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Sex therapy focuses specifically on sexual issues, but sex therapists never have sexual contact with their clients. Your therapist may help you deal with female sexual dysfunctions, such as painful intercourse, decreased arousal, reduced vaginal lubrication, and orgasm difficulties, or male sexual dysfunctions, such as low sex drive, premature ejaculation, impotence, or other erectile or ejaculation issues. You may seek sex therapy to address intimacy issues caused by a traumatic sexual experience or a chronic condition, such as cancer, diabetes, or arthritis.
It may be time to consider sex therapy if you rarely or never feel like having sex or avoid having sex with your partner. When you can’t get or stay aroused, even if you really want to have sex, or you can’t have an orgasm, sex therapy may help. Sex therapy is recommended for anyone having problems with intimacy, who’ve become distressed by their problems with sex, and/or whose quality of life is being affected by their sexual function.
Anxiety, stress, or depression may be an underlying issue of your concerns about sex and intimacy. With sex therapy, you may uncover and address issues you’re not aware are causing problems in the bedroom. To get to the root of your sexual issues, your therapist will ask you about your current sexual practices, relationships, and attitude toward sex. They’ll also ask about other symptoms or medical problems you might be experiencing and any medications you’re taking.
Talk therapy is the primary treatment for sexual issues. Your sex therapist treats your condition by helping you talk through your feelings, worries, and experiences. They may use various talk therapies combined with at-home components, such as cognitive behavioral therapy, couples communication techniques, and sensate focus. If part of your sexual issues stems from a physical condition, medications may be combined with therapy.
For sex therapy to be effective, you must have good communication with your therapist and be able to trust them and their guidance. Finding a sex therapist near you who’s a good fit also depends on your comfort level. If you and your partner are seeing the therapist together, you must both feel comfortable sharing extremely intimate details of your relationship.
Because it’s an extremely sensitive topic, consider everything that might make you more comfortable working with a specific sex therapist. You may prefer working with a therapist of the same sex, around the same age, of the same race or ethnicity, or who has similar religious viewpoints. If you’re seeking therapy for issues regarding your sexual orientation, you want a nonjudgmental, LGBTQ-friendly therapist.
Sex therapy may be provided by licensed professional therapists, clinical social workers, marriage and family therapists, psychologists, or psychiatrists with advanced training in sexual health and relationships. Every state requires therapists to be licensed, and reputable sex therapists are usually certified. Check their credentials to ensure they’re qualified to dispense sexuality-based therapy. If a sex therapist is licensed and certified, they’ll be listed with the American Association of Sexuality Educators, Counselors, and Therapists.
A sex therapist’s fee per session is also a factor, but it shouldn’t be the sole criteria you use to choose a therapist. Ask your health insurance provider if it covers psychotherapy and confirm your coverage because some have limitations. Ask potential therapists whether they accept your insurance and/or offer a sliding fee scale. Also, consider a therapist’s location. If their office isn’t conveniently located, you may make excuses not to go to therapy. Some sex therapists offer teletherapy, which allows you to receive therapy online and makes it easier to work with them.
To eliminate the possibility that your sex issues stem from a medical problem, getting a physical exam before your first session is recommended. Make a list of all medicines you’re taking, including prescriptions, over-the-counter drugs, herbal remedies, vitamins, and supplements, and the dosages you take. Create another list of any recent life changes or major stresses that could be factors and all the details of your sexual problems, including when they started, any treatments you’ve received and the outcomes, and any other therapists you’ve seen. Write down any questions you have for your therapist about your sexual concerns.
When male or female sexual dysfunction is due to a physical condition, medications may be combined with sex therapy, but pharmaceuticals alone won’t cure most sexual disorders. Sex therapy is primarily talk therapy, but sex therapists use various approaches, including:
Cognitive behavioral therapy
Cognitive behavioral therapy is a promising treatment to help reduce and improve symptoms of anxiety, depression, and negative thoughts about sexual activity that make sexual problems worse. CBT is thought to improve your belief in your ability to succeed sexually and improve couples’ relationships and marital satisfaction. Internet-based CBT has also been found to work especially well for women who underwent breast cancer treatment and feel an internet-based intervention is less threatening. Studies have shown that internet-based therapy can help improve sexual functioning for anyone and is preferred by some for its accessibility, convenience, and privacy.
Mindfulness-based interventions are widely applicable to many types of sexual problems but have been broadly used for desire and arousal issues, pain during intercourse, sexual issues related to medical conditions, and inability to reach orgasm. These interventions are similar to mindfulness-based cognitive therapy but tailored for a sexual context. They’ve also been shown to help improve sexual function and satisfaction in men and women and reduce sex-related distress and fear linked to sexual activity.
Sensate focus is a component of sex therapy that couples utilize in the privacy of their home and involves a series of exercises that focus on nonsexual and sexual touching. Two of the primary goals of sensate focus is to improve communication and reduce performance anxiety. It also allows couples to build intimacy and trust. Sensate focus has been shown to help with arousal and desire disorders, erectile dysfunction, premature ejaculation, pain during sex, and sexual difficulties brought on by a medical condition.
In addition to your sex therapy sessions, your therapist will probably assign homework exercises for you and your partner. Communication exercises are a prime component as are exercises that help you change the way you interact sexually and non-sexually with your partner. You may also be asked to read or watch educational materials or videos about sexual health. Focusing on what you’re sensing, such as through mindfulness techniques, during intimate encounters may also help.
If you’d like additional information about sex therapy, explore the sources used throughout this guide.