Sexual problems can affect both individuals and relationships. Some people experience sexual dysfunction regardless of their partner, and even in ‘solo sex,’ e.g. masturbation. These dysfunctions can exist from the time a person is beginning to be sexual, or may develop later in adulthood. Some problems – erectile dysfunction in men, diminished sexual desire in women -are particularly common as people approach middle age. For example, 50% of middle-aged and older men experience erectile dysfunction, and more than a third of women in this age group experience diminished sexual desire. Other sexual problems, particularly discrepancies in sexual desire or diminished sexual desire over time, affect couples. Whether individual or relationship-based, sexual difficulties impair quality of life and can sabotage a relationship. Examples of sexual dysfunction include:
• difficulty controlling/delaying ejaculation(premature ejaculation)
• problems attaining or keeping an erection (erectile dysfunction)
• partial or total inability to orgasm or ejaculate(delayed ejaculation)
• difficulty/inability to orgasm(anorgasmia)
• painful penetration/inability to be penetrated (dyspareunia, vaginismus)
• difficulty with lubrication and/or arousal
For both men and women:
• low or nonexistent sexual desire
• differences in desire to have sex (desire discrepancy)
• low or nonexistent sexual activity
For information on other sexual issues see our pages on:
C. Shawn Oak, PHD, is trained as a marriage and family therapist to provide sex therapy as well. Since most sexual problems have a biological as well as a psychological component, contemporary treatment usually includes focused behavioral techniques and a referral to a physician, possibly for medication. Sex therapists, like the ones at Oak & Associates, LLC, take sexual problems at ‘face value,’ and explore solutions rather than psychodynamic causes. In other words, if you are a man who is having trouble keeping his erection, we will rarely discuss your childhood issues with your parents. Instead, we will help you determine how much of your problem is medical – perhaps you have been smoking cigarettes for years and have minor vascular damage impairing blood flow to the penis- and explore treatment alternatives that might include silfadenil (Viagra) as well as ways to alleviate the performance anxiety that often coincides with and worsens erectile dysfunction. If you are a woman who doesn’t have orgasms, we probably won’t be talking to you about your unconscious motives to block your own pleasure – but we might give you a video showing how different women attain and enhance their orgasms during masturbation in order to then teach a partner how to help them attain climax. If you and your partner seek help because of flagging sexual desire, we won’t assume you have hidden relationship problems. Rather, we’ll give you practical advice on how to restore passion, perhaps suggesting sex manuals, ‘training videos,’ and specific sexual techniques.
Sex therapy is often short-term- less than fifteen sessions – and can be done by itself or as part of ongoing individual or relationship counseling. More than most other counseling, sex therapy relies on ‘homework’ that you or you and your partner do in between sessions, and often bi-weekly meetings with the therapist are sufficient to attain lasting change.