Even though men with sexual dysfunction, as a whole, experience less positive and more negative emotion to sexual situations than do men without sexual dysfunction, men with sexual dysfunction themselves show considerable differences in their emotional responses. The authors explored a set of a priori factors that might contribute to the emotional response of men with sexual dysfunction in the context of a partnered sexual experience. The authors constructed 5 global affective response factors-2 positive and 3 negative-through principle components analysis and related them to 5 independent predictor variables in a sample of 66 men with sexual dysfunction visiting a urology clinic. Predictor variables included the following: dysfunction severity, cardiovascular/metabolic health, age, self-reported importance of sex, and perceived importance of sex to the partner. The affective factor, apprehension, was the most sensitive of the 5 derived emotional response factors, with most predictor variables significantly affecting this factor. However, of the predictor variables, the self-rated importance of sex to the patient and the perceived importance of sex to the partner were most strongly related to the affective factors. These findings suggest that, no matter the etiology, the therapeutic strategy should include attention to men's emotional experiences associated with sexual activity by addressing individual and partner expectations, self-efficacy, and communication in the sexual relationship.