The sexual complaints most frequently encountered by sex therapists involve problems with sexual arousal, lack of sexual desire, pain during intercourse, and lack of orgasm. These complaints often co-occur; they are not necessarily separate from each other. Interestingly, a number of studies show that a woman’s physiological response (e.g., blood flow to the genitals and vaginal lubrication) may not always correspond to her subjective sense of sexual arousal. While some physiological response may occur quite easily, the conscious sense of sexual excitement is much more tied to a woman’s emotional state. Feelings of depression, anxiety, and emotional distance can dampen sexual desire while feelings of relaxation and intimacy heighten it. Negative emotions can be in response to current situations, but also a result of long-term emotional difficulties related to sex.