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The 4 Most Common Problems Sex Therapists See—and How to Solve Each

If something went wrong with your health, house, or job, you’d take the proactive step of finding the right specialist to help you tackle it. But a problem with your sex life? Out of awkwardness or because you don’t know where to turn, you’re more likely to play it down and hope things magically get better.

But you do have resources, like a sex therapist—a professional who helps people find out what’s holding them back from sexual fulfillment. There’s no reason to feel embarrassed in front of these experts, because they’ve seen it all. “As a sex therapist who treats adult individuals and couples, I see a myriad of presenting issues,” says Jennifer Wiessner, who is based in Maine.

If there’s an issue in your bedroom but you’re not quite ready for a therapy session, you’re in luck: We’re bringing the sex therapists to you. Here, they lay out the four most common issues people seek help for, plus the simple fixes for each.

Low desire keeps sex from happening

Rarely in the mood to get it on? You’re not alone. According to Wiessner, up to 40% of women report feeling low desire—and about half of them feel guilty for it. One common cause of a sunken sex drive? Medication.

Certain antidepressants, as well as “the birth control pill, antihistamines, and opiates can greatly impact a woman’s ability to connect to arousal and desire,” says Wiessner. “Weighing the pros and cons with your provider and exploring alternative options such as an IUD for birth control, a different antidepressant, or another pain management option may help resurrect desire.” Medical conditions can also result in a lower libido, so if a drug isn’t behind your low libido, see your doctor for a checkup.

Another possibility: Nothing is actually wrong with your sex drive—you might simply be expecting the same rip-your-clothes-off sex you had in the early months of your relationship. “Real life isn’t like the movies, which portray sex as hot, spontaneous, unprotected, and orgasmic every time,” notes Wiessner. “This sets people up for feeling deficient when in reality, it’s normal.”

The sex is routine and boring

No matter how much you love brownies, if you had them for dinner night after night, you’d eventually start craving something else. It’s the same with sex, says Ian Kerner, PhD, a New York City-based sex therapist. A desire for novelty and adventure is something his clients frequently talk about.

“Couples generally develop a sex menu with a set list of items that appear on it,” he explains. “For many couples the sex menu is very intercourse-focused. It might not have enough appetizers in the form of foreplay, or all the activities on the menu are purely physical and there isn’t enough of a psychological dimension, like talking in a sexy way during sex.”

When partners don’t find something they really want on the menu, they can feel less satisfied by sex. If this is the case, Kerner asks clients to first talk through their sex menu with him. “I’ll literally say, ‘Tell me about the last time you had sex,’ and I’ll ask them to walk me through what happened.”

According to Kerner, this is when tons of couples admit that they don’t engage in much foreplay but simply get undressed and go right to intercourse. “Well no wonder the female isn’t orgasmic and no wonder it’s hard for him to ejaculate,” he tells Health. “The sex menu is lacking in foreplay, psychological stimulation, and clitoral stimulation.” Womp womp.

The key is to craft a sex menu with your partner that serves up a few delicious courses for both of you. To do this, talk openly about the things that turn you on so they know what will rock the bedsheets.

There’s not enough time in the day to have sex

It can be hard to feel sexy when you have to pack kid lunches, answer work emails, and pay the bills all before bedtime. “With work being a call or text away 24 hours a day, with high expectations and low support for working mothers, financial worries, parenting challenges, and minimal time for self care, women report being ‘in their head’ and feeling disconnected from their bodies,” says Wiessner.

You can’t abandon all your job and family responsibilities, but you can dial some of them back and spend the time alone with your partner—catching up on TV shows, working out, or just de-stressing and relaxing. That’s likely to lead to more (and better) activity in the bedroom. Female clients who do this “generally notice improvements in connecting to their desire,” she says.

You’re having sex, but you’re not connecting

“Desire tends to be in sync at the start of a relationship, but discrepancies can arise as time goes on—and things like age differences, health issues, and varying lifestyles start to matter more,” says Kerner. In this situation, both partners desire sex, but they’re not on the same page at the same time.

Kerner encourages clients to engage in lots of foreplay, which turns up the heat and gets both partners fully aroused. “That could be making out and fooling around, experimenting with massage, or reading erotica together,” he says. Couples can also consider scheduling sex. If you know when you’ll be having it, you can do things to prime yourself and get in a sexy mood, so you’re in the same mindset.

No matter what the issue is, however, both partners should also remember to be empathic and patient with each other, says Kerner, or else resentment can creep into their relationship and fray their bond.

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