What are sexual problems?

For some people, the idea of talking about sex is embarrassing, let alone opening up about it when things aren’t going so well. However, a recent survey suggests that 15% of men and 30% of women are affected by some sort of sexual problem, whether that be difficulty getting aroused, climaxing or a lack of interest in sex completely.

According to a Relate survey, when asked whether they thought their sex life was good, one in three people said they weren’t sure. Perhaps our society’s focus on sex, and (sometimes seemingly absurd) media ideas about ‘how to have great sex’, have made it very difficult for people to judge their subjective, personal experience without having a benchmark to set it against. This is a problem, as people can feel confused and unwilling to talk about their problems openly, and perhaps even feel that there is something wrong with them. 

Sexual desire naturally fluctuates at different times of your life (or your month, week or day for that matter), but if a problem has persisted for three months or more it is worth talking to someone about it, especially if it is having a negative impact on other areas of your life, such as your relationships, mental and/or emotional health and sense of self. There is no need to feel ashamed or self-conscious, and the right person listening, professional or otherwise, will ensure that you do not.

What are the most common sexual problems?

(The following statistics are taken from the 2012 Sex Census)

• Difficulty reaching orgasm is the most common problem in women (28%)
• 16% of women said they struggled with a lack of sexual desire
• 12% of women said pain during sex, also known as dyspareunia, was their biggest sexual problem
• 15% of men struggle with premature ejaculation
• 10% cite erection difficulties
• 8% experience a lack of sexual desire
• Tiredness, low body confidence and low self-esteem were ranked as having a big impact of the sex lives of both men and women

What might cause sexual problems?

Though sexual problems often manifest themselves similarly in people, the reasons they occur can be as individual as the person they affect, and there may seemingly be no reason for them at all. Though sexual problems are most often associated with older age, and this is the age group most likely to be affected, sexual problems can beset people of any age. Once age is taken out of consideration, the most likely causes for sexual problems were mental health issues, such as depression, and poor physical health.

Physical factors

There are certain health conditions that may cause erectile dysfunction in men: heart disease, diabetes, high blood pressure, raised cholesterol levels, and low testosterone levels. Hormone disorders are a common cause of lack of sexual desire in women.

The use of drugs (recreational and prescription), consumption of alcohol and smoking can also cause erectile dysfunction in men.  Substance abuse and addiction entails many complicated facets, including causing or exacerbating mental health issues and causing rifts in relationships, all of which can have a negative impact on the sex life and attitudes of both men and women.

Pregnancy, birth and the menopause are all life events that may have an impact on the sex life of women.

Situational factors

A change in circumstance can create stress which has a potential knock on effect on a person’s or couple’s sex life. This could take the form of redundancy, retirement, financial stress, having a baby, moving home.

Depression

Sexual desire is cultivated in the brain, and if you are experiencing depression at this stage of your life, your brain is not likely to be the friendliest, most supportive place, never mind the energy and motivation-sapping nature of depression and what that can mean for your sex life. Being open with your partner about how you feel, or indeed about your lack of feelings and desires as may be the case, is important as it will go some way to helping you both be patient and understanding about the situation. It’s very important not to beat yourself up, be self-compassionate, and seek professional help when/if needed – whether your lack of sex drive is a symptom of your depression, or whether it has become the very thing exacerbating your low feelings. 

Sex anxiety

Those struggling with sex anxiety, or sex performance anxiety, may struggle to relax or enjoy sex as they are preoccupied with worries about their appearance and/or performance. Arousal and sexual satisfaction is as much an emotional and psychological response as it is physical, so experiencing high levels of anxiety during sex can naturally have a damaging effect on your sexual experience. Stress and anxiety during sex can affect both men and women. Talking about your worries with your partner, and considering talking to a professional about it, is a good first step to resolving the issue and moving towards a happier relationship with sex.

Pornography

The frequent use of pornography can have a harmful effect on a person or couple’s sex life. Becoming aroused by unrealistic representations of sexual behaviour has the potential to influence a person’s attitude and expectations about sex. In relationships, one person’s excessive use of pornography can create a rift, with the other party feeling replaced, or that their partner no longer finds them attractive. This can cause a situation where one person feels that some form of trust has been breached, which can require effort and determination to repair.

The internet has certainly changed the landscape of pornography. At younger and younger ages, people are able to easily access porn, often creating anxiety in young people, both male and female, about how they are meant to behave in sexual situations, which they may not have even come across in their real lives at that point.

Sex addiction

If you have a high sex drive, particular fantasies and/or many partners, this does not necessarily mean you have a sex addiction. Sex addiction is used to describe sexual behaviour that feels out of control. If a situation is out of your control, it has the potential to cause harm to yourself, to your relationship, or other aspects of your life, such as your family or work. 

As is common with most addictions, sex addiction is characterised by a need to get a ‘high’, often followed by feelings of shame or guilt. Someone with a sex addiction may find that they have begun to neglect other commitments in favour of satisfying their sexual desires, that they are spending increasing amounts of time planning how and where to get their next fix. If you believe that your behaviour has reached a point that you foresee potential negative consequences, and choose to continue regardless, you may need to consider whether your behaviour is symptomatic of an addition.

Trauma

Previous bad experiences involving sex, whether that means having been the victim of infidelity or abuse (in childhood or adulthood) or sexual violence, can make it extremely difficult to have a healthy relationship with sex. For some women, previous trauma may result in their having vaginismus, a condition characterised by involuntary spasms of the muscles that surround the vagina and consequently causing pain during sex. Whether or not you are experiencing physical symptoms associated with trauma, if you have had damaging past experiences associated with sex, there is much to be gained from seeking the help you deserve – this goes for men and women.

What is the impact of having sexual difficulties?

Experiencing sexual problems, whether in a relationship or single, can have a huge impact on a person’s life. Before reaching out for support, you might feel alienated, as though there is something ‘wrong’ with you. This can create a vicious cycle where sex becomes an extremely pressured situation and topic of conversation, further entrenching the barriers against getting help. The vast majority of sex problems are not only extremely common but also treatable. Some physical sexual problems are readily treated with medication. Other sexual problems, such as those arising from depression, other mental health issues, addiction and low self-esteem can be treated with the help of psychotherapy.  

How can counselling help with sexual problems?

Many types of therapy can effectively deal with the mental health difficulties that may cause sexual problems, but you could also visit a sex therapist, who will be specially trained in the area. Sex therapists may employ various different types of therapy style within their practice. Some may use CBT techniques, which means they might suggest exercises for you to do, such as making note of the moment when you felt anxious and trying to identify the thought that accompanied the feeling. Others will use a person-centred or psychodynamic approach, both of which are focused on listening to the client and encouraging them to see that they have the power to make positive change in their lives. Others might use an integrative approach, meaning they draw from various therapy styles. You can learn more about each individual sex therapist's style by reading their profiles on welldoing and contacting them to find out more. You can use our questionnaire to find the right person for you.

Sex therapy is considered a highly effective form of treatment for sexual dysfunction. Psychosexual therapists are experienced in working with a wide range of sexual problems, and you can visit them alone or as a couple.

Relationship counselling may also be worth considering if the sexual problems experienced within a couple have had an effect on other areas of life and it has become difficult to untangle them and communicate helpfully. 

Find a psychosexual or couples therapist here

Last updated 16 March 2016