Obsessive-compulsive disorder (OCD) can show up in your sex life in surprising ways, like unwanted thoughts or strict routines that make intimacy feel stressful.
These experiences are more common than you might think — and you’re not broken or alone if you’re going through them.
With the right therapy, support, and communication, it’s possible to feel more comfortable and connected in your relationships.
If you live with obsessive-compulsive disorder (OCD), you might already know how much it can affect your thoughts and daily routines. But when OCD starts to impact your sex life, it can feel confusing, frustrating, or even embarrassing. You're not alone. The truth is that OCD and sex are more connected than many people realize — and talking about it can help you understand what’s really going on.
Maybe you avoid intimacy because of intrusive thoughts. Or maybe you feel ashamed, anxious, or disconnected during sex. These experiences can feel isolating, but they’re not your fault. The good news is that with the right support, it’s possible to manage OCD’s impact and build a healthier, more comfortable relationship with your body and your partner(s).
How OCD can affect intimacy
OCD can make intimacy feel really difficult — even when you care deeply about your partner. That’s because OCD isn’t just about being clean or organized. It involves unwanted thoughts and urges (obsessions) and actions you feel like you have to do (compulsions). When these show up in your sex life, they can cause stress, confusion, and shame.
Everyone’s experience is different, but OCD might affect intimacy because you:
May have scary or unwanted thoughts during intimacy: Like sudden worries about hurting your partner or not loving them “enough”
Might experience sexually intrusive thoughts: Surprising sexual images or ideas you don’t want, which can feel upsetting and hard to manage
Might feel the urge to do certain actions: Like avoiding sex or asking your partner if everything’s OK, over and over
May need to follow strict routines: Like always washing before intimacy or doing things in the same exact way every time
Might worry about germs or being “dirty:” Can make closeness hard or feel unsafe
May question your relationship a lot: Even when nothing is wrong
May notice compulsive sexual behavior: Like feeling the urge to engage in sex or view pornography in a way that feels out of control or not in line with your values
Have medication that might change your interest in sex: Something worth talking about with your psychiatric provider
If any of these sound familiar, please know you’re not broken or alone. Understanding how OCD shows up in your intimate life is the first step toward creating healthier, more fulfilling relationships.
The care you need, when you need it
Learn how Rula can support your mental health journey
How this looks in different types of OCD
OCD isn’t just about being clean or organized. It can show up in many different ways, and some types can make intimacy feel stressful or confusing. Here's how:
Relationship OCD: You might doubt whether you really love your partner or if they truly love you. These worries can make it hard to feel emotionally or physically close.
Sexual orientation OCD: You may have upsetting thoughts about your sexuality that make you question yourself. This can cause anxiety and make it hard to feel comfortable in romantic or sexual situations.
Contamination OCD: Fears about germs or getting sick might lead you to avoid touching others or being touched, including during sex or cuddling.
Harm OCD: You might worry about accidentally hurting your partner during intimate moments. These thoughts can feel scary, even if you know you wouldn’t act on them.
Checking OCD: You might feel the need to check things over and over — like whether you’ve upset your partner, whether you performed a certain action the “right” way, or if you were “fully present.” This can interrupt moments of closeness and make intimacy feel stressful.
Religious OCD: You might worry that sexual thoughts or actions go against your faith. This can lead to guilt, shame, or rituals that get in the way of connecting with your partner.
These experiences can be really tough, but you’re not alone. With support from a therapist who understands OCD, you can practice tools to manage your symptoms and feel more at ease in your relationships.
Managing OCD’s impact on your sex life
If OCD is making sex and intimacy feel difficult, you’re not alone. And the good news is that it doesn’t have to stay that way. With the right support and tools, many people find that sex becomes less stressful and more enjoyable over time.
Responding to intrusive thoughts
OCD symptoms can improve with treatment. That means your relationship with sex and intimacy can improve too. You might not be able to “control” intrusive thoughts, but you can learn to respond to them in ways that help you feel more at ease.
Should you avoid your triggers?
Avoiding OCD triggers might seem like the easiest way to deal with anxiety in the moment. But avoidance can make OCD stronger in the long run.
Instead, many therapists use exposure and response prevention (ERP) — a type of therapy that helps you face your fears in a safe and gradual way. ERP teaches your brain that you don’t need to respond to anxiety with rituals or avoidance.
Effective OCD treatments
Treatments like ERP — sometimes combined with medication — can significantly reduce OCD symptoms. When your OCD symptoms are more manageable, it can be easier to connect with your partner and enjoy intimacy more. A mental health provider can help you create a plan that fits your needs.
You can also try some helpful strategies on your own:
Practice being present in the moment without judging your thoughts or feelings.
Recognize that intrusive thoughts are just thoughts. They don’t define you or your relationship(s).
Take time for self-care, like doing activities that relax and recharge you. This can help reduce stress and improve your overall well-being.
Talking openly with your partner
It’s OK to talk about how OCD is affecting you. Let your partner know what you’re experiencing and what kind of support helps.
You can say things like, “I want to feel close to you, but sometimes my OCD makes it hard. I’m working on it, and I’d love your patience as I figure things out.” This kind of honesty can build trust and reduce shame.
Instead of trying to feel certain or ‘fix’ every thought, focus on being present and connecting with your partner. Intimacy isn’t about being perfect. Rather, it’s about showing up with honesty, patience, and care, even when OCD makes things tough.
Brandy Chalmers, LPC
Clinical reviewer
Find care with Rula
OCD can make sex and closeness feel confusing or stressful, but you're not alone. OCD can cause unwanted thoughts or habits that get in the way of feeling close to someone. The good news is that things can get better. With support, you can learn to manage your symptoms and feel more connected to your partner(s).
At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best.
Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 15,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we're here to help you make progress — wherever you are on your mental health journey.
Brandy Chalmers, LPC
Having faced challenges like childhood abuse, neglect, and the loss of her father to suicide, Brandy Chalmers is deeply passionate about providing compassionate care. She is a Licensed Professional Counselor, Nationally Certified Counselor, and Registered Play Therapist with a Master’s Degree in Clinical Counseling and Marriage and Family Therapy.
Brandy also teaches at a university, sharing her expertise with future mental health professionals. With over a decade of experience in settings like inpatient care and private practice, she specializes in helping clients with perfectionism, trauma, personality disorders, eating disorders, and life changes.
Rula's editorial process
Rula's editorial team is on a mission to make science-backed mental health insights accessible and practical for every person seeking to better understand or improve mental wellness.
Members of Rula’s clinical leadership team and other expert providers contribute to all published content, offering guidance on themes and insights based on their firsthand experience in the field. Every piece of content is thoroughly reviewed by a clinician before publishing.
