What do you enjoy about sex? How does your body feel or react to touch? In one or two words, what would you say about how sex feels for you? While these questions may invoke anxiety, seem completely foreign or even too difficult to answer the answers likely indicate how self reflection on one’s sexual thoughts may affect their ability to reap the benefits of sex. While doing some initial research on sexual pleasure, I read through dozens of articles pertaining to sexual health. While most were informative about birth control, facts about preventing STIs, and the top reasons your sexual desire may be low, I did not find much literature relating to achieving sexual pleasure. Is it such a foreign principle? Is it so shameful or taboo that it cannot be incorporated into sexuality education? Any more information than it “should feel good” can lead one to the conclusion that when it is not enjoyable, there must be something dysfunctional about them. Unfortunately, this can lead to a snowball effect of negative thoughts, shameful feelings and sexual dysfunction.

How does one create a positive or healthy approach to sex when their experiences have been just the opposite? It begins within the therapy room, where I see myself (as the clinician) and my patients facing an uphill battle… it begins at the start line. Before someone can learn, process and accept sexual functioning from a healthy perspective, I work with my clients to examine any maladaptive, negative or shameful thoughts and feelings about sex that existed long before walking into my office. As part of my initial meeting with a patient seeking sex therapy treatment, I preface that our work together will include discussion about sexual function and pleasure. How do these two correlate? Are they intended to? Many clients who have symptoms of low sexual desire, also report that sexual activity doesn’t feel pleasurable for them either. If one is experiencing physical pain with sex, please make an appointment with a gynecologist who can address these issues and provide additional resources if necessary. In these cases, it is likely that there is a physical/biological issue causing pain which can result in a lack of pleasure. Once the biological/physical issue is resolved, it is possible for sex to become pleasurable. That is the goal! However, when pain is not a factor, having sex out of “obligatory guilt” to please a partner, or abstaining from sex altogether (unless both agree) are not healthy recipes for happiness.

In therapy, one of the fundamental principles that I emphasize in treatment is that sex should feel good and that each person is deserving of pleasure. However, this often brings uneasy reactions, which lead back to my initial questions presented above: what do you derive pleasure from within your sexual activity or encounters? Clinical experience indicates that having at least basic knowledge if not comprehensive understanding of one’s body helps tremendously. How familiar are you with your vulvar anatomy and how it functions? Have you ever seen your vulva with a hand mirror or participated in self exploration? Initially doing this may feel uncomfortable, yet it is a crucial part of getting to know yourself and owning your body.

Think of your body as a car…you wouldn’t hesitate to ask a car salesman to give you an overview of how it operates, read the owner’s manual, or even take it for a test drive, but when it comes to how your body operates, you’ve been a backseat passenger. Would you just hand the keys over to your partner without any question or expectation of taking good care of it? Taking the opportunity to teach yourself (it’s never too late) about what’s nearest and could be dearest to you with a little self care, is the best gift you can give yourself. I came upon a valuable resource that I share with almost all of my patients. A book titled “What Your Mother Never Told You About S-E-X” by Dr. Hilda Hutcherson, M.D. is a great self help guide that provides an in depth look at yourself, and normalizing what your body can do. Sex can really can be wonderful, desirable and pleasurable with YOU as the mastermind, the driver behind the wheel to your own body.

What do you enjoy about sex? How does your body feel or react to touch? In one or two words, what would you say about how sex feels for you? While these questions may invoke anxiety, seem completely foreign or even too difficult to answer the answers likely indicate how self reflection on one’s sexual thoughts may affect their ability to reap the benefits of sex. While doing some initial research on sexual pleasure, I read through dozens of articles pertaining to sexual health. While most were informative about birth control, facts about preventing STIs, and the top reasons your sexual desire may be low, I did not find much literature relating to achieving sexual pleasure. Is it such a foreign principle? Is it so shameful or taboo that it cannot be incorporated into sexuality education? Any more information than it “should feel good” can lead one to the conclusion that when it is not enjoyable, there must be something dysfunctional about them. Unfortunately, this can lead to a snowball effect of negative thoughts, shameful feelings and sexual dysfunction.

