Sex & Sexual Wellbeing: A Practical Guide for Women

Sexual wellbeing is not about having a certain amount of sex, reaching particular milestones or matching somebody else’s idea of a good sex life. It is about feeling informed, respected and able to make choices about your body, relationships, pleasure, boundaries and sexual health.

For some women, sex is an important part of life or a relationship. For others, it is occasional, complicated, uninteresting or simply not a priority. Those experiences can also change over time.

Looking after your sexual wellbeing means paying attention to what feels right for you, communicating where another person is involved, protecting your health and knowing that you can ask for professional support when something concerns you.

What does sexual wellbeing actually mean?

Sexual wellbeing includes more than avoiding pregnancy or sexually transmitted infections. It can involve how comfortable you feel with your body, your ability to communicate preferences and boundaries, your experience of desire and pleasure, and whether sexual activity feels safe and genuinely consensual.

It can also include deciding not to have sex.

There is no single standard you need to meet. A person can have frequent sex and feel dissatisfied, or have little or no sex and feel perfectly content.

A more useful question than “Is my sex life normal?” is often “Am I comfortable with my sex life as it is?”

If the answer is no, try to identify what feels wrong before deciding what needs to change.

Desire can change throughout life

Sex drive is not fixed.

According to the NHS, possible reasons for low sex drive include relationship difficulties, stress, anxiety or depression, sexual problems such as vaginal dryness, pregnancy and having a baby, menopause, some medicines, hormonal contraception, alcohol and certain long-term health conditions.

That means a change in libido does not automatically tell you something is wrong with your relationship or attraction to a partner.

You may also simply want sex more at some stages of life than others.

Rather than comparing your desire with someone else’s, notice whether a change is unusual for you and whether it bothers you.

If your sex drive has changed significantly, you are worried about it, or you think medication or contraception may be affecting it, the NHS recommends speaking to a GP.

Pleasure does not have one correct formula

People experience sexual pleasure differently, and your own preferences may change.

You do not need to enjoy a particular sexual activity because other people seem to. You also do not need to reach orgasm every time for an intimate experience to have value.

Try to pay attention to what you genuinely enjoy rather than what you think you should enjoy.

That can involve learning what kinds of affection, touch, pace, communication or emotional connection help you feel comfortable. It may also involve recognising things you dislike.

If you are with a partner, giving kind and specific feedback can help. You might say what feels good, ask for something different or explain that you want to stop.

You are allowed to change your mind, including about things you previously enjoyed.

Consent is central to sexual wellbeing.

Sexual activity should be something everyone involved freely agrees to. Consent to one activity does not mean consent to another, and agreeing once does not create permission for the future.

You can withdraw consent at any time.

Being in a relationship, dating someone, being married, having had sex previously or having started sexual activity does not remove anyone’s right to say no.

Pressure, threats, fear, manipulation or continuing after someone has withdrawn consent are not healthy forms of sexual communication.

It is also worth remembering that checking consent does not need to feel formal. Simple questions such as “Is this okay?”, “Do you want to keep going?” or “Would you like to stop?” can make space for an honest answer.

Talking about sex can make intimacy easier

Many people find conversations about sex awkward, especially if they grew up in an environment where the subject was rarely discussed.

You do not need sophisticated language.

You can talk about what you like, what you do not enjoy, what you are curious about and what you are not comfortable trying.

Choose a moment when neither person feels under pressure to have sex. This can make it easier to speak honestly without worrying that the conversation has to lead immediately to sexual activity.

Try describing your own experience rather than criticising your partner.

For example, “I’d like us to slow down a little” gives useful information. Blaming or mocking someone is more likely to make honest communication difficult.

The conversation should work in both directions. Your partner’s preferences and boundaries deserve the same respect as yours.

Safer sex is part of sexual wellbeing

Sexual wellbeing also includes practical decisions about contraception and sexually transmitted infections.

If pregnancy is possible and you do not want to become pregnant, you can choose from several forms of contraception. NHS contraception services are free and confidential, and options are available through sexual health clinics, some GP surgeries and pharmacies.

Condoms can help prevent pregnancy and reduce the risk of sexually transmitted infections. No contraceptive method is right for everyone, so a healthcare professional can help you understand your options.

If you have a new sexual partner, multiple partners or another reason to be concerned about STIs, testing can be an ordinary part of looking after your health.

