She feels defective, she feels guilty and she feels helpless. And if she perceives her partner as always ready to have sex, the woman may feel that she's the one with the problem and that she's totally to blame for the unsatisfactory sex life, says Kessler. What's Really Wrong ISD is probably best thought of as a symptom of an underlying problem, says Dr. Carroll. The most common causes are more likely to be psychological than physical, he says. At the top of the list is depression, he says.
Depression can affect one's ability to enjoy anything.
Next in line is interpersonal conflict. Problems in a relationship often manifest themselves in sexual problems, experts say. P.H., a certified nurse-midwife and sex therapist and professor in the School of Nursing at the University of Maryland in Baltimore. Unexpressed anger is often part of the picture. The problem often develops gradually, she says.