9 Sex Therapists Reveal The Most Common Problems And What Advice They Usually Give.

Sex therapists of Reddit were asked: "What are some of the most common problems you see and what can you do to solve it?" These are some of the best answers.

1/9 A lot of people came in with intimacy issues because they had grown up learning great shame when it came to sex. A few women hated themselves after their first sexual experience because they learned their body was this great temple and after they had sex, it was ruined.

These were pretty difficult, and one of the therapists I worked with said to one couple, "You believe God meant for you two to find each other, right?"
"And you feel your relationship is divinely guided?"
"You are here today because God led two people together. It was love that brought you into this world and love that keeps you together. Intimacy is a display of this love, and you aren't ruined. Just as God shares his temple with those he loves, so can you share yourself with your partner."


2/9 All humans are equally insecure about their genitals; what they look like, what they do, how they smell, everything. A good third of the stuff I did was essentially reassuring people that they weren't abnormal/someone was going to laugh at them when they got naked.

Another biggie? The confessions you get of wrongdoing and sheer stupidity when someone is afraid of being pregnant or having an STI is staggering. They're all people who have an awareness of things like contraception, but either don't know all the facts or just plain ignore them. Most of these involve me trying to diplomatically suggest that they use the scare to actually use condoms consistently, and maybe get tested if it sounds like they have due cause.

The most common thing though was pretty clich and so is the response, I'm afraid. "My SO wants to do this, but I'm not sure/uncomfortable..."

"I hate it when my SO does this, how can I..."

"My SO won't do this, how do I..."

Yaddah yaddah, you get the point.

The solution? TALK.

My mind boggles how people are more comfortable at someone manhandling their genitals, regardless of their enjoyment/sense of safety, over talking about them. If you can't talk about what you're doing with a partner honestly without fear of mockery/causing offence, you shouldn't be doing anything with them, if you should be with them at all.


3/9 I worked only with teens but the problem I inferred from the way they spoke about sex was that they didn't feel confident standing up for what they wanted or needed from sex.

If the guy didn't want to use condoms, they didn't. If the guy wasn't interested in her orgasm, she didn't have one. The girls wanted to have boyfriends and it seemed like they thought that meant having to have sex on the guy's terms, whatever they were.

I encouraged them to demand respect and to ask their partner for what they wanted.


4/9 A lot of problems couples have in bed result from unrealistic ideas about how "good sex" should be. For example, there was this one guy who told me he suffered from premature ejaculation. He was afraid that his girlfriend who he was dating for about 2 months would leave him because of it. He was pretty reluctant about details, so I started questioning him about previous relationships. I was pretty surprised that he never considered his stamina a problem before, so I talked to his girlfriend. As I asked her about how long her boyfriend would last, she told me in an embarrassed and desperate manner: "You know, he always finishes after only 25 minutes or so."


5/9 The most common theme I see in practice is people not communicating openly and honestly. The fix is simple-- talk to each other.


6/9 Elderly couples. Bringing the spark back into their sex life, what to do when certain abilities start to go, etc. The most common advice I saw given was to stop scheduling sex and initiate whenever passion struck. If there was a physical barrier, such as a lack of lubrication on the lady's end, or ED, using alternate methods of intimacy was advised. You wouldn't believe some of the kinks some of the older folks devised!


7/9 Sexual dysfunctions (like premature ejaculation, erectile dysfunction, sexual pain etc.) are the most common problems. The standard treatment for these (if the cause of the problem is not biological) is sort of a "reprogramming" of the couple's sexuality. It's called Sensate focusing by Masters & Johnson. The convenient thing about this method is, that you can adjust it to almost any sexual dysfunction and every couple's needs. Depending on the dysfunction, specific exercises can be added, for example the start-and-stop technique for premature ejaculation, dilators for vaginismus or masturbation training for anorgasmia. One reason why sensate focusing works really well is that in comparison to other psychological treatments it's actually pretty fun.


8/9 A lot of older men come in requesting Viagra because they want to start dating again; Some of them have lost their wives, some of them have had recent divorces. These men haven't been able to achieve an erection in quite some time. They get nervous when their friends set them up on dates, they believe the new women will not find their impotence attractive, so they think Viagra is the answer.

I always inform them of the side effects and tell them to take it easy at first if they aren't used to having sex. Regardless, at least once a month, it never fails, a man will show back up at my office on Monday, with his arm in a sling. I ask them "Mr. Smith, what seems to be the problem?" and they tell me, "My date didn't show up."


9/9 Abuse. This is easily the most common issue I observed. Both men and women come in with their partners having endured some sort of sexual abuse in the past that their current sex life triggers. A combination of standard therapy and relationship compromise usually helps this. (Eg. A woman is triggered by giving blowjobs, her husband is upset by this. Helping her overcome her past as well as finding other forms of intimacy that are not triggering are primary goals).



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