Lawrence Siegel

Guest Blogger Larry Siegel is a Clinical Sexologist and Sexuality Education Consultant who is on the faculties of several colleges and universities.

by Lawrence Siegel, Clinical Sexologist, MA, AASECT

For most of us, a thorough understanding of our sexuality was not one of the things we got from our parents or learned in school. Even the rare few who did get the basics—a “plumbing lesson,” pictures of nasty STDs, or warnings about the perils of pregnancy—were found wanting, as this is not a substitute for actual sex education.  Due to growing up in this kind of a vacuum, most people have a hard time dealing with sex-related issues when they do arise; and it is inevitable that they do. 

Virtually everyone will experience some type of sexual issue at some point in their lives, especially as they age.  Men will occasionally be unable to get an erection when they want one, and at some point will ejaculate more quickly than they want.  There are times when a man will not be able to ejaculate at all, or lose his erection after a time, or even go through periods where there is little to no desire for sexual activity. 

For women, the same holds true.  Most women will find, at some point, that there will be lapses in desire, an inability to orgasm, and difficulty becoming aroused – either physically (eg, vaginal wetness, clitoral erection), or emotionally (“turned on”).  Of course, we must also add in relationships, parenthood, menopause, illness, disability, trauma, and the everyday stresses of life to the equation.  It’s a wonder there are any sexually functioning people at all! Don’t despair…there is hope.

Let’s be clear: not every sexual issue warrants a trip to a doctor or therapist.  Can a man experience erection problems without having erectile dysfunction? Yes!  Can a woman lack any desire for sex without having hyposexual desire disorder?  Absolutely!  As stated, virtually everyone will experience some issue with their sexual performance at some point in their lives, but “issue” is not the same as “problem.” 

If an issue persists with regularity, then it might be a good idea to seek professional help.  Certified Sex Therapists and Counselors are mental health and medical professionals that are extensively trained to deal with all manner of sexual problems (and issues).  Neither one has any type of sexual contact with their clients and patients (that particular type of individual would be called a Sexual Surrogate, and would not be legal in some states.)

So let’s get real, because all sex is not about fantasy.  The following are some of the most common, real-world reasons that people seek sex therapy to improve their lives:

Loss of Desire Desire has many faces; so, then, does lack of desire.  Some experience a loss of desire to initiate any sexual activity with their partner but will be responsive to their sexual advances.  Others lose a specific area of desire, like lacking desire for one partner but still having desire for others.  There are still those that have a complete lack of desire for any type of sexual contact at all, neither initiating or being responsive.  Lack of desire can be experienced by both men and women and present problems in the relationship, especially if not addressed.

Too Much Desire All too often, we hear proclamations, especially by celebrities, that their sexual desires are out of control.  The truth is, some people simply have a sex drive that is significantly higher than most.  That, in and of itself, does not represent a problem.  However, if you find that you are truly worried about your sexual behavior; if you find yourself taking risks that could cost you (physical health, relationships, status) or that you feel unable or afraid to stop a particular behavior, this is NOT a sign of an addiction but, rather, that you need help regaining control of your sexual urges (and unless you have actual brain trauma, you can control them).  This is also something best worked on with a sex therapist.

Erection Problems I’m sure everyone has seen or heard numerous ads for “ED,” or erectile dysfunction.  Occasionally, men will find it difficult to achieve or maintain an erection. If it is occurring more than occasionally, sex therapy is the primary treatment, whether in conjunction with medical or medication treatment, or by itself. 

Orgasm and Ejaculation Problems – People experience orgasm quite differently in frequency, intensity, and variety.  Still, others do not experience orgasm at all.  When this is both persistent and distressing, sex therapy can provide a number of tools and techniques to rediscover and reconnect with your erotic self.

In men, we generally see one of two types of ejaculation problem:  rapid ejaculation or delayed ejaculation.  Rapid ejaculation, formerly called “premature ejaculation,” occurs when the man ejaculates very quickly, before he has a chance to penetrate or his or his partner’s satisfaction (intentional “quickies” don’t count).  It often is a source of shame and is the most common sexual problem among younger men (under 40).  Sex therapy techniques have a remarkable rate of success in dealing with early ejaculation, whether it happens once in a while or frequently.  Delayed ejaculation, on the other hand, is when the man is unable to ejaculate, to reach that “point of no return.”  Again, sex therapy can provide tremendous benefit to these men.

Sexual Pain As many as 30% of women experience some type of pain or discomfort during or after sexual intercourse. The causes of sexual pain can be numerous and varied, from lack of arousal and wetness to infection and illness.  Women who experience pain or discomfort in their labia, vagina, or pelvic area should talk with their doctor to identify a medical cause.  A sex therapist can help deal with the psychological and emotional aspects often associated with it.

Anyone who does experience a persistent sexual problem should seek help from a qualified professional.  In addition to the multitude of health and wellness benefits that result from good sex, sexual problems can also be the first sign of more serious health issues that may otherwise go unnoticed.  For example, persistent erection problems in men can be the first sign of cardiovascular disease and a lack of sexual desire in women may indicate a problem with her thyroid gland.  Maintaining good sexual health and enjoyment is not only good, it’s good for you!  To find a sex therapist or counselor in your area, go to

Guest Blogger Larry Siegel is a Clinical Sexologist and Sexuality Education Consultant. He is the founder and Director of the Sage Institute for Family Development, a non-profit training and counseling center in Florida. Larry sits on the faculties of several colleges and universities and is nationally recognized as a leader in the fields of sexuality, sexual development, sexual pharmacology, and medical sexology.  For more information on his programs and training, visit the Sage Institute and the Modern Institutes for Sex Therapy Training.