In this study of 364 young women (18–25 years old), self-efficacy theory and social interactionist perspectives were drawn upon to identify personal and situational factors that could account for sexual and romantic satisfaction and positive and negative emotional reactions to sex. As expected, young women were more satisfied and reported more positive emotional reactions and fewer negative reactions to their most recent sexual encounters, when they had elevated psychological sexual health, such as feeling more entitled to desire and reporting greater sexual self-efficacy. Also supporting study hypotheses, multivariate modeling results showed that young women who reported current steady partners and fewer negative influences of alcohol/other drug use on their sexual behavior were more satisfied and had more positive emotional reactions to sex. Condom use and the number of sexual partners were not uniquely associated with satisfaction or emotional reactions to sex in these models.