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Not Interested in Sex?
More & more people are presenting for sex therapy with a lack of desire for sex. For a couple, this can often cause a lack of understanding, blame, shame and judgement. For the single person, a lack of interest in sex can mean confusion and avoidance of relationships and intimacy. That’s not to say that these issues affect all people. Many individuals have no interest in sexual intimacy and are perfectly happy and fulfilled in their lives. However for those who do feel distressed by a disinterest in sexual activity, you are not alone and there is help out there. The key is to determine if the issue is: acquired (has occurred at some point in the individual’s lifeline or is lifelong (has always been present); generalised (occurs over all situations) or situational (only happens in certain circumstances). The answers to these questions usually give an indication of possible driving forces causing and maintaining the problem. In addition, further questions that need assessment include:

How much distress is not wanting sex causing me or my partner?

Am I really not interesting in sex or are other factors simply taking over my life?

What is the state of my health in general, both physical and emotional?

It is an educational issue?

Try and work through the issue as deeply as possible and try to establish all the facts surrounding the lack of interest in sex. Once these have been established some possible causes and solutions should be around the corner.

Women's Difficulty Reaching Orgasm
Why can some women achieve orgasm and others find it difficult or even impossible to reach? There are many reasons for this variance. Stress and anxiety, some medications, societal impacts and emotional and psychological factors can all play a part.  The other complexity is that there appears to be a substantial variation in the interpretation of what an organism actually is:

  • The clitoral versus G-spot orgasm argument. Some women who are able to reach one but not the other, may record a lack of orgasm believing that they should be experiencing the other or both types of orgasm.

  • Many women record different physical experiences of orgasm and those women lacking information, may feel they are not orgasmic when in fact they are.

  • The difference in orgasm between men and women may provide confusion for some individuals over what an orgasm is supposed to look like.

Education can often overcome confusion association with exactly what an orgasm should look like.

Sex in the 50’s, 60’s, 70’s plus
A common misconception is that sexual intimacy should decline as we get older. However does sexual desire reduce in our 50’s, 60’s & 70’s? Fact or myth? It is true, that for some individuals, the desire to have sex reduces with age but for many it does not. Many couples find that the absence of children that are now grown, more financial stability and available time, all contribute to an active and satisfying sex life. Some of the issues plaguing individuals, who do experience a reduction in sexual activity, may include: health issues, some medications, relationship problems, injuries / operations, and emotional or psychological lack of wellbeing. Sex therapy can provide a non-judgemental, supportive and educational environment to work through these issues with the goal of rediscovering previously satisfying sexual experiences.

Sex is Painful
The first step is to assess whether the pain exists only during sexual activity or exists at other times as well as during sexual activity. For example: is the pain present during walking, sitting, bending over, legs up or down? It is recommended that a physical, particularly pelvic floor examination be completed by your GP to establish any biological cause, such as vascular or pelvic damage or injury. Once it has been established that the problem is not biological other factors can be considered. Make note of when the pain during sex first occurred. Did it occur gradually or suddenly? Was there any significant event that occurred at the same time as the start of the issue?

Pain during sex is a serious health concern. Don’t delay in seeking medical advice. Then, endevour to work through the questions above, looking for a common denominator that could point to the cause of the issue. If nothing comes to light seek the services of a professional sex therapist.

I Always Initiate Sex
One of the most common problems presenting in sex therapy is the complaint that one party in the relationship, initiates sex more than the other.  For the one initiating the intimacy, this can often cause confusion, fear of rejection and dissatisfaction, however for the other the by-product can be just as problematic, causing the person to feel pressured, resentful and avoidant.

Usually the more one person pressures, the more the other avoids. The most important step is for the couple to acknowledge that pressure and blame are neither fair nor helpful. After all, who is the one that should determine how often sex should take place? Should it be the one who initiates sex and wants it more, or the one who doesn’t initiate and wants it less?

One thing is certain and that is, that no one person should determine for the couple the frequency of sex – sorry to all the initiators out there. However, help can be at hand. It’s about establishing what is reasonable and ‘do-able’ for each individual as well as the ‘meaning’ that each person in the relationship has attached to sexual frequency. It’s not easy to work through some of these issues, particularly as people by our very nature, work from our own position of ‘right’ and sense of entitlement.

If all else fails - sex therapy may be helpful in establishing a middle yet satisfying ground, and one that both individuals are happy with. Sex therapy also works towards implementing strategies to broaden and enhance sexuality with the goal of increasing the desire for sexual intimacy.

I Want Sex More Than My Partner
Mismatched libidos can be a significant problem for some couples. The problem may have existed for the entire length of the relationship or may have arisen at some point in the relationship timeline.

The driving factors for men and women are quite different. There is evidence to support that one of the most prominent issues contributing to low or no sexual desire for women in Western countries are the multiple roles women play within the family and society. Many women today still carry the burden of the ‘double shift’ by undertaking three quarters of the household work in addition to being in the outside paid workforce. On top of this, women with children are often carrying the additional load of primary child care-giver.

It is conceivable that managing these multiple roles leaves little time for the individual and especially little time and energy for developing sexual desire.

A starting point is to ensure that workloads and family responsibilities are evenly distributed. Ensure that each person has time for themselves and additional time for intimacy. Remember that pressure is never helpful and only builds mistrust, resentment and avoidance. If you want sex more than your partner  try communicating quietly and honestly with a view of arriving at a solution that works for both, not just concentrating on our own needs.

Difficulty keeping Erection
Those who have experienced erectile dysfunction cheered the development of PDE5 inhibitors (sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra). These drugs offered men, who have trouble gaining or maintaining an erection, new hope for their own sexual satisfaction as well as that of their partner’s.

The secondary benefit of the development of these drugs was an increase in the acceptance of talking about male erectile dysfunction and a greater acceptance of the view that more men, than would have been suspected, experience erectile problems.

Research suggests that just as many women as men experience sexual difficulty, of one genre or another, but women can often hide their dysfunction, whereas, for men it is obvious when dysfunction is present. PDE5’s therefore, gained popularity quite quickly but are the results really what we thought they would be?

Widespread clinical trials suggest that 30-35% of patients taking the prescription fail to respond to the treatment and at the 6–12 month follow up, only 30% were still taking the treatment. These figures suggest a drop-out rate not to be overlooked. Although currently, society desires a ‘quick fix’ for our problems, and drugs often offer this pathway, other options should usually be considered.

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