Physical & Medical Concerns

Physical and medical concerns are a highlighted theme in sex therapy due to health being connected with overall wellness. Taking into consideration the biological, psychological, and medical considerations helps when understanding the framework when working with sexual dysfunctions. Medical conditions affect sexuality in many ways including, sexual pain, pelvic pain, chronic pain, hormones with life stage transitions, physical illnesses, disabilities, drugs, alcohol and substance abuse, mental health disorders, acquired immunodeficiency syndrome (AIDS), human immunodeficiency virus (HIV), sexually transmitted diseases (STDs), obesity, pharmacology side effects, desire and arousal, cancer, grief, death, and infertility will be reviewed in the following paragraphs (Sexual Dysfunction: Symptoms, Causes, and Treatment, 2022).

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         Pain disorders and conditions can create distressing interactions that lead to relationship issues and mental health concerns (Flegge et al., 2023). Changes in hormones throughout life stages associated with sexual maturation, pregnancy, the postnatal period, perimenopause, and menopause can bring many experiences with sexual desire and arousal (Marcinkowska et al., 2023). Likewise,  physical medical conditions, for instance cardiovascular conditions and neurological diseases, affect sexual functioning through blood flow and bodily sensations.

Sex therapists will work with patients who have “acquired immunodeficiency syndrome (AIDS), human immunodeficiency virus (HIV), sexually transmitted diseases (STDs), obesity, cancer, and other conditions that may affect mental health, physical health, and physical abilities, resulting in low self-esteem, body image issues, and sexual intimacy,” (Physicians, 2003, pp. 347-352). Practitioners collaborate with other medical professionals in maintaining overall sexual health, including urologists, gynecologists, psychologists, pelvic floor specialists, physical therapists, psychiatrists, and primary care physicians.

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       When considering drugs, alcohol, abuse, and pharmacological interactions and side effects, it is another major component of sex therapy. Sexual functioning can be affected by drugs and alcohol, primarily risky sexual decisions, relationship interactions, and sexual vitality (Abad & Arcos-Romero, 2022). Prescription medications such as antidepressants and other drugs can cause many side effects that inhibit sexual desire, orgasm, and satisfaction (Staff, 2024). Collaborating together, while understanding interactions, medical health providers and sex therapists will help find a treatment plan to address sexual wellness.

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         Women’s and men’s health are major components of sexual well-being. Common areas of sexual dysfunction within women include libido, pain, vaginal dryness, hormonal changes throughout the menstrual cycle, pregnancy changes, postnatal symptoms, perimenopause, menopause, postpartum depression (PPD), premenstrual dysphoric disorder (PMDD), polyendocrine metabolic ovarian syndrome (PMOS), causing fluctuations in desire, relational dynamic shifts, and sexual satisfaction (FACOG & MD, 2024). Male sexual health focuses on concerns such as erectile dysfunction, premature ejaculation, delayed ejaculation, low libido, performance anxiety, and testosterone concerns, which can affect mental and physical health (Leslie & Sooriyamoorthy, 2024). Sex therapy helps support patients by navigating changes and how they affect relationships and overall mental well-being.