Abuse (emotional, physical, or sexual) during childhood or adolescence
Anxiety
Depression
Fear of intimacy
Fear of losing control
Fear of losing the partner
High self-expectations
Low self-esteem
Worry about inability to have an orgasm or about sexual performance in a partner
Worry about unwanted consequences of sex (such as unwanted pregnancy or sexually transmitted infections)
Situational factors
A low sexual self-image, as may result from having a negative body image, urinary incontinence, fertility problems or having had surgery to remove a breast, the uterus, or another body part associated with sex
Cultural background that restricts sexual expression or activity
Distractions or emotional stress
Relationship problems
Surroundings that are not conducive to sexual activity
Physical factors
Abnormalities in genital organs (such as birth defects or scarring after surgery or radiation therapy)