Some More on Sexual Issues 

I recently received a response to a post I made about sexual problems.  Rather than answer that specific response, I’d like to use the opportunity to address the issues that post and other people’s issues raise.  Sex is a big part of one’s relationship and so here are some suggestions:

If you and your partner are experiencing problems around sex, you should take a two-fold approach.  You should go to a therapist who is familiar with sexual problems and you should each go to your primary care physician to make sure that there is nothing medical involved.  The therapist and the doctors should have releases to talk to each other.  As a psychologist, I need to know that there is nothing medical involved in order to address the problem.

There are lots of medical problems that can affect sexual performance.  Many medications have side effects that reduce libido.  These medications include many antidepressants.  Other medical conditions like Type II diabetes have similar effects.  So does low testosterone and certain medical procedures.  High stress levels can reduce libido and attention as well.  So can aging.  Each of you in the relationship needs to know what’s going on with yourself, and with your partner.

There are other medical conditions which your primary care physician may be concerned about, and may want to refer you on to a specialist, such as an ob-gyn doctor for women or an urologist for men.  A person may experience pain during or after sexual intercourse for a variety of reasons.  As a consequence, the person may not respond to her/his partner’s overtures.  The result may be feelings of anger, frustration, and hurt on both sides.

If these or other medical problems are revealed, then you should work with your therapist.  You may have some expectations about the quality and quantity of sexual contact you expect.  You may have had that expectation from before you were together.  Now that you’re together, it’s not happening as you would like.  So, what happened to change one of you?  You have to be able to speak frankly to your partner.  Most of us don’t have the skills to do this well; we may do it at an awkward time, such as after sexual contact, or when rejected.  Couples might need a neutral ground with a referee and someone who understands what can be going wrong.  So, without getting into specifics, go get help and stop trying to figure this all out by yourself while the anger and hurt keep building up.

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