Sex therapists are privy to people’s most erotic desires and deepest insecurities ― the kinds of things they may not feel comfortable opening up about to close friends and family.
So which questions do they get asked most often? Below, sex therapists reveal the topics they find themselves addressing time and time again.
1. Am I normal?
People constantly want to know if what they are doing, feeling and fantasizing about inside and outside of the bedroom is “normal,” whether it’s their level of desire or the shape and size of their genitals. In fact, sex therapist Shannon Chavez told HuffPost that trying to conform to these so-called sexual norms causes her patients distress.
“Most people are so relieved to learn they are not the only one dealing with a particular sexual concern or that the concern is something that others have also reported and there is hope,” she said. “I’ve seen people jump up and down when they realize nothing is wrong with them and they will be able to enjoy sex ‘just like everyone else.’”
2. Can I learn to orgasm?
In sex therapist Vanessa Marin’s office, there’s one question she gets from women more than any other: How the heck do I have an orgasm? She even created an online course, aptly named Finishing School, which is designed to teach women how to do just that.
“If you haven’t yet had your first orgasm, it’s important to know that orgasm is a skill,” she said. “Like any other skill, it takes time, patience and practice to learn. But fortunately, orgasm is one of the most fun things to learn.”
Certain physical factors, like gynecological issues, and some psychological ones, like past traumas, depression and anxiety, may make orgasming especially challenging for some women. But for others, reaching the Big O may just be a matter of education. Therefore, learning certain techniques, playing with sex toys or exploring your fantasies could all help you climax.
3. How can I give my partner an orgasm?
Sex isn’t just about both partners having an orgasm, though it is certainly a very welcome bonus. But many people ― especially women (hello, orgasm gap) ― can’t orgasm from penetrative sex alone. Some people require lots of dirty talk and foreplay beforehand; others need a great deal of clitoral stimulation. And then there are those who must be in the proper head space (e.g., relaxed, well-rested) in order to climax.
The point is, there isn’t one surefire way to get a person off. Each partner needs to figure out the most effective way for them personally and then communicate that to their partner. As sex therapist Stephen Snyder reminds his patients, each person is responsible for their own orgasm.
“An orgasm isn’t something you ‘get’ from someone,” said Snyder, author of Love Worth Making: How to Have Ridiculously Great Sex in a Long-Term Relationship. “It’s something you give yourself ― though your partner might provide the conditions for you to do so.”
He added: “We sex therapists have been saying this for years, to anyone who’ll listen. Unfortunately, the message still hasn’t been heard very widely.”
4. Is my penis too small?
Size doesn’t matter as much as some men think it does. But that doesn’t stop male patients from coming into Chavez’s office looking for reassurance that the size of their member is, at the very least, average. She believes that the exceptionally large penises seen in porn have given men a distorted sense of what a real penis looks like.
“There is a lot of concern over what is average and will a certain size be more acceptable by a partner and better suited for giving pleasure,” she said. “I believe pornography sets unrealistic norms around penis size that create concern for many men.”
5. My spouse never wants to have sex anymore. What’s wrong?
In a long-term relationship, fluctuations in sexual desire are normal. But when your sex life is nonexistent and your husband or wife starts feeling more like a roommate than a romantic partner, it’s probably time to get to the root of the problem. Snyder frequently receives this complaint from concerned, sex-starved spouses in his office.
“There are myriad causes, from low testosterone to depression,” Snyder said. “But if there’s one commonality among men specifically, it’s that they tend to be terribly afraid of disappointing their partners. Once she’s registered disappointment, he’ll often emotionally and sexually withdraw in order to protect his pride.”
For women, stress and exhaustion can often get in the way of desire, as well as feelings of boredom in the bedroom or a lack of connection in the relationship overall.
“Sometimes, feeling emotionally connected helps women to feel turned on before they have sex. And guess what? This is true for men, too,” sex therapist Tammy Nelson previously told HuffPost. “Try sharing with each other three things you appreciate about your relationship. Repeat it back so you are sure you got it before moving on to the next one.”
6. Can we really recover after infidelity?
Getting your relationship back on track after an affair isn’t easy. Repairing the trust and hurt feelings takes time and considerable effort from both partners. When couples show up at sex therapist Sari Cooper’s office, they’re often wondering: Can we really get past this?
“When a couple comes in for therapy, it’s usually in the crisis of a partner discovering their partner’s affair and there is a lot of rage, pain, shame, guilt and terror that their relationship is about to implode,” Cooper, director of the Center for Love and Sex NYC, said. “Our work is to help stabilize the couple enough to allow for the partner who stepped out to be honest and clear about their intentions in coming into treatment. Then, figure out how to express remorse, establish trust step by step and take the time to really listen to the pain they caused their partner.”
Cooper also works with the couple to help figure out what led to the infidelity in the first place, but in a way that does not place blame or judgment on either partner.
“Many times a couple has stopped having sex and even discussing it, other times the emotional connection has been slowly worn away due to focus on child-rearing, intensity of work demands or a small trauma that caused one partner to shut themselves off from the other,” she said.
7. How do we keep our sex life alive?
Like most worthwhile things, a good, healthy sex life requires work; it doesn’t just happen by accident. Many long-term couples struggle with keeping that sexual spark alive because they think it’s supposed to happen naturally, Marin said.
“Having to put any sort of effort into your sex life is seen as a sign that something is ‘broken’ with your relationship,” she said. “That couldn’t be further from the truth. Great sex requires great effort. If you want an active and satisfying sex life, you have to work together as a team to keep it exciting.”
8. How can I regain control of my erections?
It’s estimated that more than 18 million men in the U.S. are affected by erectile dysfunction. When the problem persists, it can catapult a person into a downward spiral of anxiety and shame, which only worsens the issue at hand. Cooper told HuffPost that when a patient comes to her with erection trouble, she first does an assessment to make sure it isn’t caused by a physical illness, medication side effect or a mental health disorder. Then she works with a team of doctors ― urologists, primary care physicians and psychiatrists ― to help create a plan that might alleviate some of the symptoms.
“For those whose issues have a psychiatric component, we teach techniques that help to lower anxiety-like mindfulness as well as cognitive-behavioural techniques to battle negative thought patterns like catastrophizing, all-or-nothing thinking or sexual self-shaming,” she said.
She also educates patients about how the body typically reacts to stress and worry.
“For instance, I tell them it’s normal for the body to shut down blood flow after having a terrible day at work,” Cooper added. “Or I teach them how to become aware of their anxiety and how to express their particular needs to their partners.”