Sexual problems can be a symptom of a physical or mental illness, as well as the result of conflicts in a relationship or a destructive relationship dynamic. Depending on their origin, their treatment falls into the field of psychotherapy or medicine. However, there are also sociological reasons: When one's own sexuality is oriented towards social norms, so that there is a risk of distancing oneself from one's own sense of pleasure. 

Dissatisfaction with one's own sex life is widespread. In an American study, 43% of women and 35% of men reported suffering from sexual dysfunction. Male erectile dysfunction is particularly common in men and listlessness in women, as well as orgasm disorders in both sexes.

The causes of sexual problems can be manifold. Basically, at least six levels of causes can be distinguished:

• Early childhood trauma
• Mental disorders
• hurtful experiences
• Relationship problems
• Competing standards
• Physical problems

In most cases, several causes are involved in the development of a sexual disorder,

Accordingly, a careful examination and diagnosis is important, which is usually carried out in one or more sessions with the affected person, possibly also involving the partner.

We start by taking a sexual anamnesis with the patient (history and experiences of their own sexual development):

• Family history (relationship with father and mother and siblings, relationship with parents, role models, values and norms, dealing with fear and guilt, formative experiences)
• Current relationship (getting to know each other, further progress, current status)
• Current sex life (desire, arousal, contact, orgasm)

If a sexual problem is based on a mental illness, this must first be treated medically and/or psychotherapeutically before the sexual disorder can be treated. Illnesses such as depression, psychoses, anxiety disorders, personality disorders, addictions, etc. therefore speak against primary sexual therapy. In this case, sexual problems can also be addressed as part of the general psychotherapy for the underlying illness.

The following topics, for example, are covered in sex therapy:

• Lack of partnership
• Listlessness
• Impotence (e.g. as erectile dysfunction or vaginal dryness)
• Orgasm disorders (orgasm too early or no orgasm at all)
• Physical and medical disorders (such as substance abuse, alcohol, high blood pressure, age-related or general testosterone deficiency, surgery, etc...)

In sex therapy, we always work on the client's relationships. Unless they have a medical or physical cause, sexual disorders are a direct result of inner, partnership or social conflicts.

This creates a dense network of interactions that can build each other up and need to be untangled during therapy.

Sex therapy takes place in individual or couple settings.