![A lavender armchair beside a closed garden door, with a lantern lit on the wall and a notebook on the seat](https://viacara.com/img/content/sexual-difficulties-feature-light.webp) # Sexual Difficulties Low desire, pain, erection or orgasm problems are common and can be worked on. Check the physical causes with a GP, then find a psychosexual therapist. Sexual problems are among the most common things people never mention. In Britain's largest sexual survey, 42% of men and roughly half of women reported a problem with sexual response. About one in ten were distressed about their sex life. If you are in that one in ten, start with a GP. Many sexual difficulties have a physical cause, and the NHS treats those first. A talking professional comes after that check, not instead of it. Once the physical side is ruled out or under treatment, the rest is very workable. Source: [Mitchell & Mercer 2013](https://viacara.com/support/sexual-difficulties/#ref-6) ## Why the *GP* comes first Persistent erection problems can signal a treatable health condition. The NHS names high blood pressure, high cholesterol, diabetes and hormone problems among the causes. It advises seeing a GP or a sexual health clinic when the problem persists. The same applies to low desire. Lower hormone levels with age, especially around the menopause, and some medicines can reduce sex drive. The NHS says to see a GP if you are worried about it. Sexual health clinics are free and open to everyone, whatever your age, gender or sexuality. You do not need a GP referral to walk in. Sources: [NHS: erectile dysfunction](https://viacara.com/support/sexual-difficulties/#ref-1), [NHS: low sex drive](https://viacara.com/support/sexual-difficulties/#ref-2), [NHS: sexual health clinics](https://viacara.com/support/sexual-difficulties/#ref-5) ## Where a talking *professional* helps Once a physical cause is treated or ruled out, what remains is usually in the head or the relationship. Both respond to talking. The NHS itself points there. For ejaculation problems it says psychosexual counselling can help you, and a partner if you have one. For vaginismus it says a GP may refer you to a sex therapist. For low sex drive caused by relationship problems, it suggests relationship counselling. Many people find the difficulty started with something physical and stayed for a psychological reason. One lost erection becomes fear of the next one. Pain once becomes bracing for pain every time. Sources: [NHS: ejaculation problems](https://viacara.com/support/sexual-difficulties/#ref-3), [NHS: vaginismus](https://viacara.com/support/sexual-difficulties/#ref-4), [NHS: low sex drive](https://viacara.com/support/sexual-difficulties/#ref-2) ## You might find support *helpful* when - Desire has faded and the physical checks came back clear - Sex hurts and you have started avoiding it, or your partner has - Erections or orgasm have become unreliable and the worry is now the main problem - You and a partner want different things, or different amounts, and it has turned into a fight - Sex stopped after a birth, an illness, a bereavement or an affair and has not restarted - You have never enjoyed sex and have started to wonder whether that could change None of these needs to be dramatic to count. Wanting it to be better is enough. ![The same door standing open, with the chair turned towards the evening garden beyond it](https://viacara.com/img/content/sexual-difficulties-mid-light.webp) Sex therapy is talking. The work happens in the room, and the practice happens at home ## What psychosexual therapy looks like [Psychosexual therapy](https://viacara.com/approaches/psychosexual-therapy/) involves no physical contact in the room. Relate describes sessions as weekly to fortnightly, with all the work in the room based on talking. You are given exercises to do in private at home, alone or with a partner. Those exercises are the method, not an add-on. They usually start by taking sex off the table entirely, so touch can stop being a test. Then they build back up at a pace you set. You can come alone or as a couple. If the difficulty lives between two people, our [couples page](https://viacara.com/support/couples/) covers that side. Source: [Relate: sex therapy](https://viacara.com/support/sexual-difficulties/#ref-8) ## Who to *look* for The UK professional body for this work is the College of Sexual and Relationship Therapists, COSRT. It holds registers of psychosexual and relationship therapists and a public search. A professional who names COSRT