Distraction or interference in the cognitive processing of erotic stimulus plays an important role in the development of sexual dysfunctions or difficulties (Geer and Fuhr, 1976). The aim of this study was to evaluate negative automatic thoughts presented during sexual activity. A total of 191 women from the general population answered to a set of questionnaires assessing orgasm function, automatic thoughts during sexual activity and cognitive distraction. The orgasm function was measured by the Female Sexual Function Index (IIEF, Rosen et at., 2000), automatic thoughts were measured by the Sexual Modes Questionnaire (Nobre and Pinto Gouveia, 2008), and cognitive distraction by the Cognitive Distraction Scale (Dove and Wiederman, 2000). Findings indicated that lack of erotic thoughts during sexual activity was the best predictor of women's sexual difficulties. Sexual abuse thoughts, failure and disengagement thoughts, partner's lack of affection, sexual passivity and control, and lack of erotic thoughts were significantly higher in women with orgasm difficulties compared to sexually healthy women. The results are supported by the literature indicating that cognitive distraction from the erotic thoughts is strongly associated with orgasmic dysfunction. (C) 2011 Published by Elsevier Masson SAS.