Background: Female-headed households are families in which the female is the main provider in the household. The reproductive and sexual health needs of women heads of households have been marginalized due to the high pressures that they endure.

Aim: To investigate the Iranian female-supported households' sexual life challenges.

Materials: This study was a qualitative study with the content analysis approach that was done amongst women head of household in Alborz, Iran. Sixteen married females participated and were interviewed deeply in a 7 months period in 2020. All interviews were tape-recorded and transcribed in verbatim. Data were collected and recorded and were encoded, then transcript and analyzed.

Result: Females recruited in this study were of different socioeconomic levels. On average they have been lived 5 years with their husbands. Five key themes were extracted including unmet sexual needs, role conflict, concern about sexually transmitted diseases, unrestrained sexual activity due to irresponsibility of husbands, and sexual abuse from others under the guise of support.

Conclusion: From the results, it could be concluded that not only the reproductive health needs of these women not met, but also these women's sexual life are associated with worry, threats, and discrimination. This requires serious measures to be taken by the authorities and policymakers.

Keywords: Female-headed households, Challenges, Reproductive health, Qualitative study.