The most commonly reported sexual concerns for women are low desire and orgasm difficulties (Laumann, Paik & Rosen, 1999; Laumann et al., 2005). Previous research indicates that women with sexual problems may have different reasons for engaging in sex than women with healthy sexual functioning (Giles & McCabe, 2009; Sand & Fisher, 2007). The current study investigated whether motivations for sex differed by levels of sexual functioning overall and specifically among women with and without problems with sexual desire or orgasm. Seven hundred and eight heterosexual women completed an online questionnaire assessing reasons for sex and sexual functioning. Women with sexual functioning concerns were more likely to endorse insecurity reasons for sex, while women without were more likely to endorse physical reasons for sex. Women experiencing low desire were less likely to endorse emotional and physical reasons for sex. Women experiencing orgasm difficulties were more likely to endorse insecurity reasons. The limitations and implications of the results are discussed.