Worry about how the body works during sex can feel overwhelming. And it is still something we are not good at talking about. Sexual problems can include difficulties getting erections, the time it takes to ejaculate, pain during penetrative sex, low desire or motivation, and difficulty reaching orgasm. They often go unspoken. With partners, with anyone.
Sexual difficulties come from a range of factors. Sometimes biological. Often psychological. Stress, worry, performance anxiety, the everyday pressures that make it harder to connect sexually and be in the present moment.
The impact can be wide-ranging: self-confidence, motivation, the ability to feel sexual, and the connection with a partner, including the ability to communicate and to build intimacy in the ways you want.
We begin with a thorough assessment of what could be contributing. Biological, psychological, and what is going on in the relationship. Sexual difficulties usually respond best when psychological work and medication work in partnership rather than separately. Where it is appropriate, we will talk through what role medication might play, often short-term, alongside the psychological side. For most people, exploring sexual problems from a psychological angle is hugely valuable.
We look at how stress and pressure change the hormonal and neurochemical responses in the body, and therefore make it harder for the body to function in the way you want. We work on managing stress, building confidence, and allowing the body to respond more consistently. The work mixes talking through what is going on with practical tasks. Small experiments that create change in thinking, in feeling, and in how the body responds.
The outcomes for this work are strong, and often within a relatively short timeframe. People build confidence in how their bodies work. They start to have the kinds of sex they want, more consistently. Physical function improves; so does the broader relationship with sex. People often finish therapy feeling more at ease and more relaxed about approaching sex.
Coming forward and naming what you have been struggling with. We are not afraid to talk about bodies, sex, or sexual history. From there, we work out together what change could look like.