Sexual Issues Treatment in London & Online

Sexual performance anxiety, lack of libido, erectile problems, or hypersexuality are just some of the sexual difficulties that we experience. They are not something to be ashamed of. The moment you start talking about them will be when you begin your journey to improve your situation and feel better. 

In general, people have a hard time talking about their psychological issues. This is, unfortunately, even more true for sexual issues. Here at Therapy Central, we have therapists who can help you understand and treat the sexual difficulties you may be experiencing. 

If you experience a sexual issue impacting your life, contact us today and work with our qualified therapists. 

Contact us for a free 15 min consultation, and we’ll see how we can work together to improve your well-being.

COVID-19 notice: Online Therapy & Counselling now offered for continued care

What are Sexual Issues and their types?

A sexual problem is anything involving your sex life that distresses you and reduces your quality of life. For men, erectile dysfunction is perhaps the most well-known sexual issue, but it’s far from being the only problem. Men, for example, often experience sexual performance anxiety (usually related to erectile dysfunction). Women also experience difficulties in their sex life, for instance, discomfort during sex or an inability to experience pleasure or reach an orgasm.

What are the Signs and Symptoms of Sexual Difficulties?

Here’s one way to categorise sexual problems and various symptoms of sexual difficulties [1]:

Atypical sexual objects or situations

These are sometimes referred to as paraphilias – choosing an atypical sex object (or situation/behaviour) which results in significant psychological distress. 

Fetishes are another example of atypical sex objects or paraphilias. While virtually everyone has fetishes to a certain extent, these don’t bring about any psychological (or physical) distress for most people. However, when they do, you should address them within a sexual issues psychotherapy treatment. Some people are aroused by feet, toes [2], or material objects like latex. Fetishes can be perfectly normal. However, when you or your partner notice that fetishes account for too much of your sexual pleasure, that is, when the fetish becomes the centre of sexual pleasure rather than an adjunct, this can be an excellent time to seek professional help.

Moreover, elements of sadism and masochism can be present in a healthy, mutually understanding sexual relationship. But when you or your partner start to feel uneasy or distressed, it’s time to talk about it with a mental health professional. 

Here’s a helpful rule of thumb: if the way you achieve sexual pleasure brings about psychological (or physical) distress to you or your partner, it will be a good idea to find professional help. 

Even paedophilia is a paraphilia, which can and should be treated. This is something that must be talked about rather than taboo.

Sexual dysfunctions

Whereas with paraphilias, the problem lies mainly with the choice of sexually arousing objects, behaviours, and situations, with sexual dysfunction, the problem is about the intensity of desire, arousal, and orgasm:

Sexual desire issues

You can experience too little or too much sexual desire. This is not necessarily related to physical arousal. Many people can experience sexual arousal but simply don’t have a desire or interest in sex. 

If you experience other psychological problems like depression, it’s more likely that you also experience low libido/loss of interest in sex. 

Hypersexuality is the other side of the coin. This should be discussed, especially if you feel that you have too much libido and you feel uncomfortable about this. Symptoms of hypersexuality are sometimes similar to those of OCD. For example, an inability to think about anything other than sex, having obsessive thoughts about sex and engaging in sex compulsively. This is sometimes referred to as “sex addiction”.

Sexual arousal issues

Sexual arousal is distinct from desire, which is more about phantasies and general thoughts about sex. Sexual arousal is more about the psychological and physiological responses during the act of making love itself. 

Erectile dysfunction (ED) is categorised here. It’s not unusual for ED to be about performance anxiety, which is most certainly something you can work on with a mental health professional. Premature ejaculation (too much arousal) is another frequent issue men experience, once again often related to anxiety and stress. Excessive watching of pornography, for instance, can drastically reduce your arousal. 

Women often experience sexual arousal issues – for instance, you can feel psychologically aroused without physical arousal, and vice versa. The treatment of sexual issues will help you understand why this is happening and how you can help your partner help you feel better. Once again, it’s often when we are ashamed of talking about certain topics that problems start to arise. Professional treatment of sex difficulties will help you learn how to communicate your desires to your partner effectively and more thoughtfully. 

Partners should always be somewhat involved in the treatment of sex problems. Moreover, sexual issues treatment for couples can be helpful when the sexual arousal starts decreasing in long-term relationships and because of routine sex behaviour.

