Nine questions about sexual problems

Below you read nine questions which can help you to clarify what the issue is if you experience a sexual problem.

 

  1. What is your sexual problem? Common problems:
    • Having less or no desire for sex. Not managing to become sexually aroused.
    • Not having or being able to maintain an erection or a moist vagina with slightly swollen lips.
    • Not being able to have orgasms (or only with great difficulty), or always coming too quickly.
  2. When do you experience that problem?
    • Have you always had it?
    • If you have not always had it: did it appear suddenly or gradually?
    • Do you experience the problem in every situation now? Or are there some circumstances in which you don’t experience it? For example: do you get erections in the morning or when you masturbate, but not when you have sex? Can you come when you masturbate, but not when you fuck?
    • It can be handy to draw a sexual timeline: what have been important moments for you in terms of your sex life? Don’t forget to include:
      • any circumstances that might have played a role in causing the problem (for example: you just heard that you were diagnosed as having HIV).
      • any circumstances that could have played a role in maintaining the problem.
  3. What is the role of your (sex) partner(s)?
    • Do you find your partner sexually attractive? Do you find yourself sexually attractive for your partner?
    • Does your partner find you sexually attractive? Does your partner find him or herself sexually attractive for you?
    • How would you rate the level of intimacy and trust that you share?
    • Who takes the initiative when it comes to sex?
    • Do you know your own desires and boundaries? Does your partner know those? And do you know your partner’s desires and boundaries? Do you ever talk about those?
    • How does your sexual problem affect your sex life? Do you not have sex anymore because of that problem?
    • Does your partner know that you have a sexual problem? Are the two of you able to actually talk about that? Do you both see the situation in the same way? How is your partner dealing with it?
    • Does your partner also have a sexual problem? Does that play a role in your own problem?
  4. How much influence does your sexual problem have?
    How does it influence your life? And how does it influence that of your partner?
  5. Have you had any very unpleasant sexual experiences?
    Perhaps you yourself have done things that you later regretted. For example: you failed to make your own boundaries clear to the other. Or perhaps you were sexually abused or forced to do things you did not want to do.
  6. Do you find sex sickening or frightening?
    Experiencing sex as sickening or as something to fear goes quite a bit further than simply not having any desire to have sex.
  7. What can play a role physically?
    • Other conditions or diseases
      This could be practically anything. You could have something that makes you chronically tired or gives you intestinal problems. You could also have a genital condition, such as HPV (human papillomavirus: genital warts) or HSV (herpes simplex virus: painful blisters)
    • Side effects from medications
      Antidepressants can cause you to be less interested in sex, for example.
    • Alcohol and drugs
      These can play a role in connection with an erection problem, for example.
    • Smoking, not getting enough physical exercise and being overweight
      These, too, can contribute to an erection problem.
    • Hormones
      It is not very common, but a shortage of testosterone can lead to less of an appetite for sex and less vitality – in men but also in women. A doctor can prescribe medications to supplement that shortage.
    • Growing older
      Menopause can have a major impact on your sex life. And once you turn 40, your testosterone levels will decrease by about 1.5% each year. Your sexual desire gradually becomes less and less intense, and sometimes you won’t even notice that happening. Older people usually don’t have the same strong interest in sex that they had had when they were younger. But it is also not the case that older people have no more appetite for sex whatsoever.
  8. What can play a role psychologically?
    • Do you have psychological problems?
      There can be an interaction: a psychological problem can lead to a sexual problem, but the other way around is also possible: a sexual problem can also lead to psychological problems.
    • How is your mood?
    • Do you suffer from stress, strain, anxiety or depression?
    • Has something negative happened in your life that continues to affect you?
      That could be for example problems at work, the death of a loved one or bad news about your own health.
    • Are you satisfied with the way you look? Or are you ashamed of your body?
    • Are there certain actions or situations that have negative associations for you?
      For example: do you become anxious about passing on your HIV anytime you come? Or: does fucking call up images of abuse from your past?
    • Do you avoid sex in order not to be confronted with your sexual problem?
      Do you ever fake being asleep for your partner for example, or do you ever convince yourself that you are too tired for sex, while in fact you don’t want to have sex because it’s painful because you can’t come or because sex leads you to have negative feelings?
    • ast but not least: do you have any thoughts and feelings that help sustain your sexual problem?
      • When I have sex, I often feel like I am observing myself.
      • I am convinced that my sexual problem is also a big problem for my partner, but we have never really talked about it.
      • Whenever I have sex, I end up feeling guilty.
      • I’m not really able to talk to my partner about what feels good to me and about what I want to do and don’t want to do.
      • I’m afraid I’ll come too quickly.
      • When my partner does his best to help me come, I have the feeling it’s really more about him performing and less about him wanting to give me pleasure.
      • I cannot come because my partner has erection problems or comes too quickly.
      • During sex I often think about what I’m ‘supposed to do’ and what I’m ‘not supposed to do’.
      • I don’t think I’m an attractive sex partner.
      • I feel pressure to perform. I’m afraid of failing.
      • I feel vulnerable when I come.
      • For me it’s normal to have sex if my partner wants it, but I’m not usually aroused myself in those cases. It’s not about my own sexual pleasure.
      • I have to come, no matter what.
      • I think my partner and I should come at the same time.
      • I’m afraid of pain during sex.
      • I don’t tell my partner that I’m experiencing pain while we are fucking, because I’m afraid I’m inadequate.
      • I’m not a good partner because I can’t get fucked.
      • I think that my problem with sex is because I don’t think my partner is sexy enough.
  9. What have you done so far to solve your problem?
    Have you been working on the problem for some time already, or is this your first step towards dealing with it?

In this article you can read more about what a caregiver can do for you if you are experiencing a sexual problem.

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