NHS sexual health clinics offer confidential STI testing and treatment as well as contraception and sexual health advice. You do not need to wait until you have symptoms to seek advice.

If contraception fails or you have unprotected sex and pregnancy is possible, emergency contraception is available. Contact a sexual health service, GP or pharmacy promptly for advice about the options available to you.

Body confidence can affect how sex feels

You do not have to love every part of your body before you are allowed to enjoy intimacy.

Still, feeling watched or judged can make it difficult to stay present.

If body worries appear during sex, try noticing whether the criticism is coming from your partner or from your own thoughts.

A respectful partner should not shame your appearance, compare your body with other people’s or make affection conditional on looking a certain way.

If the pressure comes from within, shifting your attention towards physical sensations and communication may feel more manageable than trying to force yourself to feel completely confident.

You can also choose clothing, lighting, positions or levels of undress that help you feel more comfortable. There is no rule that intimacy must look a particular way.

Sex should not routinely hurt

Pain during sex is something worth taking seriously rather than enduring because you think it is expected.

There can be different reasons for sexual pain, including dryness, infections, skin conditions, pelvic problems and hormonal changes. Menopause and perimenopause can also involve vaginal dryness, soreness and reduced sex drive.

If something hurts, stop or change what you are doing. You do not need to continue through pain to satisfy a partner.

Persistent or recurring pain should be discussed with a GP, sexual health clinic or another appropriately qualified healthcare professional. They can help assess what may be contributing and discuss suitable options.

Sexual wellbeing can change during menopause

Perimenopause and menopause can affect sexual wellbeing in different ways.

The NHS lists reduced sex drive among possible menopause and perimenopause symptoms. Vaginal dryness can also continue after menopause and may make sexual activity uncomfortable for some people.

These changes do not mean your sex life has to follow a particular path. Some people want less sexual activity, some want different forms of intimacy and others remain very interested in sex.

If symptoms are bothering you, speak to a GP, nurse or pharmacist. NHS guidance describes treatment options for menopause symptoms, including options for vaginal dryness and, in some circumstances, low libido.

Do not assume that discomfort or a major change in sexual function is simply something you must tolerate because of age.

Your relationship status does not define your sexual wellbeing

You can care about sexual wellbeing while single, dating, in a long-term relationship or not interested in relationships at all.

Being partnered does not guarantee satisfying sex, and being single does not mean your sexual life is lacking.

If you are in a relationship, differences in desire can happen. One partner wanting sex more often does not make either person wrong.

The important part is how that difference is handled.

Nobody should have sex simply to prevent anger, guilt or conflict. At the same time, both people should be able to discuss their feelings honestly.

Sometimes couples can find ways of maintaining closeness that work for both people. Sometimes a persistent incompatibility needs a bigger conversation about the relationship. There is no universal solution.

Protect your boundaries as well as your health

Sexual wellbeing includes feeling able to say yes and no without fear.

Notice how someone responds when you set a boundary.

A respectful partner might feel disappointed, but they should still respect your decision. Repeated pressure, intimidation, threats, sexual coercion or ignoring your refusal are different from ordinary disagreement about sex.

If you feel unsafe or sexual activity has happened without your consent, you do not need to handle the situation alone. Sexual assault referral centres provide specialist support, and NHS services can help you find a centre.

Support is available regardless of whether you have reported what happened to the police.

When to get professional advice

Speak to a GP, sexual health clinic or another qualified healthcare professional if you have persistent pain during sex, unusual genital symptoms, concerns about an STI, a significant change in libido that worries you, contraception questions, pregnancy concerns or changes in sexual function.

You can also ask for help if emotional distress, anxiety, previous experiences or relationship difficulties are affecting your sexual wellbeing. Depending on the issue, support might come from a GP, counsellor, relationship therapist or psychosexual therapist.

NHS sexual health clinics provide confidential services including STI testing and treatment, contraception, pregnancy testing and sexual health advice.

If you have experienced rape or sexual assault, NHS sexual assault referral centres provide specialist medical, practical and emotional support. If you are in immediate danger, contact the emergency services.

Sexual wellbeing is personal. You do not need to meet anyone else’s standard. What matters is that your choices are genuinely yours, your boundaries are respected and you can access reliable healthcare and support when you need it.