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Psychological:
- inhibitions, ignorance, negative attitudes to sex, cultural or religious restrictions
- sexual anxiety, lack of privacy
- negative sexual experiences, sexual or emotional abuse, traumatic experience, imposed frequency and types of sex
- distractions: work stress, children, financial concerns
- relationship problems: anger, resentment, lack of trust, partner’s dysfunction, inadequate stimulation
- medical or psychiatric illness
- vaginal dryness after childbirth or after menopause, or infections, or pain with intercourse
- fatigue, stress
- side effects of some medicines: oral contraceptive, hormone replacement therapy after menopause
- alcohol or substance abuse.