Psychosexual therapy

Having sexual difficulties can feel very isolating. You may feel self-conscious and unable to speak up about them, whether that’s having an honest conversation with your partner or reaching out to a professional. The truth is, sexual problems are very common and the best way to tackle them is to talk about it.

If the problem is affecting your relationship, being honest and open with your partner about what’s happening is a great first step. For some, this alone is enough to help work through the problem. For others, more support is needed.

This is where psychosexual therapy comes in. Sex therapists are qualified counsellors, doctors or healthcare professionals who have completed extra training to help those having sex-related difficulties. Here we’ll look at what sex therapy involves, what it can help with and what to expect in sex therapy sessions.

What is sex therapy?

The aim of sex therapy is to help you improve the physical intimacy between you and your partner and overcome or manage any sexual difficulties you’re having. Whatever your gender, sexual orientation or relationship status, sex therapy can support you to feel more comfortable about getting intimate.

There can be various causes for sexual difficulties, their origins may be:

  • physical (illness, disability/chronic illness, accident, surgery or medications)
  • psychological (depression, anxiety or other mental health conditions)
  • emotional (unhappiness in the relationship, unresolved grief)
  • situational (certain situations or environments)

Visiting your doctor is a good first step if you think the cause may be physical. Sometimes there will be ways your doctor can help (for example, trying different medications), but if not, they may recommend psychosexual therapy. While you can see a sex therapist on your own, if the problem is affecting your partner it helps if they can attend sessions too.

Sex is loaded with emotion and, often, talking it through together with an impartial therapist can help ease tension and bring you closer together.  

What can sex therapy help with?

Sex therapy looks to help with any problem or difficulty relating to sexual relationships.

In men this may include:

  • a lack of sexual desire
  • difficulty getting or maintaining an erection
  • premature ejaculation, or other ejaculation problems

For women, this may include:

  • a lack of sexual desire
  • difficulty climaxing
  • pain during sex or being unable to have penetrative sex

Talking to a stranger about your sex life may feel uncomfortable, but sex therapists are not here to judge. By being honest and talking about what you’re experiencing in this confidential setting, they will be able to help you explore the root of the problem and offer ways of helping you overcome or manage symptoms.

I have a condition called vestibulodynia which makes penetrative sex very painful. Before I was diagnosed I thought I was the only person who experienced this and was afraid to talk to anyone about it. After plucking up the courage to visit my doctor, I was tested for various conditions and now understand what it is I have and how I can manage symptoms - it’s such a relief to know.

What to expect from sex therapy

Most therapists will arrange an initial consultation with you in the first instance. This is a chance to talk to your therapist about what you’re looking for help with and for them to explain more about how they can help. Here you should also get the chance to arrange logistics - how often your sessions will be, who will attend and how long the sessions will last. What will happen in the sessions will depend on what it is you’re seeking help for. Sex can often be tied up in other emotions and relationship dynamics, so you may find some sessions explore topics outside of sex.

Your sessions will give you and your partner (if they join you) the chance to talk through what’s going on and understand what could be causing the problem. Your therapist will likely advise you to try various exercises outside of your sessions. You can then reflect on how well these exercises went in future sessions.

Talking about sex and understanding how we relate to sex in a non-judgemental space can be an illuminating and liberating experience. Counselling provides the opportunity to explore and understand more fully the relationship you have with sex.

- Counsellor, Gary Barker MBACP

Once you get through the initial nervousness of talking about sex, you’ll be able to explore how sex affects your relationship and what it is you need to feel fulfilled. If sex is important in your relationship and is causing problems, sex therapy is an option to help you overcome these problems and enjoy physical intimacy again.

What qualifications should a sex therapist have? 

In the UK, practising psychosexual therapists should be trained with a minimum of two years in a post-graduate diploma in psychosexual therapy, including a minimum of 200 supervised clinical hours. Although it's not a legal obligation, some psychosexual therapists will be registered with the College of Sexual and Relationship Therapists (COSRT), the UK's leading membership organisation for therapists specialising in sexual and relationship issues. 

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