Skip to main content
Sexual health Condition

Sexual difficulties

Sexual difficulties encompass a wide range of concerns relating to sexual function, desire, pain and satisfaction that cause personal distress or relationship difficulty. They are extremely common across genders and life stages, yet rarely discussed. Psychosexual therapy provides effective, confidential specialist support for the full range of sexual concerns.

See therapies that may help

What is Sexual difficulties?

Sexual difficulties include: desire disorders (low libido, absent desire); arousal disorders (difficulty with physical arousal, erection, lubrication); orgasm disorders (difficulty reaching or reaching too quickly); pain disorders (dyspareunia, vaginismus); and concerns relating to sexual identity, behaviour or relationships.

Sexual difficulties are common — studies suggest that a significant proportion of adults experience some form of sexual difficulty at any given time. They cause significant personal distress and relationship impact and are significantly underreported and undertreated. The near-universal silence around sexual difficulties creates a false impression of rarity and prevents people from seeking the support that is widely available.

Signs and symptoms

Sexual difficulties may include any of the following causing distress or relationship concern:

  • Persistent low or absent sexual desire
  • Difficulty with physical arousal — erection, lubrication or engorgement
  • Difficulty reaching orgasm or ejaculating too quickly
  • Pain during or after sexual activity
  • Avoidance of sexual activity due to anxiety, fear or past experience
  • Significant distress about sexual identity, behaviour or relationship
  • Impact of health conditions, medications or life events on sexual function

How therapy can help

Psychosexual therapy is the specialist approach for sexual difficulties:

  • Psychosexual therapy (COSRT-accredited) — combining psychological exploration with structured behavioural approaches tailored to the specific difficulty; includes sensate focus and graduated exposure techniques; may be individual or couples-based
  • CBT — for sexual difficulties with significant anxiety, negative beliefs or avoidance
  • Mindfulness-based approaches — building present-moment sensory awareness and reducing spectatoring
  • Medical assessment — important for difficulties with potential physical contributors (hormonal, medication-related, vascular, neurological)
  • Couples therapy — for difficulties embedded in relationship dynamics and communication

Seeking help

COSRT (College of Sexual and Relationship Therapists) can help find accredited psychosexual therapists. Your GP can provide medical assessment and referral to NHS psychosexual services where available. Brook (for under 25s), sexual health clinics and Relate all offer sexual health and wellbeing support. You do not need a specific diagnosis to seek psychosexual therapy — any sexual concern causing you distress is a valid reason to seek support.

Therapies that may help with Sexual difficulties

Showing 16 therapies linked to Sexual difficulties.

Therapy Evidence Notes
Cognitive Behavioural Therapist
strong

Core use for sexual difficulties.

Counsellor
strong

Core use for sexual difficulties.

Psychotherapist
strong

Core use for sexual difficulties.

Relationship Therapist
strong

Core use for sexual difficulties.

Sex Therapist
strong

Core scope; assess psychological + relational + physical factors.

EMDR Practitioner
strong

EMDR for sexual difficulties with trauma.

ISTDP Practitioner
strong

ISTDP for sexual difficulties.

Mindfulness Practitioner
strong

Mindfulness for sexual difficulties.

Arts Therapist
moderate

Arts therapy for sexual difficulties.

EFT Practitioner
moderate

EFT for sexual difficulties.

Havening Techniques Practitioner
moderate

Havening for sexual difficulties.

Hypnotherapist
moderate

Used for a range of sexual difficulties.

Matrix Reimprinting Practitioner
moderate

Matrix reimprinting for sexual difficulties.

NLP Practitioner
moderate

NLP for sexual difficulties.

Regression Therapist
moderate

Regression therapy for sexual difficulties.

Though Field Therapy Practitioner
moderate

TFT for sexual difficulties.

Frequently asked questions

Do I need a diagnosis to see a psychosexual therapist?

No — you do not need a specific diagnosis to seek psychosexual therapy. Any sexual concern that is causing you distress or affecting your relationships is a valid reason to seek support. A psychosexual therapist will assess and formulate your specific situation in the initial sessions.

Is it normal to have sexual difficulties?

Yes — sexual difficulties are extremely common. Studies consistently show that a significant proportion of adults experience some form of sexual difficulty at any given time. The silence around sexual health creates a false impression of rarity. Most sexual difficulties are treatable, and seeking support is entirely appropriate.

Will psychosexual therapy involve physical examination?

No — psychosexual therapy is a talking therapy. It involves psychological assessment, discussion and structured exercises or assignments to complete outside sessions. Physical examination is a medical function performed by GPs or specialists, not by psychosexual therapists.

Can sexual difficulties be caused by mental health conditions?

Yes — depression, anxiety, PTSD, body image difficulties and other mental health conditions frequently affect sexual function and desire. Treating the mental health condition often improves sexual difficulties. In some cases, sexual difficulties are primarily maintained by mental health factors that respond better to general psychological therapy than to psychosexual therapy specifically.

How confidential is psychosexual therapy?

Psychosexual therapy is fully confidential, subject to the same confidentiality standards as all psychological therapy. Therapists accredited with COSRT or BACP work within professional ethical codes that protect client confidentiality. Information is only shared without consent in specific, legally defined safeguarding circumstances.