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Improving Sexual Relationships

Healthy sexuality involves a certain degree of good health and wellness; arousal (desire); physical and mental stimulation; and open communication, consent, equality, respect, and trust between sexual partners. Healthy sexuality is not associated with power or control and does not involve fear, intimidation, or anxiety.

Before entering a sexual relationship, partners should openly discuss their beliefs (e.g., cultural, moral, religious) and feelings about sexuality and sexual behavior. They also should be honest with each other about their sexual health and about their expectations regarding the relationship. Healthy sexuality can strengthen and improve loving relationships; however, unhealthy sexuality can damage relationships, can cause anger, resentment, and guilt, and can destroy self-esteem.

Improving sexual health can involve medical treatment (e.g., to treat sexually transmitted infections or sexual dysfunction) and sexual therapy, also called sex therapy. This treatment can help resolve a number of sexual problems, including erectile dysfunction (ED, impotence), premature ejaculation, female sexual dysfunction, inability to reach orgasm, and dissatisfaction.

Medications that may be used to treat conditions related to sexual health include the following:

• Antibiotics (e.g., penicillin, azithromycin, doxycycline, erythromycin; used to treat sexually transmitted infections)
• Antiretrovirals, antibiotics, and chemotherapy (used in patients with HIV/AIDS to help strengthen the immune system and treat/prevent HIV-related infections and cancer)
• Contraceptives (e.g., birth control pills, injectable hormones, subdermal implants, birth control patch; used to prevent pregnancy)
• Hormone replacement therapy (HRT; used to treat testosterone deficiency and some types of female sexual dysfunction [FSD])
• Selective enzyme inhibitors (e.g., Viagra®, Levitra®, Cialis®; used to treat erectile dysfunction)
• Topical creams (may be used to treat FSD) and topical anesthetics (e.g., lidocaine; may be used to treat premature ejaculation)

Sex therapy, which is performed by psychotherapists who specialize in sexual health (also called sex therapists or sex counselors), focuses on several aspects of sexuality. Sex therapy can help people resolve sexual issues and concerns, such as problems with arousal, stimulation, performance, and satisfaction. Sex therapists work with individuals and with couples.

Sex therapists also may address other concerns related to sexuality, including sexual trauma, sexual addiction, sexual orientation, self-esteem issues, and medical disorders that affect sexual health. In some cases, sexual therapy is combined with sex education and other treatments (e.g., medication).

Sex therapy is similar to other types of counseling. Therapists take a complete sexual history and then develop a treatment plan, often using psychological and behavioral modification techniques.

Treatment for sexual issues may involve educational materials (e.g., books, videotapes), discussion sessions, or workshops. Couples often are assigned "homework" (e.g., communication exercises, listening exercises, sexual exercises) to be performed at home. In some cases, sex counselors work with other health care providers (e.g., physicians, other therapists) to resolve sexual problems.

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