Sexual issues often stem from a combination of physiological and psychological causes. Sometimes, medical attention, such as hormone treatment or surgery is necessary, However, most women I work with can resolve their problems naturally, through addressing the roots of what is happening in the present. That said, I consult regularly with a physician, and can make referrals as needed.
The women's sexual health issues that sex therapists most commonly work with follow. The common names are first, followed by the more medical description.
Loss of Desire (Inhibited Sexual Desire) Many women are affected by low sex drive at some time. Pregnancy or periods of high stress are notorious libido killers. However, the problem can also be more general, and can impact intimate relationships. Erotic empowerment helps women own sexual pleasure for just themselves, and not because their boyfriend or girlfriend or partner or whoever else wants them to. With ISD, a woman may suffer from pain during intercourse due to dryness, lack of genital sensation, no or little interest in sex, or orgasm challenges.
Lack of Arousal (Female Sexual Arousal Disorder) Arousal is a physiological body response to sexual desire arising in the body. In women, sexual arousal means the vagina lubricates, the erectile tissue in the genitals (did you know women have as much as men?) engorges with blood, and erotic feelings are felt in the body. FSAD may reduce lubrication, causing pain during penetration, and can decrease the amount of pleasure felt. There may also be a lack of orgasmic response.
Vaginal Pain or Tightness (Vaginismus, Vulvodynia, Vestibulitis, Dyspareunia) There are many variables that can cause painful sex, including loss of desire, lack of lubrication, scar tissue, tightening of the vaginal muscles, burning or internal pain. Sexual trauma can often heighten or cause these sexual responses.
Pre-orgasmia (Anorgasmia) These words mean a for lack of orgasmic response. The medical model uses the term Anorgasmia (without orgasm), but I like Pre-orgasmia because I believe every woman can become orgasmic. As well as working with physical issues, I also support women to find and express their full erotic potential.
Reestablishing Personal Boundaries It can be all too easy to say Yes when we mean No or remain silent when actually the body is screaming "No." People can feel pressured into situations and actions which don’t feel right, but which they find it hard to express themselves.
The most important agreement I make with my clients is that we will tell each other if something doesn't feel "right." Fetting in touch with your own embodied desire, that is, knowing what you want and don't want is the first step in establishing boundaries. Then, being able to articulate them and hold them when they are challenged. I work with clients all the time on boundary issues, using simple, instructive exercises. Learning boundaries is an essential part of sexual wellness, and this type of sex therapy can help.
Intimacy and Relationship Issues Almost everyone has suffered from hurt or pain caused in intimacy or relationship. Intimacy requires that we make ourselves vulnerable, which by its very nature means that we may be hurt. Learning boundaries is one part in creating safety for ourselves in relationship. Looking at our relationships as classrooms helps us learn what we need to, so that we may deepen further our intimacies. I work with individuals who are already in relationships, as well as those recovering or seeking relationships.
Female Ejaculation Female Ejaculation a.k.a. "squirting" is a sexual "buzz word" skill at present. Some women feel shame that they cannot do this, and they wish to. Some women cannot NOT do this, and they wish to. Some women wish to explore the anatomy and techniques that make squirting happen. I work with all of it.
Sensate Focus for Increased Pleasure Many women have lost sensation in parts of their bodies, including their genitals. Disembodiment, or only living in the head, causes us to miss out on the deep pleasure the body is capable of. Think about it, how do you know what you are not feeling? Embodiment and living more fully in our human bodies is something I work on with all clients. Pleasure mapping, exploring anatomy, restoring sensation and finding new neural pathways to pleasure are a big part of Sexological Bodywork.
Undoing Trauma and Restoring Sexual Well-Being Many of us have suffered from some form of sexual trauma. Rape, sexual abuse, sexual harrasment, injury to our sexual organs or pelvic floor: all of these can cause trauma to be held within the body, prohibiting the free flow of erotic energy and keeping us from attaining our full erotic potential. Using techniques of Somatic Experiencing and Somatic Sex Coaching, I guide clients to renegotiate trauma, so that pleasure and embodiment are returned.