Evidence suggests that lumbar disc herniation (LDH) influences sexual function to a great deal. However, most existing studies have been conducted on men. Thus, the current study aimed to assess sexual function and its correlates in women with acute LDH. This descriptive cross-sectional study was conducted on 350 women of reproductive age with acute LDH in Fasa, Iran in 2023. The mean score of female sexual function was 21.33 (3.38). Almost 80% of women had sexual dysfunction. Women scored lower on sexual desire and the higher on lubrication. As the severity of LDH increased, arousal, lubrication and sexual pain score decreased and low back pain (LBP) score increased (p < 0.05). The number of sexual activities after disc herniation was significantly lower in the women with sexual dysfunction (p < 0.001). Regression analysis showed a significant association between sexual dysfunction and LBP intensity (OR = 1.13, CI 1.02–1.26, p = 0.01) and lumbar disc herniation intensity (OR = 2.22, CI 1.07–4.62, p = 0.03). Lumbar disc herniation (LDH) may significantly affect women's sexual function. Severity of low back pain and severity of lumbar disc herniation were found to be risk factors for sexual dysfunction in this population.