We interviewed and examined 293 married women, 15–49 years of age, seeking primary care at a teaching hospital in central Nigeria. One or more sexual problems were identified in 71% of women. The proportion of specific sexual problems was 39% for a desire problem, 40% for an arousal problem, 31% for a sex pain problem and 55% for an orgasmic problem. Poor marital communication, lack of foreplay, Islamic religion and advancing age were independently associated with a desire problem. Absence of foreplay was independently associated with an arousal problem. Lack of foreplay, lower abdominal pain, gynaecological conditions, working outside the home and younger age were independently associated with a sex pain problem. The absence of foreplay, poor marital communication and being a housewife were independently associated with an orgasmic problem. Sexual problems are common among married Nigerian women seeking outpatient care.