How does one create a positive or healthy approach to sex when their experiences have been just the opposite? It begins within the therapy room, where I see myself (as the clinician) and my patients facing an uphill battle… it begins at the start line. Before someone can learn, process and accept sexual functioning from a healthy perspective, I work with my clients to examine any maladaptive, negative or shameful thoughts and feelings about sex that existed long before walking into my office. As part of my initial meeting with a patient seeking sex therapy treatment, I preface that our work together will include discussion about sexual function and pleasure. How do these two correlate? Are they intended to? Many clients who have symptoms of low sexual desire, also report that sexual activity doesn’t feel pleasurable for them either. If one is experiencing physical pain with sex, please make an appointment with a gynecologist who can address these issues and provide additional resources if necessary. In these cases, it is likely that there is a physical/biological issue causing pain which can result in a lack of pleasure. Once the biological/physical issue is resolved, it is possible for sex to become pleasurable. That is the goal! However, when pain is not a factor, having sex out of “obligatory guilt” to please a partner, or abstaining from sex altogether (unless both agree) are not healthy recipes for happiness.

In therapy, one of the fundamental principles that I emphasize in treatment is that sex should feel good and that each person is deserving of pleasure. However, this often brings uneasy reactions, which lead back to my initial questions presented above: what do you derive pleasure from within your sexual activity or encounters? Clinical experience indicates that having at least basic knowledge if not comprehensive understanding of one’s body helps tremendously. How familiar are you with your vulvar anatomy and how it functions? Have you ever seen your vulva with a hand mirror or participated in self exploration? Initially doing this may feel uncomfortable, yet it is a crucial part of getting to know yourself and owning your body.

Think of your body as a car…you wouldn’t hesitate to ask a car salesman to give you an overview of how it operates, read the owner’s manual, or even take it for a test drive, but when it comes to how your body operates, you’ve been a backseat passenger. Would you just hand the keys over to your partner without any question or expectation of taking good care of it? Taking the opportunity to teach yourself (it’s never too late) about what’s nearest and could be dearest to you with a little self care, is the best gift you can give yourself. I came upon a valuable resource that I share with almost all of my patients. A book titled “What Your Mother Never Told You About S-E-X” by Dr. Hilda Hutcherson, M.D. is a great self help guide that provides an in depth look at yourself, and normalizing what your body can do. Sex can really can be wonderful, desirable and pleasurable with YOU as the mastermind, the driver behind the wheel to your own body.

Just about every day in clinical practice, I encounter a patient who tells me that she’s “just not feeling it”. What is IT referring to?

When more details are shared, there are usually long standing patterns of avoidant sexual behavior.  The woman describes her relationship as being wonderful in almost every way- that she can talk about anything with her partner, except for that pink elephant in the bedroom who has been sleeping between them for way too long.  

Women like this have been suffering in silence, and carry a heavy burden of guilt and shame.  They assume that they are alone, and that their girlfriends are having lots of great sex!  They picture the girls of “Sex and the City” and fall prey to the media’s portrayal of sex being the equivalent to breathing.  “If you’re not having sex, there must be wrong with you.” says her  inner voice so loudly she’s sure everyone know’s how damaged she is.

The feelings may be so deeply rooted in diminished self worth that the topic of sex is altogether avoided. Few women may confide in their friends, or their partner, that they have little to zero desire for sex, that they don’t think about having sex, don’t feel turned on, struggle emotionally when it comes to engaging in sexual activity with their partner, and describe sex as being like a chore. In fact, they’d prefer to take out the garbage or wash dishes then let their partner see them undressed, let alone be touched.  The reasons for this avoidance range from having a terrible migraine, to feeling too tired or unattractive.  They say that if their partner would agree,  they would be fine with never having sex again.

But I have never seen a partner consent to this notion. The catalyst that often brings the woman (or the couple) into my office is that the other partner is feeling upset and hurt from having been rejected time after time. Another presenting symptom is that the relationship is so volatile from arguing over sexual issues that they are on the verge of calling it quits. For women presenting with symptoms of acquired Hypoactive (low) Sexual Desire Disorder (HSDD), the question often comes back to “What can I do to fix this?” The answer is generally not a quick fix or as simple as taking a pill. Or is it?


In August 2015, the FDA recognized and approved the first pharmacological medication to treat acquired HSDD in premenopausal women. This drug, scientifically proven to treat HSDD is called flibanserin, or by name brand Addyi. The “pink pill” nicknamed “the female viagra” is an approved medical treatment option for many women who are bothered by their lack of sexual desire.  There are restrictions, for example, women are counseled by their provider that they should not consume ANY alcohol while taking flibanserin, which for many can be a deterrent. If you are contemplating treating HSDD with this medication, you can set up an appointment with a physician who is certified to prescribe it, and find this information in their directory (www.addyi.com).


