A question I often get asked when meeting a new client is:
“I have ____ issue affecting my sex life. Am I normal?”.
Concerns and issues related to sex and sexuality are very common. A recent international study found that about 34% of men and about 46% of women reported experiencing one or more sexual problems over the previous year (Briken et al., 2020). When it comes to specific sexual concerns, about 30% of women report experiencing chronic low desire and up to 72% of women report experiencing orgasmic problems or difficulty orgasming during their lifetime (APA, 2022). Erectile dysfunction issues have an international prevalence of between 13% and 75%, with prevalence increasing by about 10-20% per decade of age (APA, 2022).
If ‘normal’ is relative to the overall population, how could you not be normal with prevalence numbers like that! Some researchers even believe that the prevalence of sexual problems is actually greater than what is reported. Why? Because people often feel too embarrassed or ashamed to talk about their sexual problems. Sex and sexuality are treated as taboo subjects in our society. So, if no one else seems to be talking about their sexual concerns, it can feel like you are the only person in the world struggling with sex. This may cause you to feel that you have to just “tough it out” or try to ignore your sexual concerns or problems. But you don’t.
Sexual problems are nothing to be ashamed of.
If you were experiencing an ongoing and worrisome illness or physical medical issue, you would likely go to the doctor. If you were headed to work one morning only to find that your car wouldn’t start, you would likely call a mechanic. In these situations, you would seek help so that you could get back to living the kind of life you want to live. So why not do the same for erectile function issues? For pain with sex? For low desire? For sexual performance anxiety, trouble orgasming, or any other sexual issue? Taking care of your sexual and mental health is as important as taking care of your physical health (and more important than taking care of your car!). Everyone deserves a fulfilling sex life, and addressing your sexual concerns in therapy is a great first step in building the sex life, and the relationship with your sexuality, that you want.
So how can sex therapy help?
According to research, the majority of sexual functioning issues (yes, including erectile dysfunction) are caused by psychological and/or relational factors rather than physiological or medical factors (Metz & McCarthy, 2004). Sex therapy is a unique intervention in that it’s focus lies at the intersection of sexual health and mental health. Sex therapy aims to help individuals and couples (or throuples or more!) connect to their sexuality and sexual identity by helping them work through sexual and psychological problems. This is done by working with a sex therapist to cultivate an understanding of the reciprocal relationship between mental health and sexual and relational functioning, to define what sex and pleasure mean to you, and to identify and pursue goals for your sex life and your mental health. Working with a sex therapist will help you become educated on sexual functioning (i.e., arousal, desire/“libido”, orgasms, sexological anatomy, and much more), sexuality and relationships (i.e., desire discrepancy, polyamory, kinks, and more), and mental health. Sex therapy offers the benefit of working with a licensed therapist to address both mental health and sexual concerns in a supportive, judgment-free space.
We know talking to someone about sex can feel intimidating —if you’re not ready to talk to a therapist just yet, these resources are a good place to start:
- Come As You Are by Emily Nagoski
- Healing Painful Sex by Deborah Coady, MD and Nancy Fish, MSW, MPH
- Rekindling Desire by Barry McCarthy, Ph.D and Emily McCarthy
- The Truth about Men and Sex by Abraham Morgentaler, MD
- Sex Without Stress: A Couple’s Guide to Overcoming Disappointment, Avoidance, and Pressure by Jessa Zimmerman, MA, LMHC, CST
–Katelyn Chapman, LCSWA
Metz, M. E. & McCarthy, B. W. (2004). Coping with erectile dysfunction: How to regain confidence and enjoy great sex. New Harbinger Publications.
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders, Fifth edition, Text revision. Washington, D.C.: American Psychiatric Press.
Briken P, Matthiesen S, Pietras L, Wiessner C, Klein V, Reed GM, & Dekker A. (2020). Estimating the Prevalence of Sexual Dysfunction Using the New ICD-11 Guidelines. Dtsch Arztebl Int. 117(39), 653-658. doi: 10.3238/arztebl.2020.0653
Katelyn Chapman, MSW, LCSWA is a Licensed Clinical Social Worker Associate in North Carolina currently accruing hours towards her full licensure. To schedule an appointment with Katelyn or any of the therapists at Carolina Sexual Wellness Center, please call 919-297-8322.