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Psychosexual service

Problems with sex are common. Many people have problems with sex at some point in their lives.

Some of the issues we see are:

  • Loss of libido (loss of interest in sex)
  • Pain during sex
  • Vaginismus (vaginal tightness causing discomfort and difficulty with penetration)
  • Erectile dysfunction (difficulty with getting or keeping an erection)
  • Premature or delayed ejaculation (ejaculating too quickly or not at all)
  • Lack of orgasm

If you have a different problem with sex, even if different from those listed above, it is worth talking to your GP.

The usual route of referral to the psychosexual clinic is via your GP. You may be seen by a counsellor or a healthcare professional depending on your particular problem. Please be aware that there may be a considerable waiting list for these appointments (as of April 2025 the average waiting time is around 12 months).

Unfortunately, we are not able to help with relationship problems or addiction to sex or pornography. 

I think I may be experiencing a loss of libido (loss of interest in sex) - what can I do?

Loss of libido is a common problem and everyone's sex drive is different and changes throughout life.

Causes can include;

  • Stress
  • Relationship issues
  • Low mood
  • Age
  • Use of some recreational or prescribed drugs
  • Underlying health problems such as diabetes, underactive thyroid, recent surgery

NHS conditions: Low sex drive (loss of libido) - NHS (www.nhs.uk)

Sexual wellbeing: Sexual Wellbeing Resources (wordpress.com)

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CORST: COSRT Factsheets: PDF Downloads: Information for the public on therapy

I have pain during sex (dyspareunia)

Painful sex is a common problem in women, but often also affects men.

There are lots of  physical causes including skin problems, infections, side effects to medications as well as many causes of lower abdominal or pelvic pain.

Changes can also occur after the menopause which can lead to sex being painful.

Trying to have sex when not fully aroused or lubricated is another common reason sex is painful. Vaginismus causes painful sex.

Psychological factors can be very important including anxiety, previous harmful experiences and distressing or confusing feelings about sex. Relationship issues are also important.

If you are experiencing painful sex it may be important to have a gentle examination with a specially trained health care professional to look for a physical cause and offer you some treatment if needed.

Often talking the issues through for a few sessions with a therapist or health care professional who can give support and practical advice may help. This may be through your GP or at a sexual health clinic.

Brook: Why does sex hurt? - Brook: Painful sex

Sexual wellbeing: Sexual Wellbeing Resources (wordpress.com)

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CORST: COSRT Factsheets: PDF Downloads: Information for the public on therapy

 

I think I might have Vaginismus

Vaginismus is the tightening of the muscles around the vaginal opening when penetration is attempted. It may occur even if the woman really wants the penetration to happen. It can affect sexual contact, gynaecological or pelvic examinations; or even trying to insert a tampon.

Any painful or distressing condition of the vagina, vulva or surrounding area can cause vaginismus. Sometimes the problem persists long after the physical problem has cleared up.

Vaginismus can also be caused by worries about sex or previous bad experience, as well as stress, anxiety and relationship issues.

Talking the problem through with a specially trained health care professional or therapist can help. Often simple measures such as taking more time with foreplay and using a good lube are enough. Having a gentle examination to rule out other causes of pain and help to understand the problem can also help.

NHS conditions: Vaginismus- NHS conditions

Sexual wellbeing: Sexual Wellbeing Resources (wordpress.com)

Relate: Home | Relate

CORST: COSRT Factsheets: PDF Downloads: Information for the public on therapy

 

I have problems getting an erection/maintaining an erection

Erectile dysfunction (E.D.) is the inability to get or maintain an erection. It is very common; up to 50% of men aged 40-70 will struggle with this to some degree; and it is common in younger men too.

It can sometimes be a sign of underlying heart problems so it is always a good idea to see your GP for a physical check in the first instance. Other physical causes include hormonal problems, after surgery or injury or as a side effect of medication.

