John and Jane came to see me together. The immediate problem was that Jane, aged 38 years, urgently wanted a baby. John, who was 43, was willing to have a child but was completely ‘off’ sex. They had not had sexual intercourse for more than a year. However, John described himself as being turned on by other women - but he chose to stay faithful to Jane.

Jane’s childhood was spent in a loving family where physical warmth and emotional expression were freely given and received. At school Jane was a high achiever and went on to university after which she made a succesful career as a journalist. In her adolescence Jane's Father, who was a Doctor, developed bouts of intense anger. Jane found this very frightening, although the anger was directed towards her Mother. She remembered that her Mother always gave in to her Father on these occasions.

John’s childhood was more difficult. There were long periods when his Father was absent from home. Emotions were constrained and little physical affection was shown him by his Mother. He, like Jane, was highly successful at school and university where he gained a good History degree. It was at university that John and Jane met. John was very taken with the easy going affection that Jane showed and Jane loved him for his quiet steadiness and attentiveness to her. They were constant companions, sexually excited and satisfied by one another.

If you have noticed a change in your level of sexual desire, it may be a normal effect of stress or tiredness, chronic pain and illness, or simply that you are getting older. Loss of a close relative or loved on is a very natural reason to lose sexual desire.

Loss of desire in these cases, except for during bereavement, can be improved by increasing the time you spend thinking about sex, inventing some new fantasies, trying new things with your partner,and masturbating more often, but not so often that your ability to be sexual in other ways is impaired. During bereavement, you just have to wait until your mourning is over.

If you are in a relationship, it is really important to talk things over with your partner. There may be hidden anger or resentment which are the commonest reasons for reduced desire with a partner. If your partner is angry with you, you may pick it up at an unconscious level, and be affected by it. If you are angry with your partner, the same thing can happen. Partners often blame themselves, thinking they are no longer attractive to you, or that you don't love them any more.

If talking to each other is too difficult, a therapist could help you get the ball rolling.

The first part of overcoming Premature Ejaculation is thinking about the situation and how it is affecting you. Think what makes it better or worse, and any self help you have tried. It can be useful to talk over your previous sexual history with a therapist. Family traditions and ideas about sex may also be important.

One thing to remember is that usually there is nothing wrong with the penis.

Once the underlying causes of the difficulty have been addressed your therapist may prescribe sex therapy exercises, with special training work for ejaculation. These will be slightly different according to whether you have a partner willing to join in the therapy or not. The two main techniques for therapy are the Squeeze Technique and the Stop Start Technique.

There are various drugs which can help with this problem, and using them alongside the practical techniques can be really effective. Sometimes the medication on its own can be enough.

Greg is a 24 year old with a lifelong fear of sexual penetration. Ever since he became aware of his own sexuality he has known that he has not wanted to have intercourse. He says that he is heterosexual and that all his fantasies are about women. He can masturbate to these and has had a series of girlfriends - with whom he has been sexually active. He can achieve penetration, but is aware of a general anxiety that sweeps over him. He says that he prefers his girlfriend to masturbate him with her hand, or that they masturbate themselves in from of each other.

He and his partner Joanna want to get married and start a family. Greg wants to deal with his problem. Joanna thinks that Greg is frightened of being intimate with her, and possibly not wanting to make a commitment to marriage. Greg denies thus, and they have both argued a lot about this before coming to see a therapist.

If the pain has a medical cause, the the treatment may be a combination of medical and psychological approaches. We are not describing all the medical treatments on this web site, but if you want to mail us we will answer your questions. Click on "contact us" on the side bar.

The first step in treatment is to try to discover the reasons for the pain, so a sexual, relationship, and life history will be discussed.
Sometimes body tension causes pain, and Relaxation Training can help.
Deeper reasons may be helped by Self Hypnosis, which may also be effective as pain control.
Most men experiencing painful sex will be helped by Sex Therapy and a therapist will be able to guide you through it at a pace suited to you and tailored to your own particular needs.

Sex can become an obsession, compulsion or addiction, and can be used like any other addictive substance such as alcohol or drugs, to alter your state of mind. Sex makes us feel better, partly because it reduces anxiety, causes a surge of hormones, and feels pleasurable. When the need for those effects becomes a powerful driving force in a person's life, then the possibility of developing an addiction arises.

People become addicted to a range of sexual activites, such as visiting prostitutes and sex shows, masturbating, with or without using pornography, compulsively seeking love and relationships, fantasising about sex rather than living life in the present.

