What are sex problems?
Sexual problems, sometimes called sexual dysfunction, include a wide range of difficulties that can happen before, during or after sexual activity. They can affect things such as desire, arousal, orgasm, erections, ejaculation or comfort during sex.
Experiencing sexual problems at some point during your life is common. Everyone's experience is different, but many people face similar difficulties. If you are experiencing problems with sex, you may feel embarrassed, ashamed, alone or afraid. These feelings can sometimes make it harder to seek help and support.
If you're worried about sex and intimacy problems, you may find it helpful to talk to someone about what you're experiencing. This can help you understand what may be contributing to the problem and what support might be right for you. Sex therapy is one option that can help you explore sexual difficulties and the factors that may be contributing to them.
Sex problems and intimacy
If you are experiencing sex problems, you may worry that your partner is no longer interested or is less attracted to you. If sex is painful, you may avoid intimacy because you are worried about making the pain worse. Pressure around sex, such as worrying about reaching orgasm, can also affect desire and enjoyment.
You may also worry about what changes in intimacy mean for your relationship. Talking openly about these concerns can be a helpful first step. Talking with a relationship therapist or couples counsellor can help you explore conflicts or underlying issues and create a safe space for communication.
What causes sex problems?
A number of different things can cause you to develop sexual problems. Generally, issues develop due to a combination of factors. These can include:
- Physical: disabilities, illnesses, or long-term conditions such as diabetes and heart disease, as well as problems with drugs or alcohol.
- Psychological: mental health problems such as anxiety, depression, and stress can affect sexual desire and responses.
- Emotional: relationship difficulties, unresolved grief, low self-esteem, or past traumatic experiences can affect how you feel about sex and intimacy.
- Situational: changes in your day-to-day life or circumstances, such as moving home, financial difficulties, or having a child, can also affect your sex life.
Common sex problems
Sexual problems can feel very personal, but many of us face similar difficulties. Below, we explore some common sexual problems and concerns.
In this video, clinical and chartered psychologist Dr Robert O’Flaherty explains more about common sex problems and how therapy can help.
Sexual pressure and consent
One partner may want to try something sexually that the other person isn't comfortable with. This can lead to pressure, anxiety, or resentment. Talking openly about boundaries and respecting each other's consent can help both partners feel safe and comfortable.
Problems during or after sex
Problems during or after sex may include pain, feelings of guilt, anxiety, or loneliness. If sex is painful or you have other physical symptoms, speak to your GP or a sexual health clinic.
Sex problems and ageing
Ageing can bring physical changes that affect sex. These may include changes in erections, sexual desire, or how long it takes to become aroused or reach orgasm. Menopause can also cause changes such as vaginal dryness, reduced desire, and sleep problems.
Everyone experiences age-related changes differently. For some people, changes to their sex life may be a concern, while others may feel more comfortable talking about their needs and what they enjoy.
Compulsive sexual behaviour
Some people find that sexual thoughts or behaviours feel difficult to control and begin to affect their relationships, wellbeing, or daily life. This is sometimes described as 'sex addiction', although terminology varies. This might involve behaviours such as masturbation, accessing pornography, or paying for sex.
If sexual thoughts or behaviours feel difficult to control, this may lead to feelings of isolation, regret, anxiety, or shame. If they are affecting your wellbeing, relationships, or daily life, you may find it helpful to seek support.
Sex problems and physical health
If you have a long-term health condition, such as diabetes or cancer, it may affect your sex life. While being diagnosed with any of these conditions doesn’t necessarily mean you will experience sexual problems, the added stress and worry may impact your health and wellbeing.
Diabetes UK has put together a guide on some of the key problems you may experience if you have diabetes. If you have had cancer, Cancer Research UK and Macmillan Cancer Support also provide information about sex and relationships.
Pain during sex
Also known as dyspareunia, pain during sex can have many possible causes. These include vaginal dryness, sexually transmitted infections (STIs), scar tissue from surgery, and conditions such as endometriosis and ovarian cysts. Hormonal changes during menopause can also cause vaginal dryness and make sex painful.
In some cases, people with vaginas who experience pain during sex may have vaginismus. This is when the vaginal muscles tighten automatically when penetration is attempted, which can be painful or upsetting. The reasons for vaginismus are not always clear, but it can be linked to anxiety or fear around sex, previous painful experiences, sexual trauma, or difficult experiences during childbirth.
