A Help Guide for Sexual Problems - causes, signs, treatment options and sources of support. 

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Sex therapy self help guide

Sexual Problems: A Help Guide

About sexual problems

A sexual problem can be understood as something happening in your sex life which you are not happy or comfortable with. There are many different sexual problems. Common problems that can affect both men and women can include but are not limited to performance anxiety, inability to achieve orgasm, intimacy issues, sex addiction, and loss of libido. Men can also suffer from erectile dysfunction, ejaculation problems, and dealing with Peyronie's disease. Women can suffer from MRKH (Mayer Rokitansky Küster Hauser syndrome). Of course sexual problems don't affect just the sufferer, but also his or her partner or spouse and their relationship.

Many people find sexual problems to be embarrassing or the cause of deep anxiety. But letting embarrassment or fear stop you from seeking help is not a good idea. Medical professionals are used to dealing with such issues, and there are plenty of ways to combat sexual problems they can help you with. 

What are the signs of sexual problems?

Sexual problems can be minor or severe. Depending on the specific problem and the individual, the signs will differ. Common signs that may occur alongside the physical symptoms of your sexual problem can include:

  • Anxiety
  • Distress
  • Depression
  • Frustration
  • Relationship problems
  • Loss of libido 
What can cause a Sexual Problem?

There can be physiological or psychological causes of your sexual problem. In many cases it can be a combination of both.

Physical conditions. A sex problem is often a medical issue. Among men, Peyronies disease is a medical condition, as is MRKH among women.   Other things like erectile dysfunction and Vaginismus (inability to have intercourse due to muscle spasm) are also physical conditions but also have a possible psychological cause as well. 

General illness. Physical illness, especially serious and long term conditions, can reduce libido. If someone is physically ill, the body will be focusing on recovery, and their mind might be too too distracted worrying about their illness for them to relax and enjoy intimacy. This shows how it's not just physical illness but also mental illness that can affect sex drive. Loss of libido is a symptom of many mental health issues, including depression and anxiety disorders.

Poor health. Some sexual health problems are connected to poor health. For example, erectile dysfunction has been linked to heart problems, high blood pressure and high cholesterol.

Medication side effects. Medicine can affect your sex drive. If you are experiencing a low libido or other sexual challenges and are on medication, see your patient information leaflet or GP if you are concerned. Recreational drugs, alcohol and cigarettes have also been found to contribute to sexual problems.

Stress. Stressful times in life often contribute to low libido. This can include when you have recently lost a loved one, had a negative experience, are a new parent, or are experiencing challenges in your relationship. General stress, too, can result in low sexual interest and problems with performance. 

Psychological Issues. The mind is a strong part of our sexual response. Our experiences and past affect our beliefs, assumptions, feelings and behaviour, which in turn affects our confidence and esteem including when it comes to sex. Common experiences that can contribute to sexual problems include traumatic relationships, negative sexual experiences, a lack of sexual experience, and sexual abuse. 

Advice on improving sexual problems: what you can do?

Don't ignore it. Sexual problems rarely go away if you ignore them. And if your sexual problem is based on a physical condition, ignoring it can make things worse in the long term. 

See your GP. If your sexual problem involves physical symptoms, or you are experiencing any pain or discomfort during sex, it's important to book an appointment with your doctor. If you are nervous remember that doctor's are used to discussing such issues. And don't forget you can request a same sex doctor if that helps you feel comfortable. 

Talk. If a sexual problem is affecting your relationship, it can be very beneficial for you to talk about it with your partner. Discuss possible causes, anxieties and concerns. You could also consider any possible changes you can make to try and improve things. If you are finding it difficult to talk, consider seeking the help of a couple's counsellor who can create a safe space for you to communicate and share in. 

Invest in self care. Reduce negative healt habits like alcohol and smoking, both of which are depressants and can lower your sex drive. Increase positive health habits instead, like choosing a balanced diet and exercising frequently. Not only do they both give you more energy, they can help you feel more self-esteem and elevate your mood.

Seek to lower stress and anxiety. Stress levels can impact heavily on your sex life. Finding time to relax and maintain a good work/life balance is important. If you feel overwhelmed by stress, try to explore ways to manage it. Relaxation techniques such as meditation and mindfulness can help to relieve stress. Or speak to a coach or counsellor. 

Raise your self-esteem. Many sexual conditions are possibly linked to poor self concept including body image. It can help to discuss these issues with your partner or a counsellor. Work to feel better about yourself when possible. While raising your self-esteem can sound a tall order, it can start with shifting your focus on your strengths, what is going right for you and what you can do well. 

Get help for depression. It's hard to feel physically confident or interested if we are feeling very low about ourselves and our lives. Look at ways to address low mood, including self help books, online courses and information, and again, seeking the assistance of a coach, counsellor or psychotherapist. Your local area might provide mental health services free of charge. Call your local council for more information. 

Psychological approaches to addressing sexual problems

It can be overwhelming when first considering asking for help with your psychological health. But it really is no different than asking for help with your physical health. If you aren't sure if you need psychologial help for your sexual problem, consider these questions: 

Does your problem interfere with your sex life?
Does it cause you anxiety, embarrassment, despair or frustration?
Have you tried to solve the problem but cannot seem to?

If you have answered yes to these questions, a psychological therapy could be very helpful.

The kinds of therapy that help with sexual problems are known as 'psychosexual therapy'. Psychosexual therapy can be very successful in addressing the causes of your sexual problem as well as helping you manage and alleviate it. Therapy is carried out in a non-judgmental and supportive way. Your therapist can help you to develop new ways of thinking and feeling about certain experiences and situations. New approaches, coping mechanisms and thought patterns can be developed.The exact approach that your therapist uses will depend on the nature of your problem, the therapist you choose, and also your personal prefernce and personality.

There are now many counselling and therapeutic services and organisations available. Here are details of available services:

The NHS- see your GP and ask for a referral to see a specialist.

Local charities or organisations- thesemay provide support groups, therapy and advice in your area. Search online or call your council for more information. 

Private counselling and psychotherapy clinics and services- Search through online directories for organisations that offer can therapeutic help (Harley Therapy is one such clinic).

When seeing a healthcare professional you will start with an initial assessment. This will include being asked some questions to identify the issues, causes and problems. Try to be honest and open in your answers. The person asking the questions just wants to understand and help.

Advice and resources for help

Useful self-help books include:

  • Overcoming Sexual Problems: A Self-Help Guide. Vicki Ford,  (2005).
  • Resurrecting Sex: Solving Sexual Problems and Revolutionizing Your Relationship. Dr David Schnarch,  (2003).
  • Overcoming Low Self-Esteem: A Self-Help Guide. Melanie Fennell (1999).

Useful websites include: 

  • Relate offers advice, relationship counselling, sex therapy, workshops, mediation, consultations and support face-to-face, by phone. 

The NHS offers several useful guides: 

Male sexual problems

Sexual dysfuntion in women 

Talking about sex

What does a sex therapist do?  

Note: This Guide has been produced by Harley Therapy. It is subject to the usual disclaimers, and is copyright. 

References

Vicki Ford (2005) Overcoming Sexual Problems - A Self-Help Guide.

Heppner and Lee, (2002) Problem solving appraisal and psychological adjustment. Handbook of Positive Psychology, Oxford University Press, New York p. 288–298.

Moreira et al., (2005) Help-seeking behaviour for sexual problems: the Global Study of Sexual Attitudes and Behaviors. International Journal of Clinical Practice Volume 59, Issue 1, pages 6–16.

Becker et al., (2008) Sexual problems of sexual assault survivors. Women & Health Volume 9Issue 4.

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