Common Problems
There are many sexual problems that I counsel people about. These are some of the most common ones however if you have any issues of concern please contact me to discuss.
Sometimes during counselling sessions, it may become apparent to me that another therapist with expertise in a certain area would be more helpful for you to consult. In these situations, I will happily refer you to one of my colleagues who may better assist you.
At times, people may not feel a connection with their therapist and it is ok to ask for advice on who else to see. As a member of the Society of Australian Sexologists, I have developed a network of other sex therapists and can offer you referral options.
My aim is for you to have the best possible outcomes whether that is with me as your therapist or with another practitioner.
Low desire
Low desire or libido is a decreased interest in sexual thoughts and activity. Libido levels may vary throughout our lives and it can be common for libidos to not match our partners at various times. Low desire could suggest an underlying health condition so it is important to see your doctor to rule this out. Factors such as low testosterone, hormonal changes, medications, mental health issues, chronic illness, sleep problems aging and stress can affect desire.
A lack of sexual interest has the potential to strain relationships and affect intimacy and communication with our partners. Sometimes talking about low desire may be difficult or awkward and sex therapy can help support you to have these important conversations.
Mismatched libidos
It is not unusual for libidos to be out of synch with our partners at different times during the course of relationships.
Erectile difficulties
Erectile problems such as the inability to obtain or maintain an erection can significantly impact on an individual and their partners emotional well being. Although erectile problems are associated with aging they can also relate to medical conditions such as diabetes, cardiovascular disease, hypertension and obesity so a medical examination is important. Neurological conditions such as multiple sclerosis and injuries such as spinal cord damage can also affect erectile functioning.
Psychological stressors can play a significant role in erectile difficulties. Unhappy relationships, performance anxiety, unrealistic expectations, stress from money worries, children and work pressures can contribute to sexual functioning. Prior negative experiences may trigger sexual problems such as past unsuccessful sexual encounters.
Talking to a sex therapist will help you explore what factors may be negatively impacting on your erectile functioning and explore practical solutions with you for better outcomes.
Performance anxiety
Performance anxiety can inhibit our pleasurable experience of sex. People may worry about how they look, question if they are doing things correctly or whether their partner is enjoying themselves or feel concerned about relationship issues.
These psychological pressures can lead to feeling anxious where the idea of sex becomes so stressful that people avoid it or have difficulty becoming sexually aroused. Performance anxiety can create a vicious cycle where the anxiety means they may not be able to perform sexually which further compounds the performance anxiety.
Early ejaculation
Early
During sex therapy sessions, treatment options can be discussed which might include education about behavioural techniques such as the squeeze or stop-start techniques. This helps teach about arousal levels and sensations and learn to have greater control over erections and
Delayed ejaculation
Delayed
Treatment options would include taking a sexual history to explore what factors may be contributing to the problem and working with you to find solutions.
Orgasm difficulties
One of the most common problems sex therapy addresses is around achieving orgasm. Sexual counselling explores with you what the different types of orgasm difficulty are, causes and helpful ways to remedy them.
Sexual compulsion
Compulsive sexual behaviour involving the use of pornography and sex can present significant problems for people with potentially damaging consequences that can affect relationships, employment, friendships and cause legal problems.
People may feel consumed by intense, sexually arousing fantasies, sexual urges, or behaviours with some literature suggesting that people who have excessive sexual behaviours may feel shame, unworthiness, loneliness and inadequacy and be searching for a quick fix to their psychological pain through their compulsive behaviour.
If you feel that your interest in pornography or sex has become distressing or problematic, sexual counselling can help address this and explore treatment options with you.
Living with STIs
Being diagnosed with a sexually transmitted infection (STI) can be confronting and distressing. STIs are common yet unfortunately societal shame and stigma about living with an STI may make disclosing a diagnosis to an existing or new sexual partner challenging.
