Female sexual interest/arousal disorder (FSIAD) is associated with psychological, relational, and sexual consequences for affected women, and their romantic partners also suffer repercussions. Prior research suggests that women with FSIAD report more difficulties with emotion regulation than controls. Yet, whether emotion regulation is associated with the psychological, relational, and sexual well-being of both members of affected couples is unknown. Eighty-seven women diagnosed with FSIAD via a clinical interview and their male partners completed standardized measures of difficulties in emotion regulation, depression, anxiety, relationship satisfaction, dyadic conflict, sexual desire, and sexual distress. A subset (n = 71 couples) also completed measures of emotional suppression and reappraisal in relation to sex. Analyses used multilevel modeling guided by the actor–partner interdependence model. When women reported greater difficulties regulating negative emotion, they reported greater depression and anxiety, and when men reported more of these difficulties, they had greater depression, anxiety, and sexual distress, and the women with FSIAD reported lower relationship satisfaction. When women reported greater emotional suppression, they reported greater depression and anxiety, and lower relationship satisfaction; when they reported greater use of emotional reappraisal, they had fewer symptoms of depression and anxiety, and their partners reported lower dyadic conflict. When men reported greater emotional suppression, they had greater depression, lower relationship satisfaction, and sexual desire; when they reported greater emotional reappraisal, they had lower depression and anxiety, higher relationship satisfaction, lower dyadic conflict, higher sexual desire and women reported higher relationship satisfaction and lower dyadic conflict. Emotion regulation may be an important target for interventions to help couples cope with FSIAD.