I recently attended a 4-day-conference through the International Society for the Study of Womens’ Sexual Health (ISSWSH), where health professionals come together to learn about new advances that can improve the lives of their patients and clients.

As a sex therapist, I advocate for my clients and constantly learn more about treatment options that may help increase their quality of life.  I help them to believe and recognize the importance of self care, and that they deserve to have pleasurable and fulfilling sexual relationships. Treatment is not a one-size-fits-all, and Addyi is not necessarily right for everyone. Loss of sexual desire can take a painful toll on a relationship, and if you have reached that pivotal point of weighing your options, there are helpful ways to treat and regain that feeling of desire. Here’s to recognizing that your sexual desire matters!

Just about every day in clinical practice, I encounter a patient who tells me that she’s “just not feeling it”. What is IT referring to?

When more details are shared, there are usually long standing patterns of avoidant sexual behavior.  The woman describes her relationship as being wonderful in almost every way- that she can talk about anything with her partner, except for that pink elephant in the bedroom who has been sleeping between them for way too long.  

Women like this have been suffering in silence, and carry a heavy burden of guilt and shame.  They assume that they are alone, and that their girlfriends are having lots of great sex!  They picture the girls of “Sex and the City” and fall prey to the media’s portrayal of sex being the equivalent to breathing.  “If you’re not having sex, there must be wrong with you.” says her  inner voice so loudly she’s sure everyone know’s how damaged she is.

The feelings may be so deeply rooted in diminished self worth that the topic of sex is altogether avoided. Few women may confide in their friends, or their partner, that they have little to zero desire for sex, that they don’t think about having sex, don’t feel turned on, struggle emotionally when it comes to engaging in sexual activity with their partner, and describe sex as being like a chore. In fact, they’d prefer to take out the garbage or wash dishes then let their partner see them undressed, let alone be touched.  The reasons for this avoidance range from having a terrible migraine, to feeling too tired or unattractive.  They say that if their partner would agree,  they would be fine with never having sex again.

But I have never seen a partner consent to this notion. The catalyst that often brings the woman (or the couple) into my office is that the other partner is feeling upset and hurt from having been rejected time after time. Another presenting symptom is that the relationship is so volatile from arguing over sexual issues that they are on the verge of calling it quits. For women presenting with symptoms of acquired Hypoactive (low) Sexual Desire Disorder (HSDD), the question often comes back to “What can I do to fix this?” The answer is generally not a quick fix or as simple as taking a pill. Or is it?


In August 2015, the FDA recognized and approved the first pharmacological medication to treat acquired HSDD in premenopausal women. This drug, scientifically proven to treat HSDD is called flibanserin, or by name brand Addyi. The “pink pill” nicknamed “the female viagra” is an approved medical treatment option for many women who are bothered by their lack of sexual desire.  There are restrictions, for example, women are counseled by their provider that they should not consume ANY alcohol while taking flibanserin, which for many can be a deterrent. If you are contemplating treating HSDD with this medication, you can set up an appointment with a physician who is certified to prescribe it, and find this information in their directory (www.addyi.com).


I recently attended a 4-day-conference through the International Society for the Study of Womens’ Sexual Health (ISSWSH), where health professionals come together to learn about new advances that can improve the lives of their patients and clients.

As a sex therapist, I advocate for my clients and constantly learn more about treatment options that may help increase their quality of life.  I help them to believe and recognize the importance of self care, and that they deserve to have pleasurable and fulfilling sexual relationships. Treatment is not a one-size-fits-all, and Addyi is not necessarily right for everyone. Loss of sexual desire can take a painful toll on a relationship, and if you have reached that pivotal point of weighing your options, there are helpful ways to treat and regain that feeling of desire. Here’s to recognizing that your sexual desire matters!

What is sex? The Merriam-Webster dictionary defines it as “a physical activity that is related to and often includes sexual intercourse.” Clinically, I could argue that this definition often deters those who do not (or cannot) have intercourse from having “sex” or engaging in physical intimacy with their partners. For example, some women who experience pelvic pain often cannot engage in penetrative sex as it aggravates their condition, causing discomfort or even intense pain.   The relationship between partners in these situations may be often fragile or estranged, and discussions regarding sex, if and when they happen, likely are volatile.

Quite often sexual disconnect results in the avoidance of a couple’s physical or intimate relationship altogether.  So, how can we broaden our definition of sex to incorporate any form of physical touch that is desirable and makes us feel intimate or closer to our partners? When sexual contact is engaging and connects partners on an intimate level, it can be mutually pleasurable and enjoyable regardless of whether penetration occurs. Emotional closeness and desire for one another are the relationship building blocks used to strengthen the sexual bond between couples.