You may feel worried that having an STI means you will not be able to have sex again or are concerned about transmitting the infection to others. You may also experience a range of emotions that can at times feel overwhelming such as anger, frustration, sadness or loss. A sex therapist can provide emotional support and discuss with you how to disclose your diagnosis and ways to enjoy pleasurable sexual experiences and relationships whilst living with an STI.
Vaginismus
Vaginismus is involuntary contractions of the muscles around the vagina when penetration is attempted. People may feel burning, pain, penetration problems, or inability to have intercourse. Some may avoid sex due to pain or previous unsuccessful attempts which can lead to the breakdown of intimacy in relationships.
There are a number of emotional and physical causes of vaginismus such as fear of pain, anxiety and distress, negative sexual experiences, sexual abuse and assault, childbirth, menopausal or hormonal changes and illness such as cancer.
Vaginismus responds very well to treatment such as pelvic floor exercises, dilation training, stress, and pain reducing techniques. Exploring in sex therapy what emotional aspects may contribute to vaginismus and find ways to resolve these concerns is an important part of your treatment
Dyspareunia
Dyspareunia is the medical term for painful intercourse. It is defined as persistent or recurrent genital pain that occurs just before, during or after intercourse. It may be caused by structural or psychological factors and it is important to speak to your doctor if you experience painful intercourse. Sexual counselling addresses what underlying emotional factors may be contributing to the condition and explores strategies to help reduce or eliminate the pain.
Peyronie’s Disease
Peyronie’s disease is a scar formation (plaque) in the penis that can cause various problems, most notably curvature as the scar tissue prevents straightening of the penis. Symptoms include painful erections, pain in the penis, indentation and hourglass shape, curvature (bent or curved) shrinkage or loss of girth and lumps inside the penis.
Peyronie’s may be painful, distressing and impact on sexual intercourse and quality of life. Some people may have erectile difficulties due to pain and problems getting an erection and in severe cases, sexual intercourse may become impossible due to penile curvature.
This can affect how people feel about themselves and they may experience anger, depression, low self-esteem, performance anxiety and loss of confidence. If you have been diagnosed with Peyronie's Disease it may be helpful to speak to a sex therapist to explore ways to improve sexual communication and satisfaction.
Sexual abuse/assault
Sexual abuse and assault can negatively impact on the way someone feels about sex. Positive sexual interaction involves consent, trust, respect and safety, important components that are taken from people when they have been sexually assaulted. Sexual abuse and assault can leave people feeling less inclined towards sex, contribute to low levels of sexual satisfaction, depression, anxiety, low self-esteem, a fear of sex and difficulty becoming aroused.
Partners of sexual abuse/assault survivors may find it difficult to understand how to best help their loved ones and sex therapy can support individuals and couples to resolve problems originating from the abuse.
Sex and Disability
Everyone has the right to a happy, satisfying sexual life however people living with cognitive disabilities are often denied this. Perhaps people have not received adequate sex education, as they were not considered to have sexual desires or needs or had the opportunity to develop social skills to negotiate sexual relationships or the privacy to explore their sexual interests.
Physical disabilities such as spinal cord injury, blindness, deafness and cerebral palsy can affect sexual confidence and responsiveness and whilst some people may enjoy satisfying sex lives, others may struggle to express themselves sexually.
Sex therapy can address what barriers may prevent sexual expression for people living with disabilities and explore practical solutions for pleasurable outcomes.
Sexual education
Sex therapists provide advice and education about many sexual topics. Perhaps you would like to know about social groups who share your sexual interests, or want to know about certain sexual practices or how to protect yourself from STI transmission. Maybe you are seeking information about BDSM, kink practices, swingers groups, polyamory or how to use dating and hook up sites and phone apps. You may like to learn about creative fun ways to bring back the spark in your sexual life. Sometimes people find only one session is required for the information they need and others may attend for longer.
Other sexual health issues
You may be experiencing a concern that has not been discussed here. Whatever is troubling you, I am happy to make an appointment regardless of whether your issues are sexually related. Clients have told me how helpful it is to speak in confidence with someone about their concerns often for the first time, which can feel empowering and a relief.