OCD and Sexual Dysfunction

If you have OCD, you know that it can be difficult to establish and maintain an intimate relationship. A major barrier for many people with OCD engaging in a romantic relationship is problems related to sexual functioning.

For many people, one of the key ingredients required for a healthy romantic relationship is an active sex life. Although sexual problems are relatively common, research suggests that people with OCD report higher than average levels of problems with sexual functioning.

Unfortunately, it is not uncommon for people with OCD to experience:

• Trouble becoming sexually aroused
• A low sex drive
• Dissatisfaction with their sexual partner
• A fear of having sex
• High levels of disgust when thinking about sexual activities. Feelings of disgust may be particularly severe if you experience obsessions related to contamination (e.g., germs contained within bodily secretions), sexual violence (e.g., rape, molestation) or religion (e.g., sinful of prohibited sexual behavior).

Although sexual difficulties in people with OCD and other anxiety disordershave often been chalked up to side-effects of serotonin reuptake inhibitors(which are commonly known to have sexual side effects), research suggests that these problems run deeper than a simple problem with medication and likely reflect larger problems with interpersonal functioning, self-esteem and/or specific obsessions related to sex.

It is important to keep in mind that women with OCD may be particularly affected by problems with sexual functioning. In comparison to men with OCD, women with OCD are often more sexually avoidant and may have greater difficulty reaching orgasm.

• Manage Your Symptoms: The first step towards revitalizing your sex life is to get proper treatment that will allow you to better manage your symptoms; especially if you are experiencing obsessions related to contamination or sexual violence. Although not all treatments work for everyone, there are a variety of pharmaceutical and psychotherapeutic options that can provide relief of your symptoms. If you are already currently receiving treatment but still experiencing sexual difficulties, it may be time to discuss other options.
• Tell Your Treatment Provider: As embarrassing as it can be, if you are experiencing sexual difficulties, it can often be very helpful to inform a treatment provider such as a doctor, nurse or psychologist whom you trust. Some sexual difficulties can be caused by underlying health problems or by medication, and it is important that these be ruled out before seeking out OCD-specific treatment options.
• Get Your Partner Involved: If you are currently engaged in a sexual relationship, it may be helpful to engage your partner in treatment. The more your partner understands your symptoms, the more you will be able to trust one another. Not being aware of the challenges you are facing could lead to misunderstandings (like “he/she doesn’t find me attractive anymore”) that get in the way of building intimacy and trust – the basis of any healthy sexual relationship.
• Join a Support Group: Community support groups for OCD can be excellent sources of social support and provide an opportunity to hear how others are dealing with feelings of isolation or embarrassment caused by sexual difficulties.

By Owen Kelly, PhD | Medically reviewed by a board-certified physician