Sexual Therapy: A Solution for Sexual Problems Many Are Still Afraid to Talk About
Sexual problems are issues many people face but are reluctant to disclose, whether it’s concerns about performance, ejaculation problems, or pain during intercourse, which affect quality of life, relationships, and self-confidence. “Sexual Therapy” is an option that directly addresses these problems, especially physical issues that impact couples’ lives and mental health.
To help every couple live smoothly together, understanding sexual problems both physically and mentally, and knowing the appropriate therapy methods will help you regain complete sexual health and happiness.
What is Sexual Therapy?
Sexual therapy is a process of providing medical and psychological assistance to those with sexual problems. Its purpose is to help restore sexual function and improve quality of life. This therapy is neither shameful nor abnormal but an important part of health care that everyone should receive.
Types of Sexual Therapy
Sexual therapy approaches are divided into 5 main types as follows:
- Medical Treatment
- Use of medication to directly address problems, such as drugs to enhance sexual performance, hormone replacement therapy
- Medications to balance brain chemicals affecting sexual desire
- Pain relief or anti-inflammatory drugs affecting sexual activity
- Psychological Therapy
- Counseling to resolve psychological issues affecting sexual function
- Treatment for anxiety, stress, or depression
- Building confidence and a positive attitude toward sexual activity
- Therapy for psychological trauma from past negative experiences
- Physical Therapy
- Pelvic floor muscle exercises
- Massage to relieve pain and improve blood circulation
- Use of medical assistive devices
- Breathing and relaxation technique training
- Sex Education
- Providing accurate information about sexual intercourse and body functions
- Guidance on appropriate techniques and positions
- Teaching communication methods with partners about sexual needs
- Reducing misunderstandings and incorrect beliefs about sex
- Couples Therapy
- Counseling both partners to improve communication and understanding
- Resolving relationship issues affecting sexual life
- Building bonding and trust between partners
- Training in sexual techniques together
Who Should See a Sexual Therapist?
- Those with physical or psychological sexual problems affecting quality of life
- Married couples experiencing sexual life issues
- Those who have experienced unwanted sexual incidents
- Those anxious about sexual performance
- Those facing physical changes such as postpartum, post-surgery, or menopause
Common Physical Sexual Problems That Should Be Consulted with a Doctor
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Erectile Dysfunction
Erectile dysfunction occurs in both women and men. In men, it often involves insufficient erection or inability to maintain an erection during intercourse. In women, it may involve insufficient lubrication or inability to become aroused.
Common Causes
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- Diabetes, high blood pressure, or heart disease
- Hormonal imbalance
- Side effects from certain medications
- Stress, anxiety, or depression
- Smoking and excessive alcohol consumption
Treatment Approaches
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- Lifestyle and behavior changes such as exercise and adequate rest
- Medication therapy as prescribed by a doctor
- Hormone therapy in cases of hormone deficiency
- Psychological counseling to reduce anxiety
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Premature / Delayed Ejaculation
Premature ejaculation is ejaculation occurring shortly before or after penetration, generally within one minute, which is considered a problem causing dissatisfaction for both partners.
Causes of Premature Ejaculation
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- Anxiety about sexual performance
- Stress or relationship problems
- Abnormal hormone levels
- Lack of sexual experience
Delayed ejaculation is taking much longer than usual to ejaculate or inability to ejaculate despite sufficient stimulation, which may cause fatigue and disappointment for both partners.
Causes of Delayed Ejaculation
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- Side effects from certain medications, especially antidepressants
- Nervous system problems
- Low sex hormone levels
- Anxiety or psychological issues
Treatment Approaches
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- Start-Stop and Squeeze Techniques for premature ejaculation
- Pelvic floor muscle exercises (Kegel Exercise)
- Topical anesthetic medications to reduce sensation temporarily
- Adjusting or discontinuing problematic medications (under medical supervision)
- Psychological counseling and relaxation techniques
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Decreased Sexual Desire
Decreased sexual desire (Low Libido) is a common problem across all genders and ages, potentially causing gaps in relationships and dissatisfaction in couples.
Common Causes
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- Reduced sex hormones, such as Testosterone in men or Estrogen in women
- Stress and excessive workload
- Relationship problems and lack of communication
- Depression and anxiety
- Chronic diseases such as thyroid disease, diabetes
- Use of certain medications such as contraceptives, antidepressants
- Insufficient sleep
Treatment Approaches
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- Check and balance hormone levels
- Counseling for sexual and relationship issues
- Stress management and adequate rest
- Improving communication in relationships
- Exercise to increase energy and hormone levels
- Adjusting or changing medications
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Pain During Intercourse
Pain during intercourse (Dyspareunia) is a common problem in women but can also occur in men. It may cause fear of sexual activity and affect relationships.
