Background: Reduced sexual desire leaves serious impacts on women’s life. The current study aims to investigate the perceptions and concerns of Iranian women of reproductive age with female sexual interest and arousal disorder (FSIAD). Methods: This qualitative research was conducted using content analysis approach. Data were collected through seventeen in-depth interviews from October 2015 to June 2016. Purposive sampling was carried out from among reproductive-aged women suffering from FSIAD who responded to female sexual function index (FSFI) with mean scores of ≤3.3 and ≤3.4 in desire and arousal domains, respectively and went through validation by a psychologist. Data analysis was performed using Granheim and Lundman’s approach. MAXQDA 10.0 software was used for data organization. Results: The three main themes that emerged in this study included: 1) “Spoiled feminine identity” with two categories of “deteriorated sexual self-esteem” and “deteriorated feminine position”, 2) “Struggle in sexual issues” with two categories of concern about losing the relationship and spouse, and surrendering to sexual relationship, and 3) “Deterioration of the couple’s relationship” with two categories of deteriorated marital interaction and sexual disharmony between the couple. Conclusion: Feeling inability to play gender role as a woman and fear of losing the spouse are the most important concerns of women with lack of interest in sex. Training communication skills for sexual talks with the spouse and expression of feelings are the first steps to help such women.