Doctor’s Orders: 5 Reasons You Don’t Have Great Sex—And How to Fix It

Treat mental blocks like you would a physical affliction

Fix the mental blocks that affect your sex life.
Fix the mental blocks that affect your sex life. Arnel Hasanovic/Unsplash

A few reasons why your sex life might go sour include erectile dysfunction, premature ejaculation, vaginal dryness and pain during sex. We tend to think that as long as our sex organs are performing adequately, our sex life will be great.

But are the nonphysical aspects of sex getting in the way of a good sex life? Situations we don’t anticipate that can turn potentially good sex into a cascade of bad vibes. In this case, your sex organs have nothing to do with it—it’s your mind.

The mind—our brain—is actually the most important sex organ. A mind whirling with worry and anxiety can snuff out a good sex life quicker than turning off the lights.

Here are five things that trigger the mind, hinder sex, and what you can do about them:


Stress comes in waves. Some days we feel footloose and fancy free while other days it feels like we’re holding up the entire world. Stress runs the gamut from financial worries, raising children, taking care of elderly parents, health concerns, personal relationship issues and more. When our mind is focused on the worries of the day, sex often gets put on the back-burner.

What to do:

Practice ways to relieve stress and know that this too shall pass.

Performance anxiety

Both men and women can be overcome with sudden jitters about their bedroom performance. Men are particularly susceptible to this as they age. Issues of erectile dysfunction or premature ejaculation can cause a great deal of worry and make sex not enjoyable for either partner. Women may have concerns about a lack of lubrication, which makes sex painful.

What to do:

If you have a physical issue affecting your sex life, you need to talk to your doctor. There are many solutions for fixing performance related issues.

Trouble brewing within a relationship

Anytime there is tension, conflict, or arguing between a couple, sex will suffer. Squabbles over finances, child-rearing, how to spend leisure time, and more may cause disputes that spill over into a couple’s sex life.

What to do:

A relationship is a balance of give and take. Develop better communication skills and stay calm when discussing things you disagree on. Showing more empathy and learning to listen will help your partner feel heard and understood. By being an effective communicator, you will learn how to dissipate disputes.

Poor body image or self-esteem

A big part of feeling in the mood stems from how we feel about ourselves. When we look and feel good about ourselves, sex tends to follow. But when we look in the mirror and see a less than desirable person, sex may be the last thing on our mind. Feelings of unattractiveness and poor self-esteem will not be inspirational for wanting to make love.

What to do:

If body image is the issue, work on getting into better shape. Start an exercise program, make healthier food choices, stop smoking and get more sleep. It’s not all about looks; it’s about feeling good about yourself and getting healthier. If self-esteem is the issue, work with a life coach, see a therapist, and discover a new hobby that will bring enjoyment and confidence.

Our family and social upbringing

Our religious background, culture, family dynamics, and past experiences all shape our attitude towards sex. If we were raised in a household that showed love and respect for another, we are more likely to have a healthy enjoyment of sex. But if our background was grounded in fear, jealousy, or not knowing what a loving relationship looks like, we can have a jaded view of sexual relationships.

What to do:

We can’t change our upbringing, but we can change our attitudes. If moving forward away from how you were raised is difficult, seek help. Sex therapists—who often hold degrees in family therapy, social work or psychology—are trained to address emotional issues that contribute to sexual problems. They can help guide you and your partner to a better bond in and out of the bedroom.

Dr. Samadi is a board-certified urologic oncologist trained in open and traditional and laparoscopic surgery and is an expert in robotic prostate surgery. He is chairman of urology, chief of robotic surgery at Lenox Hill Hospital and professor of urology at Hofstra North Shore-LIJ School of Medicine. He is a medical correspondent for the Fox News Channel’s Medical A-Team Learn more at Visit Dr. Samadi’s blog at Follow Dr. Samadi on Twitter, Instagram, Pintrest and Facebook.

Doctor’s Orders: 5 Reasons You Don’t Have Great Sex—And How to Fix It