What does a sex therapist do?

22:56, Mar 21 2013
FEAR FACTOR: "When men can't or won't talk about an issue with their partners, they might start avoiding sex all together, which can lead to relationship problems or break down."

Whenever somebody asks me "what do you do for a living?" and I tell them I'm a "sex therapist"  most of the responses I get are quite funny.  A look of disbelief, a nervous laugh or giggle, usually people don't really know how to respond right away. Then the question that follows is: but what does a sex therapist do?

The answer is simple; the goal is to help you make your relationships and sex lives as enjoyable and fulfilling as possible. That might be different for everyone, but there are some key principles that work for most couples or individuals.

Sex therapists are qualified counsellors or other healthcare professionals who have had special training in issues related to sex and relationships. They use their specialised clinical skills and theoretical knowledge to help you resolve various sexual issues, from concerns about sexual function or feeling to the way you relate to your partners.

Through sex therapy, couples can focus on concerns such as lack of sexual desire or knowledge, intimacy issues, mismatched libidos and relationship problems.

Concerns for males include: erectile dysfunction or impotence, premature or delayed ejaculation, performance anxiety or sexual problems after illness.

For females: painful intercourse, vaginismus, difficulties experiencing an orgasm, loss of desire for sex or reaching menopause can be issues.


Other concerns include gender identity issues, confusion about sexual orientation, disability and sexuality, compulsive sexual behaviour; and past sexual trauma.

Talking about sex and intimacy may initially feel awkward, but sex therapists are trained to put you at ease and are skilled at identifying and exploring your concerns. Through sex therapy, you can learn to express your concerns clearly and be taught how to understand your partner's and your own sexual needs better.

Sexual confidence can be difficult to achieve with so many unrealistic expectations of what normal sexual behaviour should be. This is complicated by the lack of discussion around sexual problems. While women may sometimes talk to their girlfriends, men just don't.

For example "James" (not his real name) aged 19, came to see me because he believed he suffered from premature ejaculation. He'd had some girlfriends in the past, but now was mad about a girl he'd met at university and he did not want to let her down because of him "coming so quickly". From experience, I know that most men (and women) have no idea what the normal ejaculation time is. James, like many of his contemporaries these days had received most of his sex education by looking at porn.

"How many minutes do you think it takes most men to ejaculate?" I asked James.  "Oh, at least 15 to 20 minutes; some of my friends last over half an hour!"  When I explained that the normal time (penis into vagina and ejaculation) is between three and six minutes, he could not believe it. After some more sex education, advice and reassurance, he left on a high. His anxieties had disappeared.

Unlike women, men have to perform. If they start to worry about their performance, for example, with premature ejaculation, they can also acquire erectile problems that can then result in performance anxiety. I tell my clients "your mind has to be in charge of your penis" as your brain is the most powerful sex organ.

When men can't or won't talk about an issue with their partners, they might start avoiding sex all together, which can lead to relationship problems or break down. Some couples suffer for years before they seek help and by then it is often too late!

I've received calls from women who book in an appointment for their partners, insisting he has the problem and he should be fixed!  They don't realise that the issue has become a couple problem. Nothing is more confronting or demoralising for a man to be told that he is a 'dud' in the bedroom.

It's just as confrontational for women who are asked by their partners all the time: "why haven't you had an orgasm yet; what is wrong with you?" Again this is caused by a lot of misinformation as research has shown that only one in five women experience an orgasm during penetrative sex.

That's why it is so important to have the right information. Talking to a sex therapist could save your relationship. Your therapist will take a detailed history by asking questions about your issues and help you to get a better understanding of them and will help to develop the right strategies.