Judith Parizer Adler, LCSW

Sex Therapy and Psychotherapy serving Fairfield and Westchester

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Common Sexual Concerns

Some common concerns that can be resolved:

Building Intimacy:
Intimacy is a continually developing sense of closeness between partners. Emotional intimacy and physical intimacy are vital parts of any healthy relationship. Intimacy requires clear, effective and constructive communication. When a couple communicates constructively, both partners feel better about themselves and their relationship. Using communication to resolve sexual concerns builds intimacy between partners, and, in turn, greater intimacy allows for a more enjoyable sex life. This healthy cycle is self-reinforcing.

Decreased Anxiety and Greater Enjoyment:
Anxiety, greater enjoyment and comfortableness with one's sexuality are all closely related. Anxiety stems from unresolved psychological or physical problems. Solving the underling problem, either as an individual or as a couple, will open the door for decreasing anxiety, and accordingly, greater enjoyment. Similar to self-reinforcing intimacy, decreased anxiety and greater enjoyment build upon each other. Comfortableness with one's own sexuality is an integral part of this process that anyone can work towards.

Life Changes:
While some sexual difficulties stem from life-long psychological or physical difficulties, others commonly develop in response to life changes. Life changes such as job stress, grief, child birth, relocation or retirement can cause dramatic changes in sexual functioning. Depression, various medical conditions, medication use, a change in a relationship, or aging can all also have a major impact on one's sexual health. An individual's history and experiences with sex furthermore influence sexual adjustment and styles of expression.

Absent or Low Sexual Desire:
A very common complaint that can become a serious personal or relationship problem is the lack of sexual desire or even the avoidance of sexual situations entirely. This problem may reflect a difference between the desired frequency of sexual contact between partners, or it can come from such diverse sources as serious physical problems, hormonal deficiencies, relationship problems, past sexual trauma, past sexual pain or negative feelings about sexuality. Left unaddressed, differences in sexual desire between partners can often cause bad feelings and tension. Correctly diagnosing this problem is key to having a healthy sexual relationship.

Sexual Fears and Avoidance:
Sexual avoidance can be the result of anxiety about sex, pain associated with sexual contact or serious relationship concerns including abusive or coercive behavior.

Sexual Arousal for Men:
The most common problems for men are achieving and maintaining an erection. Popular treatments such as Viagra may help, but can also mask relationship or physical problems that should be addressed in order to have a more fulfilling sex life. These problems have in the past been under diagnosed, discounted as unimportant, or inadequately treated. As with all difficulties, problems with achieving and maintaining an erection can be devastating and deserve a good diagnostic understanding before attempting treatment.

Sexual Arousal for Women:
In women, arousal problems are often manifested as a lack of lubrication. Lack of lubrication arises from a number of physical and interpersonal causes and can often be treated. Using artificial lubricant may allow penetration, but as with Viagra, it may mask underlying problems.

Achieving Orgasm for Men:
Orgasm difficulties have tended to be labeled a women's "problem" as the erectile problems have been labeled a man's "problem." However, with today's erectile medicine, there are an increasing number of men reporting delayed or absent orgasm. In addition, ejaculating too quickly (Premature Ejaculation) is a common problem that affects men's sexual functioning. Although there are medical treatments and causes of early ejaculation, there are also many non-physical causes such as anxiety and learned negative sexual patterns.

Achieving Orgasm for Women:
If you have never experienced an orgasm, you are not unusual. Approximately 15% of the female population in the U.S. is anorgasmic. Experiencing an orgasm does not have to be elusive. Through the processes of establishing comfort and permission giving, education, and at-home exercises, you will be able to change the quality of your sexual experience. Orgasm difficulty is often a side effect of various medications, problems in relationships or may be lifestyle related.

Painful Intercourse:
Pain felt at the opening of the vagina or within the vagina can be caused by physical problems, emotional concerns, or both. For example, a variety of inflammatory conditions which can be difficult to diagnose are sometimes prematurely attributed to emotional causes, although the emotional stress of these conditions often requires attention as well. Pain felt deeper inside the vagina is more often due to internal gynecologic conditions. A detailed history and careful physical examination are needed to better understand the components involved in painful intercourse. A treatment plan should include all these factors.

Sexual Traumas:
Both open and hidden (or subtle) sexual abuse can interfere with the development of healthy sexual responses or behaviors. These unfortunate circumstances can lead to a decreased interest in sex, being unable to enjoy sex, feeling inadequate as a lover, becoming turned-off during intimate moments, or hiding or flaunting your body. It is possible to learn how your sexual experiences have interfered with your healthy sexual energy in your intimate life.