fearing it will lead to unwanted intimacy. This can erode emotional closeness. Humans need touch and connection, so rebuilding safe, pressure-free physical affection is important.
The Bottom Line
There is no single “normal” way to have sex and no definition of “proper” sex. What matters is that it’s consensual, safe, and feels good, whether alone or with a partner.
If you’re a woman experiencing pain, anxiety, low desire, or any sexual difficulty, you don’t have to cope alone. Reaching out to a psychosexual therapist can be the first step toward understanding your body, easing worry, and improving your sexual wellbeing.
