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Difficulty with sex is more common that people think, and many people have sexual issues at some point in their lives. The pace of day-to-day life, stress, work, illness, family pressures and even a much wanted baby, can all contribute to sexual problems. Difficulties may become apparent as a relationship develops and sexual partners get to know each other more. Individual difficulties may also be an issue either with having sex, sexual practices or with sexual orientation and identity. Sexual issues are not always easy to discuss and talking to a therapist who specialises in this area can help you.
Here at LCC we have a team of Psychosexual Therapists, counsellors with specialist training in sexual counselling, who can offer guidance and support on a range of issues and provide appropriate support to heterosexual, asexual, and gay/lesbian individuals and couples. Whether or not you decide to attend alone as an individual, or with your partner for couples’ therapy to manage your difficulty, sexual issues are dealt with sensitively in a non-judgemental environment.
All our therapists are members of the College of Sexual and Relationship Therapists - COSRT. We are gay and transgender/transsexual affirmative at Local Counselling Centre and many of our therapists are also members of Pink Therapy.
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Sometimes, you as an individual, or those around you, may experience confusion or difficulty in understanding your sexual orientation, whether you think you might be gay, straight, lesbian or asexual, resulting in much distress. Counselling can help you as an individual or as part of a couple explore these issues, and support you in coming to terms with your sexual identity.
We adhere to the World Sexology Millennium Declaration.
We are a gay affirmative service and many of our therapists are members of Pink Therapy.
Health problems, lifelong disability or acquired disability can impact enormously on your personal and sexual relationships.
● If you have a lifelong disability you may need to be creative in how you manage your sex life, as certain positions or practices may not be possible.
● After illness or surgery you may be nervous about re-starting your sex life and fear it will cause pain. You may have been affected permanently physically by your illness and may no longer look the same. You may be anxious about the effect this will have on your partner or future partners.
● You or your partner may be undergoing treatment that means you have to adapt your sexual practices, e.g. chemotherapy.
● Acquired disability will need you to develop new skills and may knock your confidence, at times this may feel like a big mountain to climb.
We can help you adapt to these problems and find a way to a fulfilling sex life. Some of our sex therapists are nurses and they have a particular skill in this area.
Please advise us when you enquire whether you have any access issues and we will be happy to accommodate these.
Loss of Sexual Desire – Lack Of Libido
This is a very common sexual difficulty. Loss of desire can either be partial, or total. Partial loss of desire means that while you may have stopped initiating sexual contact with your partner, you will respond to their approaches. Total loss of desire means that you don’t want to have sexual contact at all. There are many reasons why lack of sexual desire occurs. Life events such as bereavement, pressure at work and day-to-day stresses may mean that sex becomes of secondary importance. A difficult childbirth may also cause loss of desire, and if you are a new Mum, you may be so overwhelmed by caring for your new baby that you lose yourself for a while. Loss of desire is also a well-known side-effect of some medications, such as anti-depressants, and depressive illnesses.
Losing interest in sex can often be a response to dissatisfaction, disappointment, anger or unhappiness in your relationship as a couple. Sex therapy helps you to identify the cause of the loss of libido and to work together with your therapist to effect change.
Many individuals – both men and women - experience difficulties in achieving an orgasm, and there are some individuals who rarely or never orgasm. Whilst not all individuals need or want to orgasm to enjoy their sex lives, you may find yourself in a situation where you would like to achieve orgasm with your partner or yourself.
Sex therapy gives you an opportunity to learn about your body and your inner sexuality, so that you can increase your sexual enjoyment.
Vaginismus means you have difficulties in being penetrated by any object such as a finger, tampon or allowing your partner to penetrate with his penis. This can be despite your expressed wish for penetration to happen. Some women with vaginismus will never have had penetrative sex, and may have found tampons and smear tests difficult or been unable to co-operate with them being performed. Many women with vaginismus come to the attention of the medical profession when they present for a smear test and are referred for therapy. Other women may have been able to have penetrative sex and have used tampons, but this condition develops for example after a difficult vaginal delivery. Vaginismus can be an extremely distressing sexual difficulty for both you and your partner.
Vaginismus may be partial in that sometimes penetration is possible, though it is usually painful. This pain is often described as a burning or itchy sensation. This is called vestibulodynia. Whilst this is distressing for the sufferer there are things that can help alleviate the symptoms.
Sex therapy can help you to overcome vaginismus.
