• improving a person’s overall comfort level around sex
• low or high levels of desire
• desire discrepancies among partners
• erectile dysfunction
• menopause and age related sexual functioning
• difficulty with orgasm
• painful sex for men, women, trans and non binary or gender fluid people
• issues with body image including genital shame
• rapid or delayed ejaculation
• struggles around orientation or gender
• performance anxiety and maintaining erotic focus
• sex and infertility
• sex-related shame originating from religious or family upbringing
• intimacy after illness, disability or aging
• intimacy after infidelity or abuse
• out of control sexual behaviors
• assisting people in their personal definitions of healthy sexuality
• working on integrating a plan to add physical intimacy back into a relationship
• negotiating kink within a relationship and managing a fetish if it produces distress
• helping navigate consensual non-monogamous, poly, or open relationships

These issues may feel like they have no resolution but often they do.  Many times, one issue from this list above occurs and a few attempts are made to solve the problem.  For example, the man first goes to the internet to understand what to do about his Erectile Dysfunction. Possibly he then goes to the doctor for a medicine.   A woman finds sex painful after menopause and tries to tell herself to relax or white knuckles through the pain.    After a few attempts to solve the issues, or years of therapy with a therapist with no training in sexual health, the person decides there is no solution.  Because we tend to not talk about sex, it can easily drive a wedge within our relationships.   The issue is often dropped and people begin to lose not only the sexual connection, but also communication and intimacy within the relationship.

Resentments and feelings of anger and sadness grow over time.  The fact that the relationship is non-sexual becomes the couple’s secret.  People often go years living in shame because they don’t feel comfortable taking the risk to talk about the issue, because this issue is sexual in nature and creates vulnerability and shame.  In fact, 33% of couples have sex not at all, or less than one time a month.  The partners are left to cope alone in isolation.

While we don’t get to wave a magic wand or go back in time, there is research in the field of sexual health guiding both the biomedical and psychological treatments for the issues mentioned above.  Be open to getting help on these issues.   Rather than it being a place of shame, it can be a place of connection and intimacy.   Some spend a lifetime avoiding anxiety-producing situations but if you do the work, and proceed with accurate sexual health information, you don’t have to live in constant fear, avoiding and isolated.