Arousal is often measured by how wet the vagina gets during sex. This is a very poor measure, as it is so changeable. It can dry up half way through for no reason. If you want to know how aroused you are, you have to feel the sensations in your body. If you can't feel any and never have, you may need to learn to feel your body feelings as a first step.

Assessment
You will talk about your sex life now and in the past to try to understand why there is difficulty getting aroused. Common causes are:

• Medical reasons, like high blood pressure, diabetes, depression, and many others. If in doubt see your doctor before starting any therapy.
• Relationship problems will need to be improved. The commonest cause of arousal difficulties is hidden anger.
• Lack of confidence makes it hard to relax and "go with the flow" because you worry all the time about how you are doing.

Sex Therapy
This is the ideal next step for arousal difficulties, because it means you have to take time, be in a safe place, and, if you have a partner, it will help the relationship. Your therapist will guide you through the exercises, which you do in your own home and in your own time. If you have a hard time feeling your body feelings, this is very good for that too. When difficult feelings come up in the exercises, they can be helped.

Keeping up the good work
After therapy has ended, it is common to slip back a bit. Do not give up. You can do the exercises again from time to time, and remember the things you learnt in therapy that helped to make things better.