Orgasmic dysfunction and sexual pain

It happens that people have a strong libido and arousal but also have difficulties experiencing orgasms. This can happen to both men and women. Some men have drastically delayed ejaculation or cannot ejaculate altogether. Women can also encounter difficulties reaching an orgasm – feeling as if they are unable to.

Finally, women can also feel a lot of pain during vaginal sex. This is sometimes referred to as dyspareunia. A related problem is vaginismus. In this case, a woman cannot allow vaginal entry due to the contraction of pelvic muscles. This can be coupled with a phobic avoidance of vaginal sex despite sufficient desire and high arousal. 

The NHS [3] suggests that psychosexual therapy for vaginismus can reduce the fear of vaginal penetration and improve the quality of your sex life. Vaginismus may be caused by a highly unpleasant first sexual experience or negative beliefs about sex. This is most certainly something that you can talk about with a psychotherapist.

Types of Sexual Issues – Recapitulation

Paraphilias – atypical objects, situations, and behaviours Issues with sexual interest/desire Sexual arousal difficulties Orgasmic dysfunction Sexual pain
Fetishism

Sadism/masochism

Voyeurism

Exhibitionism

Paedophilia

Low libido

Hypersexuality

Sex aversion

Erectile dysfunction

Premature ejaculation

Discrepancy between psychological and physiological arousal

Inability to reach orgasm

Drastically delayed orgasm

Unsatisfying orgasms

Dyspareunia

Vaginismus

How are Sexual Issues Maintained?

When you avoid or minimise the sexual difficulties you are experiencing, you essentially start a vicious circle. Let’s say you have low libido even though you’re relatively young and in a happy relationship. You might be tempted to avoid this issue by reducing the frequency of sex, for example. This may seem a “good solution” for a short while. But, in the long run, your partner will notice this and start interpreting the change in your behaviour in unhelpful ways. This can trigger numerous relationship issues (e.g. lack of satisfaction, your partner believing you’re having an affair, etc.). In the end, the vicious circle is perpetuated – the relationship issues caused by low libido will reduce your sexual interest even more. 

Instead of avoiding the issue, it would be more helpful to discuss it with your partner, and preferably with a mental health professional. Psychotherapy can help you gain new insights into problems you’ve been suppressing for a long time and kickstart a process of helpful change.

Sexual Issues - Vicious Cycle

What Causes Sexual Problems?

There are two main groups of causes:

Psychological causes

We’ve already seen that erectile dysfunction and premature ejaculation can be caused by psychological symptoms such as anxiety and stress. Everyday stress (e.g., workplace issues; conflicts within a relationship; worry for the partner) and critical life events (e.g., major life transitions – getting your first job or promotion; bereavement) can also affect the quality of sex life among women. Emily Nagosky, a sex educator and researcher at Smith College, emphasised that stress makes it harder for women to enjoy sex.

Emotional and sexual abuse, unpleasant early sexual experiences, and turbulent relationships, are some of the factors that can potentially reduce the quality of your love life in the present. Here is a quick list of other psychological factors that can reduce your sexual desire, arousal, and pleasure:

  • Depression
  • Anxiety
  • Fatigue
  • Sadness or grief 

Physiological causes

Although erectile dysfunction, vaginismus, and other sex issues can be caused by psychological factors, sometimes physiological causes are behind these problems. Therefore it can be helpful to get advised by your GP or a specialist physician to rule out any physiological causes or treat them appropriately. 

Even when there is a known physiological cause of a sexual difficulty, psychotherapy can help you reduce the overall anxiety and stress you are experiencing. When the issue is mainly psychological, this is when psychotherapy can help you improve your sex life in a significant way.

When should I get Counselling for Sexual Issues?

You should do this as soon as you realise that something in your love life makes you unable to enjoy sex. Seeking help is crucial if you feel your sexual difficulties have started impacting various areas of life. Chances are that a sexual problem won’t go away on its own. By postponing the treatment of sexual difficulties, you’re likely to further complicate the vicious circle that keeps them going.

If you’ve noticed your sexual issues are making you feel low, anxious, irritable, or affecting your ability to enjoy your relationship with your partner and others around you, then the best moment to seek help is now.

Does Treatment for Sexual Difficulties Work?

The NHS [3] advises psychosexual therapy for treating problems such as vaginismus. Evidence-based psychotherapies such as CBT can improve the quality of your love life in numerous ways. This has been shown in multiple scientific studies [4] [5].