It is very common that sex addicts become addicted to other substances or compulsive behaviours to mask or to support the sex addiction, which is often their main and primary addiction. Alcohol, drugs, and gambling are examples of other addictions which may be used in this way.

The addictive behaviour can become strictly ritualised, and days or weeks may be spent planning the next event or activity. Once it has been acted out, the compulsion subsides for a while, and then the mind starts planning the next one, and the cycle starts over again.

Now there are three of you and you have become a family, many aspects of your relationship are likely to change. Your status within your wider family and friends will be affected, and people who are not parents may find it odd that you seem so preoccupied with your child. This may change your friendships and social life. As you walk in the street with a baby, people like to stop and admire him or her. This can feel very supportive, or at times a bit of a nuisance.

Between you there will be much less private time, and less energy for your relationship. Intimacy may be more difficult, and sex may be on the back burner. The importance of communicating, understanding and accepting what cannot be changed about the situation cannot be stressed enough! At least you can remind yourselves that with a baby everything is "only a phase", as things change so fast.

It is important for the two of you to get private time away from the baby as soon as you can, even if it is only an hour to go for a walk. If the baby sleeps with you at first, make sure that when your child has his or her own room that you teach them about the importance of your privacy, and the meaning of a closed door. Some parents prefer to give the children free and open access to them at all times, and are not concerned for their privacy.

Becoming a Father can take some men by surprise. They may look forward to it and share the pregnancy and birth every step of the way and be fully emotionally part of it. They may be astonished at the emotional depths they experience with this tiny scrap of humanity, and feel a connection with the child from the outset.

Others may be distanced from the process, feeling left out and that it is not really anything to do with them. They may resent the way their life is taken over, and feel jealous of the attention given to the baby. Thay may miss the warmth and closeness from the woman and hate to see it going to the child. They may also feel ashamed of these feelings and try to keep them secret.

For some men the sense of responsibility is very strong and at times unbearable. A nursing mother is vulnerable and emotionally needy, and this may seem unreasonable and unfair. This can give rise to feeling trapped, and a desperate wish to escape.

For some fathers, presence at the birth is difficult to deal with. it can seem physically frightening, even alarming, and a father who decides it is not for him should not be pressurised into being there. It can have an impact on how a man perceives his partner's sexuality, and her sexual parts. He may find it hard to feel sexual towards her in the future.

Will I be able to have/bear children? Am I fertile/potent?
If you were fertile before the accident, then unless you testicles or ovaries are damaged, you will be fertile now. If you are not able to have an erection or ejaculate, there are ways of helping you become a father. A woman may need help to deliver the baby if her pelvis has been damaged.

I am depressed at the loss of my sexuality; is this normal, and do people get over this?
Yes it is normal to feel depressed if you believe you have lost your sexual ability. Over time you may find ways of getting sexual pleasure that are not yet happening. People do get over things, though they do not think they ever will.

Will this affect the hormonal balance in my body; will this accident change who I am hormonally?
An accident of itself does not affect the sex hormone balance, but any trauma will affect all the body's systems a bit.

Explain to me what has changed to my ejaculate.
It has probably become thinner and less in quantity, due to nerve damage.

Why can I still have an erection though I have no sensation? Why is it that I can ejaculate at the slightest erotic stimulation? How has my orgasm changed?

Peter, age 47, is a highly paid and highly successful journalist, who has noticed a gradual reduction in the hardness of his erections over the past 2 years. Then, 6 weeks ago, after a particularly difficult argument with Edward, his partner of 7 years, he found himself unable to have an erection at all, and his morning erections stopped.

His doctor found he had high blood pressure, which might have caused the reduced hardness, but Peter was told that the sudden change was probably due to psychological causes, and sent him to a therapist.

During discussions with the therapist, Peter began to see that for some time he had been hiding resentment from Edward. He felt that expressing anger was a bad thing in a loving relationship, although Edward had no problem expressing his anger to Peter. This difference had led to a build up of bad feelings, and was the cause of the argument. Because of Peter's belief that expressing anger was wrong, he now felt very guilty, which could easily have caused the loss of erections.

The therapist suggested he discuss the matter with Edward, who was very understanding, and apologised for not realising how hurtful his anger had been. As a couple, they came to an agreement about the most fair way of letting each other know if they were feeling angry or upset.