Very often, however, the cause is psychological and can be due to anxiety, stress, relationship problems or loss of confidence. Some men are able to get an erection when alone but not with a partner. If the problem is psychological a few sessions of talking therapy can help to improve confidence and lessen anxiety levels.

There is medication available to help with E.D. and you can see your G.P. to discuss further. There are also other physical treatments available. Talking therapy is available through the psychosexual clinic.

NHS conditions: Erectile dysfunction (impotence) - NHS (www.nhs.uk)

Sexual wellbeing: Sexual Wellbeing Resources (wordpress.com)

Relate: Home | Relate

CORST: COSRT Factsheets: PDF Downloads: Information for the public on therapy

I'm having problems ejaculating (coming) too soon

This is called Premature Ejaculation (PE) and is when a man ejaculates or "comes" sooner than he or his partner wishes most or all of the time. It can sometimes occur even before penetration has been possible.

PE is a very common problem, especially in younger men. Rarely there is a physical cause and is much more commonly due to anxiety, worries or confusing feelings about sex, lack of confidence, or stress. Relationship issues are also important. Sometimes it is conditioning; for example if you learnt to masturbate quickly it can be difficult to break that habit.

Sometimes just talking it through with a partner might be enough or doing things that relax you and improve your confidence.

Some men find a numbing spray or gel helpful and there is medication that may improve things too. There are also a few exercises that can be helpful.

Often talking the issues through with a trained health care professional or therapist allows you to regain some feeling of control over the problem

NHS conditions: Ejaculation problems - NHS (www.nhs.uk)

Sexual wellbeing: Sexual Wellbeing Resources (wordpress.com)

Relate: Home | Relate

CORST: COSRT Factsheets: PDF Downloads: Information for the public on therapy

I'm having problems taking too long to ejaculate or being able to ejaculate at all

This is called delayed ejaculation and is when a man experiences a significant delay before ejaculating; or being unable to ejaculate at all even though he wants to.

Sometimes he is OK when he is alone but the problem occurs when he is with a partner; and sometimes it is just a problem with penetration.

Physical causes include diabetes, spinal cord injury, M.S., surgery to the bladder or prostate, increasing age and as a side effect to medication.

Psychological causes are also very common and a few sessions of talking therapy might help.

NHS conditions: Ejaculation problems - NHS (www.nhs.uk)

Sexual wellbeing: Sexual Wellbeing Resources (wordpress.com)

Relate: Home | Relate

CORST: COSRT Factsheets: PDF Downloads: Information for the public on therapy

I'm having trouble achieving an orgasm (anorgasmia)

Lack of orgasm can be a distressing problem that is very common. It can affect both women and men (see above for further info on delayed ejaculation in men)

It may be a problem when having intercourse with a partner or also during masturbation. It is very normal for women not to experience vaginal orgasm during penetrative sex but to find they are able to orgasm with clitoral stimulation. Some women feel unsure whether what they are experiencing is orgasm or not.

Any physical condition affecting health or well-being can stop orgasms. Stress, anxiety, relationship issues and previous bad experiences are all important. Some people feel under a great deal of pressure to achieve orgasm for the sake of their partner and this pressure can in itself make having an orgasm more difficult.

It can be helpful to discuss with either your GP or a specially trained health care professional or therapist.

Brook: Brook: Orgasms and pleasure

Sexual wellbeing: Sexual Wellbeing Resources (wordpress.com)

Relate: Home | Relate

CORST: COSRT Factsheets: PDF Downloads: Information for the public on therapy

Pornography

The use of online pornography is incredibly common, in fact almost a third of UK adults accessed porn according to a snapshot survey of internet use in May 2023. However, the use of porn can be problematic. Viewers may be burdened with feelings of shame, and shame can stop someone accessing the help they need. Problems with erections are often seen in people using porn compulsively, and help with this can be sought from: The Association for Treatment of Sexual Addiction and Compulsivity, and Sex Addicts Anonymous.

Unfortunately, the psychosexual service is not able to offer help for compulsive pornography use.