Sex therapy is a therapeutic strategy for the improvement of sexual function and treatment of sexual dysfunction. This includes dysfunctions such as premature ejaculation and delayed ejaculation, erectile dysfunction, lack of sexual interest or arousal, and painful sex (vaginismus and dyspareunia); as well as problems imposed by atypical sexual interests (paraphilias), gender dysphoria (and being transgender), highly overactive libido or hypersexuality, a lack of sexual confidence, and recovering from sexual abuse (such as rape or sexual assault); and also includes sexual issues related to aging, illness, or disability.
Practice
Modern sex therapy often integrates psychotherapeutic techniques and medical ones, such as Viagra (sildenafil) and Cialis (tadalafil) to increase erectile response and Paxil (paroxetine) to treat premature ejaculation. Sex therapists assist those experiencing problems in overcoming them, in doing so possibly regaining an active and healthy sex life. The transformative approach to sex therapy aims to understand the psychological, biological, pharmacological, relational, and contextual aspects of sexual problems.
Sex therapy requires rigorous evaluation that includes a medical and psychological examination. The reason is that sexual dysfunction may have a somatic base or a psychogenic basis. A clear example is erectile dysfunction (sometimes still called "impotence"), whose causes may include circulatory problems and performance anxiety. Sex therapy is frequently short term, with duration depending on the causes for therapy.
Sex therapy can be provided by licensed psychologists or physicians who have undergone training and become certified.
Symptoms
Sex therapy sessions are focused on the individual's symptoms rather than on underlying psychodynamic conflicts. The sexual dysfunctions which may be addressed by sex therapy include non-consummation, premature ejaculation, erectile dysfunction, low libido, unwanted sexual fetishes, sexual addiction, painful sex, or a lack of sexual confidence, assisting people who are recovering from sexual assault, problems commonly caused by stress, tiredness, and other environmental and relationship factors. Sex therapy can either be on an individual basis or with the sex partner. The interest in sex therapy among couples has increased along with the number of sexuality educators, counselors, and therapists. These physical changes often affect the intensity of youthful sex and may give way to more subdued responses during middle and later life. Nevertheless, older adults believed that an active sexual life offers great pleasure and contributes materially to overall emotional and physical health. Older men experience changes that occur in sexual physiology and affect both erectile function and ejaculation. It can include sensate focus, communication, and fantasy exercises as well as psychodynamic therapy.
Sex therapy for older adults is similar to sex therapy with other populations. It includes the use of water-based personal lubricants (for decreased vaginal lubrication), hormone therapy, and medications. Sex therapists working with older adults should know about sexuality and aging. Curriculum for this includes communication, masturbation, body image, and spirituality.
History
Sex therapy has existed in different cultures throughout time, including ancient India, China, Greece, and Rome. It has taken the form of manuals, spells, anaphrodisiacs or aphrodisiacs, and tantric yoga, among others. Much of sex therapy and sexual dysfunction in Western cultures was limited to scientific discussion, especially throughout the 19th century and into the early 20th century. The work of Jack Annon in 1976 also saw the creation of the PLISSIT model that sought to create a structured system of levels for the therapist to follow.
The mid-1980s saw the medicalization of sex therapy, with a primary focus on male sexual dysfunction.