Sexology treatment in English

Quite often, there is a difference in how often each of you feels the desire to have sex. Sometimes, this difference can grow over the years, and there can be barriers for one of you to be able to enjoy sex. This can be very difficult for both of you, for the one who feels less desire and for the other one to cope with this
Then typically, the couple slips into a very negative interaction pattern with one pressurising and the other one avoiding, usually ending up in both avoiding the issue altogether, and both being unhappy.

As a sexologist, I can help in changing this interaction pattern, in finding out what barriers may play a role in decreasing your sexual desire. Maybe there are thoughts crossing your mind that are not helpful at all. I can help you revealing what it is that is bothering you, or help you finding what aids in arousing you sexually. It is important to consider the fact that, although in the beginning when you were in love with each other there was often sexual arousal, this changes over time. That is normal. Also, sexual arousal is not something that comes instantly and automatically, usually you have to do something to make it happen. On the other hand, I can help the other partner dealing with a difference in desire, or helping eachother in finding the right way to stimulate sexual arousal. Maybe you will see that there are other things you can do or think that will help you both.

Some people find themselves in the situation in which the need for sex, the desire to visit prostitutes, the need for watching porn or cybersex is an important part of their everyday life. Obviously, most marriages won't be able to deal with promiscuity of most of these types. Furthermore, sometimes also working life can suffer, you may experience that the need for sex is increasing and increasing over the years and not really satisfying.
Then there might be that you are suffering from a sex addiction, and that we need to deal with that. I treat sex addiction according to the method of van Zessen (LINK) added with either cognitive behavioral therapy or EMDR.

Usually pain is a problem that mostly women encounter, but also men can have pain problems (e.g. during or after ejaculation). For women, quite often, pain (dyspareunia) is in the long run or the short run a result of coitus without enough sexual arousal. If that is the case, the focus of the treatment is on causes that prevent sexual arousal, causes of still having sexual intercourse with a partner whilst being in pain, relation therapy, exercises, cognitive therapy, often also EMDR. Dependent on the type of pain there may be co-treatment with physician-sexuologist.

Some women suffer from vaginismus. In that case, there is an anticipation of pain or disgust with coitus which automatically triggers spasm in the muscles in the pelvis. These women are not able to control this and cannot relax those muscles when they want to. Treatment involves treating the anxiety or the disgust, usually by behavior therapy and co-treatment with a physiotherapist and EMDR.

A common problem that men may experience is that sometimes the erection disappears or is not showing at all in sexual contexts. Sometimes there may be a physical problem, or it may be a side effect of drug taking, but if there are regularly morning erections than usually the problem is merely psychological. This can be treated by finding out why the focus is fading or distracted, what the thoughts may be that causes this to happen. Cognitive therapy, sometimes EMDR, and exercises to be done at home, is the most frequently used treatment method. Communication between the partners is also an import point of discussion, to see what needs to be improved.

Most men ejaculate between 3 – 10 minutes after penetration. However, also many men ejaculate sometimes between 1 and 3 minutes and both partners can be completely happy with that. I would hesitate by stating how long the latency time should need to be, since it is mostly a matter of what both partners like and what fits in their pattern of love making. Men can have the experience that they experience no control regarding their ejaculation. Sometimes men experience a lot of tension which disables them to focus on what they feel and then the ejaculation can be sudden and quick. Drug taking can be a cause, or other physical causes. Treatment is usually by exercises at home and finding out what factors play a role in building up the tension levels.