Sexual difficulties are more common than many people realise — and they can affect individuals of all genders, ages, and backgrounds. These challenges may arise suddenly or develop gradually, and they can impact both individuals and couples in deeply emotional ways.
Whether you’re experiencing a loss of desire, difficulties with arousal or orgasm, or distress around performance or pain, you are not alone. Many of these issues can be explored and addressed through psychosexual therapy. This article offers an overview of some of the most common sexual dysfunctions and how therapeutic support can help.
Erectile Dysfunction
(ED) Erectile dysfunction, sometimes referred to as impotence, is when a person with a penis has difficulty getting or maintaining an erection firm enough for sexual activity. While occasional difficulties are common, ongoing challenges can affect self-esteem, relationships, and overall well-being.
ED is more likely with age, but it is not an inevitable part of aging. Physical health conditions like high blood pressure, heart disease, or diabetes are common contributing factors, as are emotional issues such as stress, anxiety, or relationship strain. Psychosexual therapy can support individuals in identifying underlying causes, managing performance anxiety, and improving confidence and communication with partners.
Anorgasmia
Anorgasmia is a condition where a person is unable to reach orgasm despite adequate stimulation and arousal. It is more common in women, although it can also affect men, typically in the form of delayed ejaculation.
Anorgasmia can be influenced by psychological, emotional, or physical factors. These might include past trauma, anxiety, relationship issues, hormonal imbalances, or certain medications. A psychosexual therapist can help explore and address these contributing factors in a supportive, non-judgmental space.
Dyspareunia (Painful Intercourse)
Dyspareunia refers to persistent or recurrent pain during or after sexual intercourse. Though it is more commonly experienced by women, men can also be affected. Causes may be physical (such as infections, endometriosis, or menopause) or psychological (including anxiety, past trauma, or relationship difficulties).
Even when the original physical cause has resolved, pain can continue due to anticipatory anxiety or muscle tension. Therapy can help individuals and couples understand the mind-body connection and rebuild confidence and comfort in intimate situations.
Vaginismus
Vaginismus involves the involuntary tightening of the vaginal muscles when penetration is attempted, making intercourse, tampon use, or medical exams painful or impossible. It can be distressing and isolating for those affected.
Therapy offers a safe and supportive space to explore the emotional, relational, and physical contributors to vaginismus. With guidance, many individuals can learn to gently work through the condition and rebuild a sense of safety and confidence in their bodies.
Premature Ejaculation
Premature ejaculation is when ejaculation happens sooner than desired, often before or shortly after penetration. It is one of the most common sexual issues among men and can cause distress for both partners.
While it is not uncommon for this to occur occasionally, frequent premature ejaculation can lead to frustration and lowered sexual satisfaction. Psychosexual therapy can help individuals explore psychological and physiological causes, develop coping strategies, and build confidence in sexual relationships.
Delayed Ejaculation (Retarded Ejaculation)
Delayed ejaculation is when there is a persistent difficulty or inability to reach ejaculation during sexual activity, despite adequate arousal and desire. It can be frustrating and confusing, especially when other areas of sexual functioning feel unaffected.
Factors may include anxiety, trauma, relationship conflict, or side effects from medications. Therapy can help uncover underlying issues and introduce practical techniques for improving responsiveness and satisfaction.
Loss of Libido (Sexual Desire)
Loss of sexual desire can affect people at any stage of life and is often linked to hormonal changes, stress, emotional distress, relationship dynamics, or certain health conditions.
Although fluctuations in libido are normal, a persistent or distressing loss of desire can impact one’s self-esteem and intimacy with a partner. Psychosexual therapy can provide a space to explore these experiences and identify ways to reignite connection and desire.
Fear of Intimacy
Fear of intimacy can result in emotional distance, difficulty with trust, or avoidance of closeness and vulnerability. It may stem from past trauma, attachment wounds, or fear of rejection.
This fear can create a deep sense of loneliness and confusion, even in committed relationships. Through therapy, individuals can begin to explore their patterns, develop self-awareness, and move toward deeper emotional connection.
Sex Addiction (Hypersexuality)
Sex addiction, or hypersexuality, is marked by compulsive sexual behaviour that feels out of control or harmful. Individuals may struggle with intrusive sexual thoughts or feel compelled to engage in behaviours that negatively affect their well-being or relationships.
Psychosexual therapy offers a space to explore the underlying emotional drivers of addiction and begin developing healthier, more connected ways of relating.
Sexual Issues in Relationships
Sexual problems often reflect or contribute to relationship challenges. For example, one partner may equate sex with emotional validation, while the other may seek intimacy through non-sexual closeness. These mismatches can lead to misunderstanding, resentment, or withdrawal.
Relationship therapy can help couples navigate these differences, improve communication, and strengthen both emotional and physical intimacy.
Seeking Support If you or your partner are experiencing sexual difficulties, please know that you are not alone and that support is available. Psychosexual therapy provides a confidential, compassionate space to explore these concerns and move toward greater connection, healing, and fulfilment.
(Psychosexual therapy is a specialised form of talking therapy that focuses on emotional, relational, and psychological well-being. It does not involve physical touch, and all interventions are strictly verbal. This approach adheres to high professional standards, ensuring the safety, respect, and dignity of all clients. Please note that psychosexual therapy is not a substitute for medical treatment. For any physical or medical concerns, clients are encouraged to seek advice from their GP or an appropriate healthcare professional.)
📞 Contact Mirlene Santos Therapy to start your next chapter.
mirlenesantostherapy.com
24th Apr 2025
Mirlene Santos 