Painful Intercourse – Dyspareunia
Both men and women can experience pain through intercourse.
Women can experience pain when they are not fully aroused and penetration takes place. Some penetration positions can involve deeper penetration and can be painful. Medical conditions such as pelvic infections, surgery and child birth injuries can also cause pain.
Men can experience pain on intercourse if the foreskin is tight - phimosis. This occurs in uncircumcised men and can lead to infections.
Any medical condition that is causing you pain should first be treated. Where a medical condition has been ruled out, then sex therapy can help you to improve your sexual relationship.
‘Erectile difficulties’ means that you have difficulty in obtaining and maintaining an erection, which makes penetration difficult or impossible. In some cases an erection is never obtained.
This can be very upsetting for both you and your partner, who often feels to blame and so the associated stress becomes cyclical.
If there is no medical reason for your erectile difficulties, then sex therapy combined with a cognitive behavioural approach can be can be extremely effective in bringing about rapid improvement.
If there are medical reasons why your erectile difficulties have occurred, sex therapy can still be very helpful in helping you and your partner to explore ways of adapting your sexual relationship to the difficulties.
Premature ejaculation means that you have not yet learnt to control the ‘point of inevitability’ – the sign that tells you that you are about to orgasm. As a result, you might ejaculate before penetration, or soon afterwards, which may leave you and your partner frustrated. Sex therapy helps you to learn how to identify your ‘point of inevitability’ and manage your sexual excitement so that you have more control over when you ejaculate, and have a more satisfying sexual relationship.
Delayed ejaculation is a medical condition in which you cannot ejaculate, either during intercourse or by manual stimulation with a partner. Most men ejaculate within a few minutes of starting to thrust during intercourse. However if you have delayed ejaculation you may be unable to ejaculate (for example, during intercourse), or may only be able to ejaculate with great effort after having intercourse for a long time (for example, 30 to 45 minutes).
Delayed ejaculation can have psychological or physical causes. Some medication can also interfere with ejaculation. Sex therapy is helpful when medical causes have been ruled out to help you to change this. Sessions can be individual or with your partner.
Retrograde ejaculation is a condition that occurs when semen enters the bladder instead of going out through the urethra during ejaculation. The main reason for retrograde ejaculation is that the bladder neck does not close. This causes semen to go backwards into the bladder rather than forward out of the penis.
Retrograde ejaculation may also be caused by medical conditions such as diabetes, surgery to the prostate and medications. Injury can also cause retrograde ejaculation. You might notice that there is little semen on orgasm and that your urine is cloudy. Treatment is by stopping any medication that may be causing this.
While treatment is mainly medical for this condition, psychological support and sex therapy can be beneficial for you and your partner.
The term “sexual addiction” is used to describe the behaviour of a person who has an unusually intense sex drive or an obsession with sex. Sex and the thoughts of sex tend to dominate the sex addict’s thinking. This can impact on their work and makes it difficult to engage in healthy relationships.
Sex addicts, like other types of addicts, engage in distorted thinking, often rationalising and justifying their behaviour and blaming others for problems. They generally deny they have a problem and make excuses for their actions.
Sexual addiction also is associated with risk-taking behaviours for themselves and others which can put both parties at risk of emotional and physical injury.
For some people, the sex addiction progresses to involve illegal activities, such as exhibitionism (exposing oneself in public), making obscene phone calls, or molestation. Other examples of manifestations of sex addiction include:-
● Compulsive masturbation (self-stimulation)
● Multiple affairs (extra-marital affairs)
● Multiple or anonymous sexual partners and/or one-night stands
● Consistent use of pornography
● Unsafe sex
● Phone or computer sex (cybersex)
● Prostitution or use of prostitutes
● Obsessive dating through personal ads
● Sexual harassment
● Voyeurism (watching others) and/or stalking
If you feel that any of these traits apply or seem familiar to you or your partner, then sex therapy can help you or your partner to control these compulsive behaviours.
Fetish and Paraphilia
Sexual fetishism, or erotic fetishism is defined as the sexual arousal a person receives from a physical object, or from a specific situation. If a sexual fetish causes you significant psychosocial distress or has negative effects on important areas of your life, it might be called a paraphilia.
Most fetishes are entirely harmless, though they can cause anxiety for you or your partner. The aim of psychosexual therapy is not necessarily to eliminate the fetish or paraphilia, but rather to assist you or your partner to understand and control it, where necessary.