Causes in Women
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- Insufficient lubrication
- Infections in the vagina or urinary tract
- Endometriosis or Fibroids, conditions where tissue similar to the uterine lining grows outside the uterus (e.g., ovaries, fallopian tubes, abdomen) causing inflammation
- Vaginismus (involuntary contraction of vaginal muscles)
- Hormonal changes, especially postpartum or menopause
- Scarring from childbirth or surgery
Causes in Men
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- Inflammation of the genital organs
- Peyronie’s Disease (abnormal curvature of the penis)
- Prostate infections
- Phimosis (tight foreskin)
Treatment Approaches
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- Treatment of infections with prescribed medications
- Use of lubricants or topical hormone creams
- Physical therapy such as pelvic floor muscle massage
- Psychological counseling to reduce anxiety
- Surgery if necessary, such as for Endometriosis or Fibroids
- Training in relaxation and breathing techniques
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Postpartum, Post-Surgery, or Menopausal Problems
Postpartum Problems Childbirth significantly affects a woman’s body and hormones, causing various sexual problems.
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- Perineal pain
- Vaginal dryness due to low Estrogen levels
- Fatigue from childcare
- Reduced sexual desire due to hormonal changes
- Postpartum depression
- Concerns about body image
Treatment Approaches
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- Allow the body time to recover, at least 6 weeks
- Use of lubricants
- Pelvic floor muscle exercises to restore strength
- Psychological and relationship counseling
- Open communication with partner
Post-Surgery Problems Surgery in the pelvic area, lower abdomen, or genital organs, such as hysterectomy, prostate surgery, or tumor removal, may affect sexual function.
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- Pain at the surgical site
- Anatomical changes affecting sexual activity
- Anxiety about sexual performance
- Hormonal changes
Treatment Approaches
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- Consult with a doctor about the appropriate time to resume sexual activity
- Physical and psychological rehabilitation
- Adjusting sexual positions suitable for physical condition
- Sexual and psychological counseling
Menopausal Problems Women in menopause experience significant hormonal changes, especially decreased Estrogen, resulting in:
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- Vaginal dryness, thinning, and loss of elasticity
- Decreased sexual desire
- Pain during intercourse
- Hot flashes
- Mood swings
Middle-aged men also experience “Andropause” or decreased Testosterone, causing
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- Decreased sexual desire
- Erectile dysfunction
- Increased fatigue
- Loss of muscle mass
Treatment Approaches
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- Hormone replacement therapy under medical supervision
- Use of lubricants or topical Estrogen creams
- Regular exercise
- Maintaining a healthy weight
- Lifestyle changes for better health
- Counseling to adapt to changes
Benefits of Receiving Targeted and Effective Therapy
- Receive advice from knowledgeable experts
- Improve quality of life and marital relationships
- Increase self-confidence
- Reduce anxiety and stress
- Receive confidential and private care
Preparation Before Therapy
- Open your mind and accept the problem: One must accept there is a problem as the first step to solving it
- Provide health history: Prepare information about chronic diseases, medications used, and symptoms experienced
- Record symptoms: Keep a record of when the problem occurs, how often, and what improves or worsens it
- Communicate with your partner: If possible, talk with your partner to make therapy more effective
- Prepare questions: Write down questions you want to ask the doctor or therapist on the appointment day
Therapy Process
When deciding to see a sexual therapist, the initial treatment process includes:
- Problem assessment: The doctor or therapist will take history and assess the cause of the problem
- Preliminary diagnosis: Physical and mental health examinations to find the true cause
- Treatment planning: Determine appropriate therapy methods for each individual
- Therapy implementation: Follow the treatment plan continuously
- Follow-up: Evaluate progress and adjust the treatment plan as needed
Sexual therapy under the care of doctors or therapists at Phyathai 3 Hospital follows a safe, confidential process and is provided by well-trained specialists. Whatever your problem is, solutions are available, so do not hesitate to seek help.
We are ready to care for you and emphasize natural body balance treatment combined with modern innovations for recovery, provided by a professional medical team.
Sexual Therapy: A Helper to Improve Quality of Life
If you have physical sexual problems, do not ignore or hide them. Although these are sensitive issues and many are still reluctant to disclose, these problems can be effectively resolved through sexual therapy. Whether it is erectile dysfunction, premature or delayed ejaculation, decreased sexual desire, pain during intercourse, or problems occurring postpartum, post-surgery, and menopause.
Receiving sexual therapy not only helps solve physical problems but also improves quality of life, confidence, and marital relationships. Consulting knowledgeable and experienced specialists will help you receive appropriate and safe treatment.
Dr. Karit Jayasakul
Specialist in Obstetrics-Gynecology and Sexual Medicine
Phyathai 3 Hospital
References
- American Association of Sexuality Educators, Counselors and Therapists (AASECT). “What is Sex Therapy?” https://www.aasect.org
- Laumann, E. O. et al. “Sexual dysfunction in the United States.” JAMA, 1999; 281(6): 537-544.
- What Is Sex Therapy? Q&A With a Northwestern Medicine Sex Therapist
- An evidence-based unified definition of lifelong and acquired premature ejaculation: report of the second International Society for Sexual Medicine Ad Hoc Committee for the Definition of Premature Ejaculation
- Sex after childbirth: postpartum sexual function
