Psychological causes of sexual problems
Updated 10 December 2014
by Sarah Graham
Tuesday 09 December 20141017 0
Adults can experience sexual problems at any stage in their life, which can be personally distressing and may also cause difficulties within relationships. Your difficulties in the bedroom may be related to a physical condition, which your GP can advise on, however sexual problems often also have a psychological aspect. In these cases, you may find it useful to discuss your concerns with a sex therapist, who will ask you questions to help ascertain the exact cause of your problem. We asked three RSCPP therapists, who work with individuals and couples to address sexual problems, to explain some of the common causes of difficulties around sex.
Concerns around sexual desire
Many people are concerned about their sexual desire - 'Am I wanting sex too much or too little, or why aren't I interested in sex?' The truth is there is no hard and fast rule, though for a couple it's helpful if both are comfortable with the amount of intimacy and sex they have. Intimacy and sex are not quite the same thing, yet intimacy is essential to most humans and definitely enhances sexual activity, which most would like to enjoy and feel positive about. It is normal to have less (or perhaps more) desire for sex, in certain circumstances. Some common causes of changes in sexual desire include: illness, feeling disconnected from your partner, being unhappy about your body image, and distractions such as technology or porn. You may also experience a change in your sexual desire if you are feeling emotionally stressed, for example if you are depressed, suffering loss or conflict. You may not be enjoying sex, have a fear of failure, or sexual problems such as pain on intercourse, premature ejaculation, erection difficulties or inability to orgasm; or you may have issues relating to sexual abuse you've experienced in the past. Ideally, talking to a counsellor who understands psychosexual issues is a good starting place for both couples and individuals.
Difficulties having intercourse
Some women have difficulties with penetrative sex, and may never have been able to, even if they really want to. As well as the physical condition vaginismus, which causes difficulties with penetration, you may be experiencing: an inability to become aroused; dryness and lack of lubrication; an inability to achieve orgasm (anorgasmia); or dyspareunia, which means pain on intercourse. Both men and women can experience pain through intercourse. Women can experience pain when they are not fully aroused and penetration takes place. Some sexual positions can involve deeper penetration and can be painful. Medical conditions such as pelvic infections, surgery and childbirth injuries can also cause pain. Men can experience pain on intercourse if their foreskin is tight (phimosis). Women may have previously been able to have penetrative sex but find that difficulty in penetration has developed after an event such as a traumatic childbirth. This can be extremely distressing for both you and your partner. All these conditions can be benefited by psychosexual therapy by learning how to relax, learning about giving and receiving sensual pleasure and making sex more erotic.
Difficulties in having intercourse can be a topic that many people are hesitant to discuss. If the cause is not physical, it may be due to stress, anxiety, concern about sexual performance, marital or relationship problems, depression, feelings of guilt, or the effects of a past sexual trauma. By talking about some of these issues you, could help to reduce your problems with intercourse.
Compulsive sexual behaviour
Sexual addiction is something that some people find hard to take seriously and cannot understand how this can manifest itself in a relationship. However, if your partner cannot ever seem to be satisfied with the frequency of sex, and the actual physical act seems to bear little or no difference to their needs, you may begin to realise that there is a problem that cannot be just a "high sex drive". If you are affected by this addiction, it can lead to many other difficulties in other areas of your life. This behaviour can involve constant masturbation, porn browsing, secrecy around spending, and putting yourself in extremely risky situations to satisfy a desire that is rarely fulfilled. You may find yourself losing your job through this, as well as ruining your relationships, getting into debt and becoming socially isolated. It is important to realise that, like any addiction, the compulsion is rarely static and often escalates as your needs are never fully met.
You can find out more about symptoms and causes of Sexual Problems
, including how to find a therapist. If this route is not appropriate for you, your GP can assess you and direct you towards support.