Questions about sexuality

Sexuality is an integral part of our lives and an important part of our identity and sense of self-worth. It influences our perception and expectations of ourselves and others and plays a major role in our intimate relations. Since sexuality varies greatly from person to person and is seldom discussed openly, most of us have questions about what is “normal” in ourselves and others:

  • Should I be concerned about the frequency or type of sex my partner or I prefer?
  • How does the arrival of children change a couple’s sexual relationship?
  • How do health conditions and medications affect sex?
  • Does a history of sexual abuse or trauma affect one’s sexuality?
  • Is it typical for desire and excitement to diminish over time in a relationship?
  • Are there treatments for lack of sexual desire?
  • What is normal sexual aging, and when does it happen?


Influences on Sexuality

A number of factors affect sexuality including parental attitudes, societal influences, past sexual abuse, relationship issues and aging.

Sexual attitudes and beliefs

From childhood we internalize beliefs about sex from our parents, friends, religion, and the media. Negative attitudes about sex can cause feelings of shame and guilt, and affect one’s ability to take pleasure in sex and communicate openly about it. Unrealistic expectations and myths about sex, particularly from TV, movies and pornography, are common and can create uncertainty and stress concerning our bodies, fantasies and behavior.

Effects of stress and life transitions on sex

Many people underestimate the effects of life stressors, and are often surprised to discover they are the source of sexual problems. Life transitions can cause one to feel unsettled, confused, or even depressed. These transitions include marriage, fertility problems, childbirth, divorce, menopause, a new career, unemployment or retirement. Stress resulting from circumstances such as illness, financial problems or couple conflict can also have significant impact on an individual’s or couple’s sexuality.

Past experiences of sexual abuse and trauma

Sexual abuse can create lasting feelings of fear and helplessness that profoundly affect one’s sexuality and ability to establish trust and intimacy. Some long-term effects are depression, anxiety, body-image issues, or feelings of shame and guilt, all of which may lead to avoidance or lack of interest in sex. During sexual contact some experience anger, intrusive thoughts, emotional numbness, lack of physical sensation, difficulty becoming aroused, guilt, or even disgust. Such reactions will also cause distress in one’s partner and couples may be at a loss for how to cope.

Relationship problems and sexuality

A couple’s sex life tends to reflect their emotional relationship. Feelings experienced by one or both partners – distrust, jealousy, anger – will affect the sexual dynamic. For instance, one partner’s depression can have a devastating effect on both partners’ sexual desire. A man’s performance anxiety can cause emotional distance and lead to the self-fulfilling prophecy of “failure to perform.” Fear of rejection can create a desperate need to please which can dampen the other partner’s desire. Often, embarrassment or attempts to protect each other’s feelings hamper communication, exacerbating and perpetuating problems.

Unhealthy lifestyle

Sexual response depends on one’s overall health. Factors such as alcohol and smoking, addiction (internet surfing, substance abuse, gambling), excessive stress and obesity may contribute to sexual dysfunction. For example, erectile dysfunction is frequently caused by obesity, smoking or high blood-pressure. An unhealthy lifestyle often leads to medical conditions which in turn impact sexual function.

Sexual dysfunction due to medical conditions and medication

Conditions such as heart disease, diabetes, sleep apnea, prostate conditions, pelvic disorders and nerve damage may all lead to sexual dysfunction. Health issues that cause chronic pain and fatigue, or affect hormonal balance may impact sexual desire and function. Both acute and chronic illness can lead to anxiety, depression, or body image problems, all which will affect one’s sexuality. Moreover, medications such as steroids, antidepressants, anti-hypertensives, antihistamines, sedatives, anti-epileptics and oral contraceptives can cause unwanted sexual side effects. When partners respond with frustration or anger to a sexual side-effect, it can exacerbate the problem. Consequently, what was initially a physiological problem can balloon into an emotionally-laden relationship problem.

Aging and sex

Aging makes our bodies respond more slowly and less intensely, but it need not mean the end of a satisfying sex life. Those expecting to function as they did in their youth may experience anxiety and disappointment. However, many learn to explore facets of sex and intimacy which they could not appreciate in earlier years. Couples who are adaptable and communicative will adjust more smoothly to the transition of aging. It is a common misconception that passing years bring boredom and lack of interest in sex: couples who maintain a sense of vitality and spontaneity in their relationship seldom have this problem.

Sex therapy in Haifa area, North Israel

Problems with sexual function are not uncommon and may include lack of desire, erectile dysfunction, difficulty becoming aroused or reaching orgasm, rapid ejaculation, vaginismus, pain during intercourse (dyspareunia) or sexual addiction. Fortunately, sex therapy can address and help treat these problems.