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Sex therapy

Sex therapy is a therapeutic strategy for the improvement of sexual function and treatment of sexual dysfunction. This includes dysfunctions such as premature ejaculation and delayed ejaculation, erectile dysfunction, lack of sexual interest or arousal, and painful sex (vaginismus and dyspareunia); as well as problems imposed by atypical sexual interests (paraphilias), gender dysphoria (and being transgender), highly overactive libido or hypersexuality, a lack of sexual confidence, and recovering from sexual abuse (such as rape or sexual assault); and also includes sexual issues related to aging, illness, or disability.

Modern sex therapy often integrates psychotherapeutic techniques and medical ones, such as Viagra (sildenafil) and Cialis (tadalafil) to increase erectile response and Paxil (paroxetine) to treat premature ejaculation. Sex therapists assist those experiencing problems in overcoming them, in doing so possibly regaining an active and healthy sex life. The transformative approach to sex therapy aims to understand the psychological, biological, pharmacological, relational, and contextual aspects of sexual problems.

Sex therapy requires rigorous evaluation that includes a medical and psychological examination. The reason is that sexual dysfunction may have a somatic base or a psychogenic basis. A clear example is erectile dysfunction (sometimes still called "impotence"), whose causes may include circulatory problems and performance anxiety. Sex therapy is frequently short term, with duration depending on the causes for therapy.

Sex therapy can be provided by licensed psychologists or physicians, who have undergone training and become certified. These trainings and certifications usually begin with a master's degree, and internship, and a license. This can take up to two years, and longer if a doctoral degree is desired.

Certified sex therapists do not have sexual contact with their clients. Sex therapy is distinct from sex surrogates. Whereas sex therapists discuss and instruct clients in sex-based exercises to be performed at home between sessions, sexual surrogates participate in the exercises with their clients as part of helping them to practice and develop improved skills. Therapists and surrogates sometimes collaborate on cases.

Sex therapy sessions are focused on the individual's symptoms rather than on underlying psychodynamic conflicts. The sexual dysfunctions which may be addressed by sex therapy include non-consummation, premature ejaculation, erectile dysfunction, low libido, unwanted sexual fetishes, sexual addiction, painful sex, or a lack of sexual confidence, assisting people who are recovering from sexual assault, problems commonly caused by stress, tiredness, and other environmental and relationship factors. Sex therapy can either be on an individual basis or with the sex partner. Sex therapy can be conducted with any adult client, including older adults, any gender expression, and LGBTQ-identified people.

A therapist's misunderstanding of these conflicts can lead to resistance or serve as a barrier to improving sexual dysfunctions that are directly or indirectly related to sex. The interest in sex therapy among couples has increased along with the number of sexuality educators, counselors, and therapists. Today, sexual problems are no longer regarded as symptoms of hidden deviant, pathological, or psychological defects in maturity or development. Sex therapy has also influenced the emergence of sexual medicine and exploring integrative approaches to sex therapy, in addition to reducing or eliminating sexual problems and increasing sexual satisfaction for individuals of all stages of life. Health therapists, educators, and counselors are conducting research and administering surveys to fully understand normative sexual function – what most people do and experience as they grow older and live longer.

Both physical and emotional transformation throughout various stages of life can affect the body and sexuality. The subsequent decline in hormone levels and changes in neurological and circulatory functioning may lead to sexual problems such as erectile dysfunction or vaginal pain. These physical changes often affect the intensity of youthful sex and may give way to more subdued responses during middle and later life. Issues with low libido and sexual dysfunction are usually considered to be a byproduct of old age. The emotional byproducts of maturity, however — increased confidence, better communication skills, and lessened inhibitions — can help create a richer, more nuanced, and ultimately satisfying sexual experience. During AARP's last surveys in 1999, 2004, and 2009 statistics show well-being among older adults has increased; however, overall sexual satisfaction has decreased. Nevertheless, older adults believed that an active sexual life offers great pleasure and contributes materially to overall emotional and physical health.

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