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Sexual Problems

Common Sexual Problems

Sexual problems are not uncommon. Estimates of prevalence for adults is approximately between 30% and 45%, depending on gender and age. Some of the most common concerns include:

•    Anxiety about sex
•    Impotence
•    Lack of sexual desire
•    Anxiety or uncertainty about sexual orientation
•    Conflicting sexual desires between partners
•    Recovery from sexual abuse or sexual assault
•    Loneliness
•    Body-image issues
•    Sexual impulses or compulsions that cause distress
•    Promiscuity.

Often, sexual issues are a result of negative feelings or traumatic experiences that prevent a person from being able to fully participate during sexual intimacy. Sex therapist Jill Denton explains, "Each of us possesses a unique model of sexuality, formed at least in part by incoming family messages, childhood abuse or neglect, culture, the media, and, of course, religious influences," and sometimes these messages can prevent or disrupt the development of healthy intimacy.

Sexual problems can also surface as a product of another mental health issue, such as depression or anxiety, or they may be derived from physical conditions, such as bowel or urinary problems, chemical imbalances resulting from certain medications, or, for women, changing hormonal levels resulting from menopause or childbirth.
Sexual Disorders as Listed in the Diagnostic and Statistical Manual
The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) lists three diagnosable sexual disorders for females and four for males:

•    Female sexual disorders:
o    Sexual interest/arousal disorder
o    Orgasmic disorder
o    Genito-pelvic pain/penetration disorder

•    Male sexual disorders
o    Hypoactive sexual desire disorder
o    Delayed ejaculation
o    Erectile disorder
o    Premature ejaculation

The DSM lists a number of paraphilias—sexual preferences for unusual and sometimes socially unacceptable behaviours, such as voyeurism or paedophilia—as being potentially problematic when specific criteria are met. A paraphilia might qualify as a paraphilic disorder when recurring personal psychological distress is associated with the behaviour, or the distress, injury, or death of another non-consenting person or group results from the behaviour. Paraphilias that are acted out between consenting adults are not indicative of mental disorders. Paraphilias listed in the DSM-5 include: fetishism, frotteurism, paedophilia, sexual masochism, sexual sadism, transvestic disorder, exhibitionism, and voyeurism. Fantasies associated with these behaviours are not necessarily cause for concern, unless the person experiencing the fantasy finds them distressing. In fact, most of these behaviours can be explored in a healthy, safe way between willing partners; they are considered problematic only when someone is harmed psychologically or physically by the act.

Addressing Sexuality in Therapy

Sexual energy is powerful and can profoundly affect a person’s mood, thoughts, and general state of being. Discussing one’s sexuality with partners, family, and friends can provoke anxiety, frustration, and even shame when a person believes his or her fantasies and behaviours may be deemed inappropriate by others. Fortunately, finding the right counsellor means finding a safe place to talk about any difficulties, fantasies, fears, memories, or desires regarding sexuality. 

Sexual intimacy can be one of the most satisfying and fulfilling experiences, but for many people, sexual activity is void of pleasure. Counselling4you can to help individuals and couples identify the source of their distress and reduce or remove those emotional barriers in order to enhance sexual experiences. Whether the physical symptom manifests through the inability to achieve orgasm or maintain arousal, or even through painful sex, we can help identify the psychological source of the symptom. By treating the whole person, psychologically and physically, we can help a person enhance his or her sexual experiences.

When a person chooses to enter sex therapy individually, he or she may be more comfortable discussing sexual issues with a therapist of the same gender. Counselling4you can help clients address the emotional, physical, and biological issues that can influence sexual activity in men and women. Sessions are strictly instructive and verbal, and all exercises and suggestions of a physical nature are performed outside of the session.