Counselling and therapy have become much more popular options in recent times, but if you have a sex problem, then you most likely need to see someone who specialises in sex and/or relationships, rather than someone who is a general counsellor. The other thing is that some sex difficulties are medical problems, and to get help for these you need to see a doctors (GPs).

Isn't talking about sex embarrassing?

It shouldn't be, but of course some GPs aren't very good at dealing with more personal issues. So, if you have a good relationship with your GP and know that s/he is easy to talk to, then start with your own doc. But if you're going to be too embarrassed to talk to this person, or you think that he or she might not be experienced enough, your best bet is to go to someone whose specialty is sexual medicine.

The obvious places to go for free, expert help are: Brook Advisory Centres (if you're under 25); Family Planning Clinics; or Genito-Urinary Medicine (GUM) clinics, which are usually found in large hospitals. There are also psychosexual units in hospitals in some parts of the UK, staffed by doctors and therapists. Unfortunately, they do not exist everywhere - and where they do, there is usually a waiting list. Your GP can tell you more.

What sorts of sex problems are medical?

• Things that hurt - like a tight foreskin or a vagina that feels taut and uncomfortable if intercourse is attempted;
• Erectile Dysfunction or impotence - In young people this is usually about performance anxiety, but there is always the possibility that it is being caused by a medical condition, such as diabetes;
• Rashes, allergies etc - Also discharge from a penis or vagina or if it hurts when you pee;
• A penis that is bent;
• Premature Ejaculation  - This can often be helped by a non-medical counsellor, but one possible treatment is to take an antidepressant, which slows down the sexual function, and you'd need to see a doc to get these.

Other problems:

• Inability to reach orgasm (come);
• Lack of interest in sex;
• Relationship problems.

These sorts of problems can be sorted by a counsellor - rather than a doctor - at Brook, Relate or a family planning clinic. There are also private therapists who are highly trained in sex and relationship problems and they usually belong to an organisation called the College for Sexual and Relationship Therapy (COSRT)

Such therapists can also treat:

• Erectile Dysfunction so long as it's definitely not caused by a medical condition;
• Premature Ejaculation if you want a non-medical approach. For instance, some counsellors will teach you and your partner the Masters and Johnson grip. This sounds painful, but isn't. But by learning to grip the penis in a certain way while you are having sex, you can train yourself to last much longer before you come.
• Pain during intercourse - particularly in women, so long as the problem is psychological rather than medical.

Updated: 19/09/2011