Sexual difficulties

A couple’s sexual relationship is something they work out for themselves. How often you have sex, when and what you do is personal to your relationship. As long as you both enjoy it and it’s not harming anyone else, then it’s your choice.
However, if your sexual relationship isn’t giving you the pleasure or satisfaction it once did, or if it never has, then you may find talking to a sex therapist helpful. Talking about your sexual relationship may seem a little strange at first, but you will be talking to someone who is trained and skilled in working with sexual difficulties.

How can sex therapy help me?

Our sexual and relationship therapy service is offered by experienced relationship therapists who have completed a further two years training specialising in working with sexual difficulties. Within sessions you will be helped to look at your sexual relationship to find the right outcomes for you and your relationship. We work with individuals and couples to explore what is not working and what needs to be different.

What sort of problems do sex therapists work with?

Our therapists can deal with different kinds of sexual problems. Those might be associated with desire for or not wanting sex;  having sex; by things happening to you, such as ageing, accidents, illness or children, which may affect your sexual relationship; or those things that are to do with each of you as individuals that may affect how you are or see yourself as a sexual being.

Some of the main issues we deal with are:
Erectile problems - Erectile problems are not being able to get or maintain an erection or feeling that your erection is not as hard as it used to be.
Orgasm difficulties - Orgasm difficulties are not being able to reach orgasm or climaxing/ejaculating too soon, not being able to ejaculate.
Painful sex - This is usually pain when penetration is attempted, although sometimes it can also happen after sex.
Desire problems - Desire problems might be loss of desire for sex or when there are different levels of desire in a couple, one wanting sex more than the other.
Illness or disability - This refers to anyone or any couple where disability, illness or accident is impinging on their sexual relationships; it could include physical disabilities, diabetes or surgery.
Gender issues - When a person feels they are not being who they feel inside
Sexual orientation - When people think they may be attracted to someone of the same sex.
Sexual or porn addictions - When people might be addicted to the internet, chat rooms, pornography or masturbation.

What happens at sex therapy?

• Your therapist will meet you for an initial session to assess what the difficulty is and whether it’s something they can work with.

• If you both agree to go ahead, they will arrange to meet each person individually to take a full history. This can take more than one session.

•  When the therapist has taken each person’s history and looked at what the problem is, they will meet you as a couple to discuss a treatment programme that is designed to help with your particular difficulty.

• A treatment plan explains what you will need to do to try and sort out the problem. You won’t have to do anything in front of the therapist or anyone else. The therapist will give you homework at each session for you and your partner to do at home.

• If you are in a couple then your therapist may recommend that you have relationship counselling before starting on a sex therapy programme. This is because sex therapy requires couples to work closely together on their sexual relationship, but if there are any underlying relationship problems, they will quickly surface.

How long will sex therapy take?

It depends on your situation and the problems you’re experiencing. Your therapist will discuss that with you.

Is it confidential?

Yes. Our therapists are bound by a duty of confidentiality, unless circumstances suggest that the issues being discussed may pose a risk to clients or the wider community. Such issues include domestic abuse, child protection, money laundering and terrorism. In all circumstances, care is taken to protect confidentiality and no disclosure will be made without discussing the issues first, unless there is an urgent risk of harm. All our sexual therapists work to the ethical standards of both Relationships Scotland and COSRT (College of Sexual and Relationship Therapists www. COSRT is the professional association covering sex therapy.

How much will it cost?

If you are referred by NHS Borders, there is no fee. However, you will be asked to contribute towards the cost of the service you receive, if you can afford to do so. Please see our Fees and Contributions page.