therapist

How to Find a Therapist

Five expert-backed tips to help you snag an appointment with the mental health pro that’ll help you the most.

Iron Supplementation

The Explainer: Iron Supplementation

Hair loss? Fatigue? Restless legs? You could be low on iron. Read more here about this frustratingly common problem for women in their 40s. 

Five Questions Sex Therapists Are Asked All the Time—Answered

Ever wonder if other couples are going through the same things you are? Read on! 

As a sex therapist, folks often come to me with their deepest and most private concerns, which is a privilege I don’t take lightly. They’ll ask questions they’d never dream to ask anyone else—and they share thoughts and feelings they may have never spoken aloud before. There’s no touching or taking off clothes in a sex therapist’s office; we just create a safe, non-judgmental space to talk. Human sexuality is a wide and varied space, so there are very few limits to what is discussed on any given day. However, there are certain questions that I hear more than others. While my feedback varies greatly depending on each specific person’s unique story and situation, here’s where I generally start when addressing these common topics. 

Common Question No. 1: I don’t have orgasms during sex. What do I do? 

So many female-bodied people come to sex therapy (no pun intended) for this issue. In the session, we always start with a little anatomy talk, since many of us never got this information in school. If you haven’t explored your vulva in a mirror in a while (or ever), that’s a good place to start. Get to know all its beautiful parts and be sure you know where your clitoris is (there are plenty of diagrams online that can help). Then, explore different types of touch alone, with the goal of sinking into pleasure instead of searching for a climax. A vibrator is a fantastic way to increase stimulation, which a lot of vulvas need to get to orgasm. 

If you’ve figured it out alone but are having trouble translating that with a partner, ask yourself, “How similar is the sex I’m having with my partner to what actually works for me when I’m alone?” For example, 88% of women don’t tend to put anything inside of the vagina when they masturbate, but then they get frustrated when they don’t orgasm from penetration alone (which less than 5% of women can reliably do!). Try as best you can to replicate what you’re doing by yourself, which may mean bringing a vibrator into the mix.  

Related: Want to Learn How to Squirt? Here’s How One Woman Finally Got There in Her 40s

Remember: there’s nothing that scares an orgasm away faster than pressure to have an orgasm. So, keep leaning in as long as things are feeling pleasurable, while trying not to rush to the finish line. There’s no such thing as taking too long as long as everyone’s having fun! 

Common Question No. 2: My partner wants more sex than I do. Is there something wrong with us? 

Libido is complex and varies over time, so it’s normal not to feel completely attuned to our partners all the time. After all, it’s the rare (read: nonexistent) couple that always wants to have sex at the same time for their entire relationship. But when these differences go unaddressed and undiscussed, the chasm tends to feel like it just keeps getting bigger. 

In session, I’ll always first assess for any pressure or coercion coming from the higher desire partner, which is never OK, no matter how frustrated you are. Not only is it manipulative to snap or mope when your partner doesn’t want sex, it’s decidedly unsexy and will not draw your partner toward you. Then we can talk about other ways to connect when your partner isn’t in a sexy mood. 

If you’re the lower desire partner and you’re wishing you wanted more sex, first ask yourself, “Is the sex I’m having worth wanting?” Humans tend to crave things that feel good! So if the answer is “no,” it’s worth exploring what might feel more pleasurable during sex. 

If you do tend to enjoy sex once you’re having it (but you just don’t spontaneously crave it), you have responsive desire, which is a perfectly normal way for libido to show up. This means that you generally desire sex only after something sexy happens. This gives you the option to try leaning into your partner’s initiation even if you’re not quite feeling it yet. (Caveat: This can only happen if you trust that opting out at any point will not lead to consequences.) 

I often recommend scheduling (yes, scheduling) time for physical intimacy with no expectation that it will lead to sex. Being skin to skin with your partner may create space for that responsive desire to catch. And increased touch and connection that doesn’t lead to sex will help that gap between you feel smaller and less disconnecting. 

Common Question No. 3: How can I ask my partner to try something new sexually?  

While sharing what you’d like in the bedroom can feel super vulnerable, it usually pays off! It’s easy to fall into repetitive sexual patterns, reverting to what “works”—especially with a long-term partner. But even the most reliable sexual routines can get tedious with time. 

If you have ideas for what you’d like to introduce, bring them up as an invitation rather than a critique. “Our sex life has gotten so boring” won’t land well. “Wouldn’t it be fun if we tried…” will open the door for a more light-hearted conversation. If you’re worried about how your partner will respond, try having a “meta-conversation” first—that is, a conversation about the conversation. 

“I’d love to talk about what we’d like to try in the bedroom. Would you be open to that?” This will give your partner a chance to do their own thinking about what they’d like to bring to the table. And you won’t be catching them when they’re not in an exploratory mood. 

If you’re unsure of what you’d like to try, search for a “Yes, No, Maybe” list online (I like the list on Scarleteen.com) where you can each pick from an inventory of sexy options. Or try an app like Kindu where you each swipe right for things you’d like to try. 

Common Question No. 4: We’re having a lot less sex now than we used to. Is something wrong with us? 

When you’re in a new relationship, that can’t-keep-our-hands-off-each-other sexual energy can feel so good. That heightened state of arousal is brought to you by feel-good chemicals dopamine and serotonin, which help us get attached to our new partner. This initial stage feels exciting and sexy, but it’s not sustainable. 

As a relationship gets more stable, our body chemistry does too. This indicates that the relationship is no longer precarious and uncertain. As comfort increases, so do levels of oxytocin, the bonding hormone, and things start to feel safer and more familial—which often means less sex. 

If you’re craving more, recognize that your hormones are no longer taking the lead, so try to be more intentional about creating the sexual contexts you’re craving. This may be tough—especially since your lives may be a lot busier or more stressful than when you first got together. 

Start by brainstorming ideas about how to insert sexuality throughout your day. Basically, flirt with your partner! Text each other sexy little reminders, plan a real date night complete with lots of little touches, kiss every day, and look for opportunities to remind yourself how good it feels to be sexual. 

Related: This is How One Woman Learned to Reclaim Her Erotic Pleasure

Common Question No. 5: Are my fantasies normal? 

Fantasizing about sex is very common—and it’s totally healthy! Clients will sometimes ask me to interpret their fantasies much like a psychoanalyst would interpret dreams. But the truth is, fantasies are often just a fantastic way for our mind to explore the depth of our imaginations—and they don’t have to mean anything deeper at all. Sometimes we want to recreate our fantasies in real life (how fun!), and sometimes we don’t. Both are normal.  

Fantasies are often about taboo acts or even things that are illegal (like sex in public). It’s OK to treat fantasies as a safe space to explore the depths of our imagination without judgment. Of course, if you feel the need or urge to act on something that could potentially hurt others, there’s reason for concern. But as long as you can distinguish between fantasy and reality, try to just enjoy what your brain comes up with! 

Of course, for many, especially those on the asexuality spectrum, it feels more appealing to fantasize about a decedent dinner or an exotic vacation than sexual scenarios. And that’s perfectly normal, too.  

Related: Here’s How One Woman’s Fantasy Life Became Her Real Life—and Why She’s Happier Than Ever

Rachel Zar, LMFT, CST, is a couple and family therapist and an AASECT-certified sex therapist. She is currently a clinician at Spark Chicago Therapy in downtown Chicago, and she also provides therapy at the Northwestern Medicine Center for Sexual Medicine & Menopause (CSMM). To learn more, visit rachelzartherapy.com
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