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Vulvodynia is a condition that affects the vulva, or the external genital organs of the female anatomy. Symptoms of this sexual dysfunction include pain, burning, stinging, irritation or a sharp pain in the vulva. Vulvodynia may be constant, intermittent, or only occurring upon touch. Furthermore, symptoms are not always localized to one place but could affect the entire vulva. Vulvodynia may make it difficult for a woman to participate in many recreational activities, such as bike riding, to sit for prolonged periods of time, and to engage in sexual activity. Although vulvodynia is mostly diagnosed as a psychosomatic condition, there are some physical causes for the dysfunction. Possible causes include allergy or sensitivity, genetic predispositions to inflammation, yeast infections, human paploma virus (HPV), and injury.

Vaginismus is the involuntary spasms of the muscles of the outer third of the vagina. These vaginal spasms interfere with sexual intercourse. There are two types of vaginismus, situational and general. Situational vaginismus is limited to certain types of stimulation, situations or partners, while generalized vaginismus occurs regardless of the types of stimulation, situations, or partners. Vaginismus can be either lifelong or acquired. Lifelong vaginismus is diagnosed in a person who has never been able to have penetrative sex without pain. Acquired vaginismus is diagnosed in a person who loses the ability to experience penetration without pain.

Anorgasmia is the persistent delay in or absence of an orgasm during sexual activity. This sexual dysfunction disrupts the third stage of the sexual response cycle, the orgasm phase. Although the term anorgasmia includes the medical inability to reach orgasm, the great majority of anorgasmia cases are caused by psychological, social, cultural, or relationship variables and are, therefore, best treated in therapy.

Premature ejaculation is one of the most common sexual dysfunctions among males. It occurs in the third stage of the sexual response cycle, the orgasmic phase. Ejaculation of semen occurs quicker than expected, usually due to anxiety. A diagnosing clinician should assess for factors affecting duration of excitement phase in the sexual response cycle such as age, novelty of sexual partner or situation and frequency of sexual activity. When premature ejaculation causes interpersonal difficulty or distress for the individual, and is not the result of substance use, it can be diagnosed therapeutically. 

Erectile dysfunction occurs during the first phase of the sexual response cycle, the excitement phase, and is the inability to achieve or sustain an erection effective for intercourse. When this disturbance causes significant distress to the individual or interpersonal difficulty, it can be diagnosed as a psychological condition. Erectile dysfunction is not the result of physiological impairments, substance use, or an already identified medical condition. Many causes of erectile dysfunction, however, are mental and emotional. Therefore, sex therapy can be extremely helpful in resolving them.

processing sexual violence  •  gender dynamics, identity, and exploration  •  STI diagnosis  •  jealousy  •  infidelity  •  sexuality and hormones  •  developing a positive personal relationship with sexual identity  •  desire discrepancy  •  sexual pleasure and aging  •  cultural and religious factors  •  mindfulness and sensuality  •  enhancing pleasure  •  diversity in sexual expression  •  kinks  •  polyamory  •  LGBTQIA2S+  •  pelvic floor health  •  compulsive masturbation  •  conflict regarding sexual interests/behaviors  •  sexual dysfunction due to chronic illness