By Emma Mathews, Psychosexual and Relationship Therapist
Sexual problems can be incredibly hard to talk about, and a lot of thoughts, feelings and desires around sex can be left unsaid. Because of this people often develop beliefs and assumptions surrounding sex which can cause confusion and anxiety. For example, “sex…this is something that I should just be able to do, right?”, “everyone else manages it just fine” “there’s something wrong with me”, “I’m inadequate”, “I’m not sexy”, “I don’t really know how I feel about sex”, “I don’t know what to do to make me or my partner feel good”, “it’s just so awkward”, etc.
Well, here’s news, you’re not alone!
Lots of people feel these same pressures. Having asked hundreds of clients about how they learned about sex, it appears that sex education received at school is mainly biological (if you received any education at all), delivered by teachers who feel unprepared and sometimes a bit embarrassed, and school sex education is not usually focused on helping you though the emotional side of sex, issues with your own self-image, your beliefs around how your genitals should look or behave, or focussed on the fact that sex can be whatever you want it to be.
I’m often asked about what is normal. There is no normal. The individuals and couples I provide sex therapy for are frequently hung up about what sex should be, and how often they should be doing it. Many people believe that sex should end in some attempt at a part of one person’s body (penis) being put into another person’s body (vagina, anus), for a certain period of time, with thrusting movements, until both are left in some state of mind-blowing ecstasy (like in the movies).
Let me enlighten you… this is not true, and so long as you believe this myth, you’ll potentially end up anxious, disappointed, feeling inadequate, feeling as though you’re doing it wrong, or not having “proper sex”.
Pornography is a massive problem in terms of expectations and also perpetuating myths about sex. Pornography is a billion-dollar industry. Men have rock hard erections that last for ever and their partners have orgasms that are well up there on the Richter scale. Women have neat, tidy, hairless genitals with seemingly absent labia. No wonder people are confused and feel they’re not doing it right, and no surprise that both men and women are developing high levels of body dissatisfaction.
Sex is a two-way interaction, and a discovery. No two couples’ sexual relationship is the same, which is wonderful and what makes us unique and sex exciting. It’s a process of learning, together, what works and “does it” for you in that particular relationship. Communication is absolutely vital. What worked with an ex-partner is unlikely to work with your current or next partner. So, if a current partner communicates that what you’re doing isn’t quite their “thing” don’t take offence, it’s not about you “doing it wrong” ask what they do like, we all have our own sexual preferences and templates. Sex is a journey, some journeys you may not choose to repeat, other journeys you may enjoy and wish to keep on exploring…this is all okay.
And just to bust a few myths…
Men do not usually keep erections throughout foreplay, they come and go depending on focus and attention, if a man is focusing on their partner’s pleasure for a time and there is no direct attention in terms of stimulating them, then it’s quite normal for their erection to subside for a while… here’s the good news…it can come back, no need to catastrophise! “OMG…it’s gone, it’ll never come back, I’m damaged, I’m not good enough, etc.”
Only about 30% of women reach climax through penetrative sex.
Sex can be good and normal however often it happens, whether it is once a year or several times a day.
It is extremely rare for a couple to reach climax simultaneously, if it happens it’s usually a fluke and you’ll certainly be very disappointed if you aim for this every time.
Intercourse, whatever form that takes - penis in vagina, penis in anus, is NOT better than outercourse, i.e. no penis in any orifice sex, for example mutual masturbation, oral stimulation or using a sex toy. It’s all sex and if it feels good, do it, it still definitely counts as sex.
Sometimes sexual appetite and ability changes, for example after you have a baby, or as you get older. Hormonal changes and life changes can alter your libido, as can changes to your mental health.
When couples transition to parents, many changes happen. Whilst sex may have previously been more spontaneous, now opportunity, lack of sleep and the responsibility of parenthood can make sexual intimacy more tricky. Breasts, an erogenous zone for many women often take on a new role. Vaginal lubrication can decrease due to the hormonal changes during breast feeding and depending on the type of birth you experienced you may also have a different relationship with your genitals or have concerns regarding pain.
As women get older and approach the menopause they can start to worry that their sex drive has decreased and they may also experience physical changes, such as changing body shape, reduced energy, vaginal dryness, hot sweats, etc. They can start to feel anxious that their libido has changed and feel sad that they are not the woman they once were. This can impact on self-esteem and brings worries about their relationship and the future.
As men get older the same problems can also happen. Libido can reduce, it may be more difficult to keep an erection, this can also impact on self-esteem, sense of masculinity and brings worries about the relationship and the future.
The Sexual Wellbeing Clinic team offer treatments for both the physical and psychological aspects of sexual problems. Often sexual problems seem to be physical, as people experience physical symptoms, for example pain or loss of erection. However sometimes there is also a psychological aspect that maintains the problem, for example ‘performance anxiety’ or fear. Even if the sexual difficulty is purely physical in nature, the problem may have impacted on your sexual relationship, you may wish to discuss this and be given strategies on how to get things back on track, re-establish and renegotiate the sexual side of you.
The team also offer support and treatment for the physical and emotional changes relating to menopause. A 2016 survey conducted on behalf of the British Menopause Society found:
- 50% of women did not consult with a healthcare professional about their menopause symptoms
- 50% of women reported the menopause had impacted negatively on their sex lives
- 45% of women reported that menopause symptoms had impacted negatively on their work life
- 36% of women reported that menopause symptoms had impacted negatively on their social life
- 38% of partners reported feeling helpless and not knowing how to support their partner through the menopause
At the Sexual Wellbeing Clinic, we ensure that people who come to us with a sexual difficulty or menopause symptoms experience a smooth, multi-professional approach to care, and are able to access consultation, ongoing appointments, and medical interventions from a team of experienced professionals who are able to address and advise on the medical, physical, emotional, relational and psychological aspects of the problem.
Who is on the Sexual Wellbeing Clinic Team?
Psychosexual Therapy: Emma can also offer a comprehensive range of treatments for psychological problems, see the following link for further details
Gynaecology: Ash can also offer a comprehensive range of treatments for gynaecological problems, see the following links for further details
Urology: Ian can also offer a comprehensive range of treatments for urological problems, see the following link for further details