membership has trained specifically in this. Ask how they work with your particular difficulty, and whether they see people alone, as a couple or both. If you would prefer a professional of a particular gender, say so at the start. Source: [COSRT: professional body](https://viacara.com/support/sexual-difficulties/#ref-7) ## Kink, fetish and nothing to *fix* Wanting something specific in bed is not a difficulty. A kink or a fetish is not a presenting problem, and a good professional will not treat it as one. It becomes something to talk about only when it causes distress, partners want different things or shame does damage. Then the work is on the distress, the mismatch or the shame. Not on the wanting. Look for a professional who states that they work with kink and non-monogamy. The ones who do tend to say so. ## *Services* you can contact today If you would rather walk in somewhere than book anything, these are the places to start. [NHS sexual health clinics](https://www.nhs.uk/nhs-services/sexual-health-services/find-a-sexual-health-clinic/) Everyone England Free clinics open to everyone that check the physical side of erection, pain and desire problems, with no GP referral needed. [Find a clinic](https://www.nhs.uk/nhs-services/sexual-health-services/find-a-sexual-health-clinic/) [Relate](https://www.relate.org.uk) Adults and couples Sex therapy and relationship counselling from a national charity, online or at local centres, with fees set by the centre. Now part of Family Action. Local Relate centres set their own fees. [Sex therapy at Relate](https://www.relate.org.uk/relationship-help/help-sex/sex-therapy) Most sexual difficulties get better once someone is allowed to talk about them. Tell us what has changed, and we will find the right person. Thanks for your interest. We're not taking on new clients at the moment. ## Ready to talk about it without the *awkward* bit? We ask what matters to you, then find professionals who fit. Leave your email and we'll let you know as soon as we're ready for you. This conversation helps us find you the right support. What you share helps us understand what you're looking for and find someone who fits. Your email keeps you updated on what's happening next and isn't shared with anyone we introduce you to. [Privacy policy](https://viacara.com/privacy) [Terms of service](https://viacara.com/terms) ## References 1. National Health Service (2026). *Erectile dysfunction (impotence)*. [Link](https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/) 2. National Health Service (2026). *Low sex drive (loss of libido)*. [Link](https://www.nhs.uk/conditions/loss-of-libido/) 3. National Health Service (2026). *Ejaculation problems*. [Link](https://www.nhs.uk/conditions/ejaculation-problems/) 4. National Health Service (2026). *Vaginismus*. [Link](https://www.nhs.uk/conditions/vaginismus/) 5. National Health Service (2026). *Find a sexual health clinic*. [Link](https://www.nhs.uk/nhs-services/sexual-health-services/find-a-sexual-health-clinic/) 6. Mitchell, K. R., Mercer, C. H., Ploubidis, G. B. et al. (2013). *Sexual function in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3)*. The Lancet. [doi:10.1016/S0140-6736(13)62366-1](https://doi.org/10.1016/S0140-6736(13)62366-1) 7. College of Sexual and Relationship Therapists (2026). *COSRT: the professional body for psychosexual and relationship therapies*. [Link](https://www.cosrt.org.uk/) 8. Relate (2026). *Sex therapy*. [Link](https://www.relate.org.uk/relationship-help/help-sex/sex-therapy) ## Related ### [Couples Therapy](https://viacara.com/support/couples/) Couples therapy for any kind of couple: how sessions work, time alone with the therapist, what it costs for two and when it is not the right start. ### [Understanding Anxiety](https://viacara.com/support/anxiety/) Learn about anxiety, its symptoms and how therapy can help. Find the right practitioner for anxiety support. ### [Finding the Right Practitioner](https://viacara.com/guides/finding-a-practitioner/) A practical guide to finding a mental health practitioner who fits your needs, preferences and budget. ### [What to Expect from a First Consultation](https://viacara.com/guides/what-to-expect/) Everything you need to know about your first therapy or coaching session, from what to say to how to prepare. ### [Psychosexual Therapy](https://viacara.com/approaches/psychosexual-therapy/) Learn what psychosexual therapy involves, why a GP check often comes first, what happens in sessions and how to find a qualified therapist.