INTRODUCTION Few studies have looked at prevalence estimates for female sexual dysfunctions in combination with personal distress, although existing diagnostic criteria for sexual disorders include both aspects. Further, the variation in female sexual function has been shown to be largely explained by unique nongenetic factors. Such factors may include partner sexual function and perception of sexual compatibility with a partner, factors which may also be associated with sexual distress. AIM We investigated the association between female sexual dysfunction and distress as well as their association with partner compatibility. METHODS In order to assess sexual function and distress, the Female Sexual Function Index and seven items from the Female Sexual Distress Scale were used in a population-based sample of 5,463 women, aged 18-49 years. The women were, based on cutoff points, classified as either having neither dysfunction nor distress, one of them, or both, separately for each dysfunction. Further, the associations between partner compatibility, distress, and sexual dysfunctions were analyzed. Sexual compatibility with partner was investigated by using several items exploring, for example, amount of foreplay, interest in sex, and communication about sexual matters. MAIN OUTCOME MEASURES Associations between partner compatibility and female sexual function and sexual distress. RESULTS The proportion of women reporting both sexual dysfunction and distress ranged from 7% to 23%, depending on the dysfunction. Desire disorders followed by orgasmic disorders were most common. All compatibility variables were significantly associated with distress and with most of the sexual dysfunctions. The main complaints of the women were "too little foreplay" (42%) and "partner is more interested" (35%). The women feeling distress or having a sexual dysfunction reported more incompatibility with partner compared with functional women. CONCLUSIONS The findings highlight the importance of addressing partner compatibility for successful treatment and counseling of female sexual dysfunctions.