What’s the best Therapy Approach for Dealing with Sexual Issues?

There are many ways to treat sexual problems. CBT is perhaps the approach with the most research and evidence behind it and, as such, is the most reliable way to treat sexual issues. 

Some people experience low self-esteem, which in turn can reduce the pleasure they are experiencing during sex. In this case, therapy would focus on maladaptive beliefs related to a lack of self-esteem, for example, “I must always have to be good in bed”, “I cannot perform at my best, then I am worthless”. Premature ejaculation and related issues such as sex anxiety can be successfully treated with CBT and other approaches [4]. Similarly, stress management training can reduce the psychological symptoms related to erectile dysfunction and subsequently improve sexual functioning [5].

What are the Benefits of Counselling for Sexual Difficulties?

Sexual issues treatment can help you in the following ways:

  • Decreased anxiety about sex
  • Improved sexual self-esteem (and self-esteem/confidence generally)
  • More pleasurable and satisfying love life
  • More fulfilling intimate relationships
  • Embracing and accepting your sexuality 
  • A better understanding of sexual difficulties you may have experienced in the past

How long does Sexual Issues Treatment Last?

The length of treatment depends on various factors, such as the severity of the issue. 8 to 12 sessions of CBT for specific problems such as premature ejaculation were shown to produce significant improvements such as increased sexual satisfaction for both partners and reduced sexual anxiety and fear [4]

Issues that stem from sexual trauma may be more severe and necessitate extended periods of focused, therapeutic work. Fortunately, problems like these can also be worked through with therapy. 

Does Online Therapy work for Sexual Difficulties?

Research has proven the efficiency of CBT online intervention for women who experience sexual desire and arousal difficulties [6]. Online treatment approaches, like online CBT, focus on psychoeducation (learning about different sexual issues) and techniques such as recording and challenging negative thoughts and promoting more helpful behaviours. Research has shown that online CBT effectively increases sexual desire, arousal, and satisfaction while reducing sexual distress.

Tips to get you started Managing Sexual Issues

Although the most efficient and reliable way to treat sexual issues is to find a suitable mental health professional, there are certain things you can do on your own to start feeling better:

  • Reduce the consumption of pornography (e.g. avoid watching it every day)
  • Talk about your issues with your partner (and other trusted people) 
  • Communicate your desires to your partner in a clear way 
  • Refrain from comparing your sexual performance with the “ideal” performance (e.g., what you see in movies or read in books)
  • Reduce your alcohol intake (alcohol reduces the sexual pleasure in both sexes and can cause erectile dysfunction in men); certain substances like amphetamine (Adderall) can also cause erectile dysfunction
  • Get enough rest and physical activity

Our Therapists Specialised in Sexual Issues Treatment

All of our therapists are qualified psychologists, psychotherapists or counsellors registered with several professional bodies. These include the Health and Care Professions Council (HCPC), the British Psychological Society (BPS), as well as, BACP, UKCP and BABCP.

Our therapists use CBT (Cognitive Behavioral Therapy), psychodynamic, humanistic and integrative approaches tailored around your needs to help you deal with your unique challenges and reach your goals.

Dr. Karin Kihlberg

Counselling Psychologist

Dr Bertha Rogers

Clinical Psychologist

Dr. Alana Whitlock

Clinical Psychologist

Dr. Yasmeen Jaina

Counselling Psychologist

Panos Vythoulkas

Senior Clinical Psychologist

Tatum Aspeling

Clinical Psychologist

Dr Gail Freedman

Counselling Psychologist

Dr. Caroline Tovey

Clinical Psychologist

Dr. Andrew Aboud

Counselling Psychologist

Marisa Poggioli

Counselling Psychologist

Rebecca Leakey

Psychotherapist

Dr Sara Chaudhrey

Counselling Psychologist

Ben Dustin

Psychotherapist

Mary O'Byrne

Psychotherapist & Supervisor

Dr Soha Daru

Counselling Psychologist

Lisa Crossman

Psychotherapeutic Counsellor

Joanne Videtsky

Clinical Psychologist

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Thank you to all at Therapy Central.

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The Therapist shows that she really cares and has the ability to make you feel calm whilst discussing any personal issue. 

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Fees & Insurances

Therapy, Counselling and CBT sessions are 50 minutes long and are usually held at regular weekly time slots.

