Can I Talk About Sex With My Counsellor?
Talking about sex can feel awkward, even with those closest to us. Many people wonder if it’s something they can bring up in relationship counselling—or if it’s even appropriate to do so. The short answer is yes. At Relate Avon, our counsellors are trained to support couples and individuals in discussing all aspects of their relationships, including intimacy and sexual concerns. However, in some cases, sex therapy or medical advice may be a more appropriate next step.
Why Talk About Sex in Counselling?
Sex and intimacy play a significant role in many relationships. When things aren’t going well—whether due to mismatched desires, physical difficulties, or emotional disconnection—it can create tension, frustration, and even feelings of rejection. However, these challenges are common, and avoiding the conversation can often make the situation worse. Relationship counselling provides a safe, non-judgmental space to explore these issues openly and work towards solutions.
Common Sexual Concerns in Relationship Counselling
Every couple and individual has their own unique experiences, but some common topics that arise in counselling include:
Differences in desire – One partner wanting sex more or less frequently than the other.
Loss of intimacy – Feeling emotionally or physically disconnected.
Trust issues – The impact of infidelity, secrecy, or past relationship difficulties.
Emotional barriers to intimacy – Stress, communication issues, or relationship tension affecting closeness.
Impact of life changes – Parenthood, menopause, illness, or aging affecting sexual connection.
If your concerns around intimacy stem primarily from relationship difficulties, such as communication breakdowns, emotional distance, or unresolved conflicts, then relationship counselling can be a great place to start.
When Might Sex Therapy Be More Appropriate?
While relationship counselling can help with many aspects of intimacy, some sexual issues have psychological or physiological causes that require more specialist support. You might consider seeing a sex therapist if:
You or your partner experience ongoing pain or discomfort during sex.
There are persistent physical difficulties such as erectile dysfunction, vaginismus, or an inability to orgasm.
Anxiety, past trauma, or body confidence issues are significantly affecting your ability to engage in a fulfilling sex life.
You or your partner experience compulsive sexual behaviours that are impacting your well-being or relationship.
There is a medical condition or medication affecting sexual function, and you need support in adjusting to the changes.
Seeing a sex therapist involves an assessment process with the therapist to see if a helpful treatment programme can be offered. Such work tends to be more involved and targeted than relationship counselling. It can be challenging and requires commitment, but often has very positive results.
When Should You See a GP Before Sex Therapy?
If you’re experiencing certain physical symptoms, it’s advisable to see a GP before seeking sex therapy as some sexual difficulties may be linked to underlying medical conditions:
Persistent pain during sex – This could be caused by conditions such as endometriosis, infections, or hormonal changes.
Erectile dysfunction – This may be linked to diabetes, cardiovascular issues, or side effects of medication.
Vaginismus (involuntary muscle tightening) – While this can have psychological causes, medical assessment is important to rule out physical factors.
Loss of sexual desire linked to hormonal changes – Issues such as menopause, thyroid imbalances, or low testosterone levels can affect libido.
Unexplained changes in sexual function – If you’ve noticed sudden or drastic changes in your sexual response, it’s worth discussing with a doctor first.
If a medical issue is identified, your GP may recommend treatment, refer you to a specialist, or suggest working alongside a sex therapist to provide holistic support.
What If I Feel Embarrassed?
It’s completely normal to feel nervous about discussing sex, especially if it’s not something you talk about openly. However, Relate Avon’s counsellors are professionals who are used to discussing intimate topics in a respectful, supportive way. You won’t be judged, and you won’t be pressured to share more than you’re comfortable with.
If you find it difficult to start the conversation, you might begin by saying something like:
"There’s something personal I’d like to talk about, but I feel a bit nervous."
"We’ve been struggling with intimacy/sex has become a challenge, and I’m not sure how to bring it up."
Your counsellor will help you navigate the conversation in a way that feels safe and constructive.
Taking the First Step
If concerns about sex or intimacy are affecting your relationship, you don’t have to struggle in silence. Relationship counselling at Relate Avon offers a space to work through these challenges with understanding and guidance. If needed, we can also advise you on whether specialist sex therapy or medical support might be a better option for your situation.
If you’re ready to take the first step, get in touch with us today. Talking about sex may feel difficult, but with the right support, it can lead to a healthier, happier relationship.