Psychosexual Therapy
Online & In-person

For many people, sexual difficulty shows up first in the body. Pain, tightness, numbness, anxiety, or involuntary responses can make sex feel stressful rather than connective. This may include experiences such as vaginismus, dyspareunia (pain during sex), vulvodynia, pain during penetration or arousal, ongoing vulval or pelvic pain, anal pain, pelvic floor difficulties, or pain linked to erection – including conditions such as Peyronie’s disease or experiences of priapism.

These experiences can be influenced by many factors, including stress, past medical or sexual health experiences, trauma, hormonal changes, or shifts in the body over time – such as those associated with pregnancy, menopause, or ageing. In many cases, psychosexual therapy forms part of a broader psychological treatment approach that considers both body and mind.

Difficulties with desire are one of the most common reasons people seek a psychosexual therapy service. This might involve low libido, loss of sexual desire, feeling disconnected from desire, or sexual desire discrepancies within a relationship – differences in frequency, initiation, or sexual needs.

Desire is sensitive to context. It can be affected by emotional safety, relationship dynamics, stress, mental health, trauma, hormonal changes (including perimenopause and menopause), medication, and life transitions. For some people, questions about desire are also closely linked to attraction, identity, gaps in sex education earlier in life, or changes in how they experience themselves sexually. 

Some people seek therapy because orgasm feels difficult, delayed, absent, or overshadowed by pressure. This can include anorgasmia, rapid ejaculation, delayed ejaculation, or anxiety around timing, performance, and control, all of which sit within a wider spectrum of sexual issues.

These experiences often develop in the context of expectation, self-monitoring, fear of disappointment, or past experiences where sex felt unsafe, rushed, or disconnected. Physical changes, medication, hormonal shifts, arousal difficulties, and emotional factors can also play a role. 

Sometimes sex continues, but something essential feels missing. You might feel emotionally disconnected or caught in patterns where sex feels routine, performative, or tense, despite wanting closeness with your sexual partner.

For others, intimacy is longed for, but sex has become a source of conflict, avoidance, or silence. These patterns are often shaped by earlier relational experiences, trauma, communication difficulties, unspoken fears, and ongoing relationship difficulties. Psychosexual therapy supports individuals and couples to explore how closeness, vulnerability, trust, and emotional connection show up within sex itself – while allowing space to link into couple and relationship therapy to work with relationship therapists where deeper relational work is needed.

Some people come to therapy feeling concerned about their sexual behaviour or fantasies – how often sex, fantasy, pornography use, or masturbation is relied on, or the role sexual behaviour plays in coping with stress, loneliness, or difficult emotions. Compulsive sexual behaviour is approached here as a pattern, rather than a moral failing or a lack of willpower.

These patterns often develop in response to emotional pain, trauma, or unmet needs, and may sit alongside secrecy, shame, or risk-taking behaviours such as chemsex. A therapy session provides a confidential and non-judgemental space to explore these experiences safely.

Sexual difficulties sometimes sit alongside questions about sexual orientation, gender identity, or how you experience attraction, intimacy, and power in relationships. You might be exploring parts of yourself that feel uncertain, newly emerging, or difficult to integrate into your sexual or relational life.

Psychosexual therapy can offer a space to explore these questions thoughtfully and at your own pace, often with the support of a qualified sex therapist. Where helpful, this work can connect with more focused LGBTQIA+ affirming therapy or Kink-affirming therapy.

Sexual difficulties don’t require a relationship to show up. Many people come to psychosexual therapy on their own – navigating sexual aversion or avoidance, a complicated relationship with their own body, compulsive sexual behaviour, low or absent desire, shame around sexuality, or a sense that intimacy has always felt difficult. Some are working through experiences they want to understand before entering a new relationship. Others simply want to feel more at ease with their own sexuality. You don’t need a partner, a diagnosis, or a clear presenting problem to begin.

Whether you are married, in a monogamous relationship, or in an ethical non-monogamous or polyamorous relationship, sometimes the concern feels personal rather than relational – something you want to explore on your own before bringing a partner into the work, or because your partner isn’t ready to attend. Individual psychosexual therapy can be a meaningful starting point even when the difficulties affect the relationship. It offers space to understand your own patterns, desires, erotic template, and responses without the complexity of navigating them with a partner present. If couples work becomes relevant later, that conversation can happen in its own time.

For some couples, sexual difficulties are the primary reason for seeking support – not conflict or communication, but something that has shifted in the sexual relationship and is beginning to affect how partners feel about each other. This might involve differences in desire, avoidance of sex, pain during sex, pressure around intimacy, or a gradual disconnection that’s difficult to name. Psychosexual therapy holds both the sexual and relational dimensions together, with equal attention to each partner’s experience.

Queer, same-sex, trans, and non-binary individuals and couples can find an affirming space for psychosexual work. Our therapists provide LGBTQIA+ affirming therapy to navigate sexual identity, desire, intimacy, and relationship challenges without assumptions about what a “typical” sexuality or relationship should look like. This might include exploring parts of gender or sexual identity, and potential gender dysphoria, that feel newly emerging or difficult to integrate, navigating the impact of internalised shame, or working through vulnerability and sexual difficulties in a space that doesn’t require explanation or justification.

We work with neurodivergent individuals and couples – including those who are autistic, have ADHD, or are otherwise neurodivergent. Sex and intimacy can be shaped by differences in sensory processing, desire, communication, and the way affection is experienced and expressed. One partner may find certain types of touch overwhelming, while the other experiences this as distance or rejection. Psychosexual relationship therapy helps individuals communicate needs and boundaries within their relationship more openly, navigate intimacy differences with greater understanding, and develop a sexual relationship that feels comfortable and authentic for everyone involved.

Life transitions can profoundly alter how we experience our own sexuality. Menopause, post-cancer treatment, post-pregnancy, chronic illness, ageing, or significant loss can all shift desire, body image, physical comfort, and how intimacy feels. Some people find themselves grieving a version of their sexuality they feel they’ve lost; others are discovering something new. Psychosexual therapy offers a space to make sense of these changes – not to restore what was, but to find a relationship with sexuality that feels honest and workable for where you are now.