Let’s talk about sex. While sexual problems can be difficult to talk about – even with a partner – talking is often the solution. They’re also far more common than you might think, affecting over a third of us. Problems may be due to a physical issue – but often the cause is emotional or psychological. This is where psychosexual therapy can be enormously helpful. So it’s good to talk – and important to seek treatment for any issues you may be struggling with.

Why sex matters

Research shows that sexual satisfaction is linked to our satisfaction with life – and also to our overall health and wellbeing. But it’s not only important for individual health and happiness: it’s also closely related to relationship satisfaction. You don’t have to be sexual to be happy. But if you are, and there are problems, this can result in emotional difficulties.

If you experience sexual problems, you’re likely to experience lower wellbeing and self-esteem, and be at greater risk of stress, anxiety and depression. And these problems can affect your relationships too. They can lead to relationship difficulties or even a complete breakdown in a relationship. Psychosexual therapy can help before things get to this stage.

What are sexual problems – and how common are they?

Sexual problems may include loss of desire, erectile dysfunction, pain during sex, difficulty achieving orgasm and premature or delayed ejaculation. There are many different causes of these problems. They can also vary in how intense they are and how long they last. Some may be minor and brief, while others may be something you’ve struggled with for a long time. They may also result from previous traumatic experiences.

According to Relate’s Let’s Talk About Sex report (2017), which surveyed more than 5,000 people across the UK, at least one in three of us has experienced a sexual problem. Nearly a quarter of respondents said they were disatisfied with their sex lives – and only a third that they were satisfied.

If you’re currently dealing with a sexual problem, you’re certainly not alone. It might be something you’ve struggled with and have been keeping to yourself for a long time. This can leave you feeling anxious, isolated and alone on top of everything else. But you don’t have to suffer in silence.

What causes sexual problems?

Sexual problems can have a physical or psychological cause – or a combination of the two. There may also be environmental, social or cultural factors.

  • Physical causes may include cardiovascular disease, diabetes, neurological disorders, drug or alcohol addiction or the side effects of some medications. They may also simply be a factor of ageing or hormonal changes.
  • Psychological/emotional causes may include stress, anxiety, depression, feelings of guilt or shame, difficulties with intimacy or communication, or past trauma.
  • Environmental/social factors may include things like having small children or moving in with the in-laws! These factors tend to be more pragmatic and situational than emotional.
  • Cultural/psychosocial factors may include ignorance or poor sex education, or conflicts of values to do with family or religion.

According to therapists surveyed as part of the Relate report, the causes of sexual problems certainly aren’t limited to sexual dysfunction. This is, however, a more common reason for men (44%) than women (2%). But the top reasons cited for both men and women are lack of emotional intimacy and lack of communication between partners. Other common reasons include stress, tiredness, poor body image or bad history with sex/abuse. These are all issues that therapy can help with.

What are psychosexual issues?

Psychosexual issues are sexual problems that have a psychological or emotional basis rather than a physical one. There may be psychological or emotional blocks that affect your ability to be intimate, for example. These sorts of issues are the focus of psychosexual therapy.

The body and mind are inextricably linked. While psychosexual issues have emotional or psychological roots, they can also lead to or be caused by physical issues. So, while sexual problems can lead to feelings of guilt, stress, anxiety and depression, they may also be caused by them.

And while physical issues can make your sex life problematic, these can lead to psychological problems too. For example, an illness, condition or surgical procedure may leave you feeling less desirable. Which makes you feel depressed. And depression can affect your desire for sex. It’s a complicated two-way relationship.

How can psychosexual therapy help?

If you have a sexual problem, it may be helpful to see your GP, as they can assess, treat or rule out any physical cause or dysfunction. But because non-physical reasons for sexual problems are so common – particularly issues around communication and intimacy – talking is often a key part of overcoming them. This is where psychosexual therapy can be so helpful.

And even if a problem is purely physical, it can still cause emotional distress and relationship problems – so you can still benefit from therapy.

What does a sex therapist do?

A therapist who specialises in psychosexual therapy may also be referred to as a ‘sex therapist’ or ‘sex and relationship therapist’. But forget any media images or stereotypes you may have seen or heard! A sex therapist is a highly-trained specialist who will create a safe, trusting, confidential space for you to discuss things as openly and honestly as possible. Whatever your issue, relationship status, gender or sexuality, a qualified sex therapist has heard it all before. They won’t judge – and will be able to help.

You can see a therapist by yourself, but if you’re in a relationship it may be helpful to attend with your partner. Your therapist will listen to your concerns and assess your problems, and help determine whether the cause is likely to be physical, psychological or both.

Talking about the issue will help you get a better understanding of what’s happening – and why. Once the problem has been identified, your therapist will work out a personalised plan for you. This may include strategies for dealing with difficult situations or issues. Your therapist may also give you exercises and tasks to do with your partner in your own time.

Cognitive Behavioural Therapy (CBT) can be helpful for dealing with any unhelpful automatic thoughts and behaviours. But a range of methods and approaches can be used to help you manage and overcome psychosexual issues. Find out how to get started with My Online Therapy.

While it’s not always easy to talk about sexual problems, if you take the first step to seeking it, help is available. With the right support, you can enjoy the fulfilling sex life and relationships you deserve.