However, oftentimes couples facing sexual difficulties can disconnect and/or judge themselves and their sexual relationship because of standards set by Western culture and media. Sex in Western media continually and often distorts the reality of what many individuals are facing in their own lives. Distorted conceptions of sex contributes to shame, guilt, judgment and criticism of one’s self if one doesn’t feel that they can measure up to society’s expectations of what great sex is.

For the sake of your own health, focus on what makes you feel good and what you think helps you to feel close with your partner. If it brings a smile to your face, gets you excited and the end result is a good time had, then you’ve accomplished your goal. Sex is a journey that couples can experience when they define it in a way that helps to bring them together. So just keep in mind that you can have “sex” anyway you’d like to. It will be worth it!

What is sex? The Merriam-Webster dictionary defines it as “a physical activity that is related to and often includes sexual intercourse.” Clinically, I could argue that this definition often deters those who do not (or cannot) have intercourse from having “sex” or engaging in physical intimacy with their partners. For example, some women who experience pelvic pain often cannot engage in penetrative sex as it aggravates their condition, causing discomfort or even intense pain.   The relationship between partners in these situations may be often fragile or estranged, and discussions regarding sex, if and when they happen, likely are volatile.

Quite often sexual disconnect results in the avoidance of a couple’s physical or intimate relationship altogether.  So, how can we broaden our definition of sex to incorporate any form of physical touch that is desirable and makes us feel intimate or closer to our partners? When sexual contact is engaging and connects partners on an intimate level, it can be mutually pleasurable and enjoyable regardless of whether penetration occurs. Emotional closeness and desire for one another are the relationship building blocks used to strengthen the sexual bond between couples.

However, oftentimes couples facing sexual difficulties can disconnect and/or judge themselves and their sexual relationship because of standards set by Western culture and media. Sex in Western media continually and often distorts the reality of what many individuals are facing in their own lives. Distorted conceptions of sex contributes to shame, guilt, judgment and criticism of one’s self if one doesn’t feel that they can measure up to society’s expectations of what great sex is.

For the sake of your own health, focus on what makes you feel good and what you think helps you to feel close with your partner. If it brings a smile to your face, gets you excited and the end result is a good time had, then you’ve accomplished your goal. Sex is a journey that couples can experience when they define it in a way that helps to bring them together. So just keep in mind that you can have “sex” anyway you’d like to. It will be worth it!

After many years as a practitioner in sexual health, I have found that the psychotherapy session is often devoted to understanding intimacy. Clients will search the web for “sex therapist” because they are in search of a professional who is going to address and help them “fix” or “solve” their problems in the bedroom. However, all too often whatever the sexual issue they are experiencing is often accompanied by a lack of intimacy with their partner.

What is intimacy?

Intimacy can be defined many different ways. The most common described form of intimacy my clients can relate to are their sexual relationships. To be intimate can mean to be close, familiar, comfortable, private, or affectionate. We can achieve intimacy in different ways; emotionally, physically, sexually, intellectually and spiritually are some that come to mind. But how do we personally define intimacy? Can we really achieve the ultimate feeling of intimacy that is at the core of having healthy relationships? In order to make things great in the bedroom, it starts with what’s outside of the bedroom and beyond. To achieve intimacy, we have to understand ourselves, our vulnerabilities, our core hurts and how they affect the way we function as individuals.

After many years as a practitioner in sexual health, I have found that the psychotherapy session is often devoted to understanding intimacy. Clients will search the web for “sex therapist” because they are in search of a professional who is going to address and help them “fix” or “solve” their problems in the bedroom. However, all too often whatever the sexual issue they are experiencing is often accompanied by a lack of intimacy with their partner.

What is intimacy?

Intimacy can be defined many different ways. The most common described form of intimacy my clients can relate to are their sexual relationships. To be intimate can mean to be close, familiar, comfortable, private, or affectionate. We can achieve intimacy in different ways; emotionally, physically, sexually, intellectually and spiritually are some that come to mind. But how do we personally define intimacy? Can we really achieve the ultimate feeling of intimacy that is at the core of having healthy relationships? In order to make things great in the bedroom, it starts with what’s outside of the bedroom and beyond. To achieve intimacy, we have to understand ourselves, our vulnerabilities, our core hurts and how they affect the way we function as individuals.