Free
15 Minute initial
Phone consultation

£75 -£95
Psychological Therapy/
Counselling (Self-funded)

£105 - £120
Couples Therapy/
Family Therapy

Covered by
Your Private Healthcare Insurance Provider

All of our therapists are registered with several insurance providers, such as AXA PPP, Simplyhealth, Aviva, Cigna (UK/US), Vitality and WPA. If you wish to use your personal or employee private healthcare insurance to cover your sessions, please highlight this in your contact form below.

Get started with Counselling for Sexual Difficulties in London & Online

You’re not alone. All people experience some kind of difficulty in their sex lives. It’s not that only the strongest and most resilient can solve them – quite the contrary. Those who are ready to openly discuss their sexual issues are also more likely to be able to move on toward more satisfying and fulfilling sexual relationships. 

Therefore, we encourage you to open up and discuss the problems you are experiencing with a mental health professional here at Therapy Central. Contact us for a free 15-minute consultation, and we’ll find a way to work together to improve the quality of your life. You don’t have to face sexual issues alone.

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    FAQ

    What happens after I make an enquiry?

    After receiving your enquiry we’ll contact you to organise a FREE phone consultation. You will be able to tell us more about your specific circumstances and needs and ask any questions you have. Then, if you want to proceed with therapy or counselling, we’ll match you with the therapist(s) with the best expertise to help you with your challenges and send you a list of their available appointment slots. If you’re satisfied with one of these, we can then go ahead and book your first appointment. You can also request to work with a specific practitioner and, depending on availability we’ll try accomodate this.

    What happens at my first appointment with the therapist?

    Your first session will likely be different than future appointments. You and your therapist will get to know each other and will begin to build a working alliance. It will be a chance to have the confidential space to express your circumstances, feelings and thoughts and being listened to with depth, attention, empathy and without judgement . Your therapist will likely ask you more about your reasons for seeking therapy, and any symptoms you’re experiencing. You may also be asked questions about your past and the history of your issues, as well as how they currently impact your life in the present. Finally, your first session may be a powerful place to discuss what you would like to achieve with therapy and agree on the length, methods and approaches of treatment.

    Is online therapy effective?

    If you choose online over in-person therapy rest assured that this has been proven to be just as effective as regular face to face therapy, and in some cases even more effective. In addition, choosing online therapy brings additional benefits, for example avoiding longer waiting times, greater flexibility with appointments and you won’t need to travel to our practice. You can enjoy online therapy from the comfort of your home.

    How long the Therapy/counselling sessions last?

    Therapy/counselling sessions last 50 minutes and are held at regular weekly time slots. On occasions we are able to allow some flexibility. This can be discussed with your therapist.

    Do you offer reduced rates/concessions?

    We offer low-cost rates at £60 per session to people with a low income, unemployed or students. Please highlight in your enquiry if you would like a concession rate and how you qualify for this. Depending on the availability of our therapists, we’ll do our best to accommodate your request.

    Do you have a cancellation policy?

    We have a 48 hours no-fee cancellation policy. However you will be charged for sessions missed without giving the full notice.

    Our Practice in Central London

    Our comfortable and confidential therapy rooms are conveniently located 3 min walk from Oxford Circus station, in Central London (see map below). Change starts with Talking!

    [1] Hatzimouratidis, K., & Hatzichristou, D. (2007). Sexual dysfunctions: classifications and definitions. The journal of sexual medicine, 4(1), 241-250.

    [2] Sexual preferences for body parts or features. Nature

    [3] Vaginismus. NHS

    [4] Mohammadi, S. D., Mohammadkhani, P., Dolatshahi, B., & Dadkhah, A. (2013). Effectiveness of cognitive behavioral therapy on the signs, symptoms and clinical consequences of premature ejaculation. Japanese Psychological Research, 55(4), 350-357.

    [5] Kalaitzidou, I., Venetikou, M. S., Konstadinidis, K., Artemiadis, A. K., Chrousos, G., & Darviri, C. (2014). Stress management and erectile dysfunction: a pilot comparative study. Andrologia, 46(6), 698-702.

    [6] Stephenson, K. R., Zippan, N., & Brotto, L. A. (2021). Feasibility of a cognitive behavioral online intervention for women with Sexual Interest/Arousal Disorder. Journal of Clinical Psychology, 77(9), 1877-1893.

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    We're registered with AXA PPP healthcare, AXA therapists, AXA counselling, Aviva, Vitality, Cigna, BPS, HCPC, BABCP
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