Treatment for vaginismus depends on the individual and can include psychosexual therapy, relaxation and pelvic floor exercises, and vaginal trainers. If you are experiencing pain during sex, your GP or a sexual health clinic can also help to check for possible physical causes.
Difficulty reaching orgasm
Difficulty reaching orgasm is common. For some people, it can cause distress or affect their relationships. Although many do not need to have an orgasm to enjoy sex, being unable to orgasm may be troubling for some people and their partners.
There are many possible reasons why someone may find it difficult to reach orgasm. These can include hormonal, neurological, or vascular problems, as well as some medications. Other factors may include anxiety around sex, relationship difficulties, depression, or previous traumatic experiences.
Low or differing sex drives
It is common to experience a lack of sex drive at certain periods in our life – particularly during pregnancy and times of stress – but some people may have it more persistently. There are several possible causes, including diabetes, relationship problems, hormonal changes, depression, tiredness, traumatic sexual experiences, and problems with drugs or alcohol.
While many find a way to compromise, for some, a sudden increase or decrease in sex drive can lead to communication difficulties or feelings of rejection. If differing sex drives are causing difficulties in your relationship, relationship counselling may help you talk openly about your needs and concerns.
Ejaculation problems
Ejaculation problems are very common, and people will typically experience one of three types of disorder:
- Premature ejaculation: when ejaculation regularly happens sooner than you or your partner would like, and this is causing concern or affecting your sex life.
- Delayed ejaculation: when there is a significant delay in ejaculation, or you are unable to ejaculate at all. This is also known as male orgasmic disorder.
- Retrograde ejaculation: when semen travels backwards into the bladder instead of passing out through the urethra. You can still experience an orgasm, but there may be little or no semen.
Possible causes include stress, previous sexual trauma, and health conditions such as diabetes.
Erectile dysfunction
Also known as impotence, erectile dysfunction is when you have difficulty getting or keeping an erection. There can be physical and psychological causes, including high blood pressure, hormonal problems, stress, and anxiety. Worrying about getting or maintaining an erection can sometimes make the problem more difficult.
When should I seek help for sex problems?
Talking about sex problems can feel difficult or embarrassing, and some people may avoid seeking help as a result. If a sexual problem is causing you distress or affecting your wellbeing or relationships, you may find it helpful to seek support.
Sex problems can sometimes be linked to difficulties within a relationship, or they may create new challenges between partners. Changes in intimacy, communication, or how you feel about your relationship may be signs that you would benefit from support.
Some signs that sex problems may be affecting your relationship include:
- feeling disappointed or unhappy about your sex life;
- arguments or difficulties communicating about sex;
- one or both partners feeling dissatisfied;
- feeling less connected to each other;
- one or both partners feeling taken for granted or neglected.
Treatment and support for sex problems
The right support for a sexual problem will depend on what you are experiencing and what may be contributing to it. If you have pain or other physical symptoms, a GP or sexual health clinic can help identify possible physical causes and discuss appropriate treatment.
Psychosexual therapy can help you explore sexual difficulties and the factors that may be contributing to them.
Psychosexual therapy
Psychosexual therapists are specially trained to support people experiencing sexual problems. Therapy can offer a safe space to explore concerns about sex and intimacy, including how your experiences, relationships, beliefs, or feelings may be affecting you.
Psychosexual therapy may involve exploring your thoughts and feelings about sex, as well as past experiences or cultural beliefs that may have shaped them. Your therapist may ask questions about what has changed, what feels comfortable, and what you would like to be different. Together, you can explore these concerns and work towards a relationship with sex and intimacy that feels right for you.
Relationship counselling
Relationship counselling or couples therapy may be helpful when sexual problems are affecting your relationship. It can give you and your partner space to explore concerns around sex and intimacy, communicate about your needs, and better understand each other's experiences.
Finding a therapist for sex problems
When looking for a therapist, you may want to check their qualifications, experience, and any specialist training they have in psychosexual therapy. Finding someone you feel comfortable talking to is also important.
You can use Counselling Directory to find a therapist who supports people with sex problems and learn more about their experience, qualifications, and approach.
