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Writer's pictureShaun McMahon

7 Questions To Help You Diagnose Sexual Problems In Your Relationship

Updated: Jun 20

Low levels of intimacy and desire is one of the most common reasons people attend couples therapy. One of the reasons for this is a lack of education and understanding around sex and sexuality, coupled with unrealistic expectations that are fueled by what we are shown by Hollywood, and more recently, the porn industry.


As a couples therapist, one of the first things I do when seeing a couple with intimacy and desire issues is to try and understand what’s causing the problems. All too often people internalize problems and make it personal, when it might not be related to something that’s wrong with you, or your partner.


If you’re having trouble with your sex life in your relationship, here are 7 questions to get you thinking about what might be happening.


1. When your partner is interested in a sexual interaction, do you feel willing?


Consent is a difficult topic to discuss. While much of our discussions circle around new engagements (first times, hook-ups etc), we don’t often consider consent in the context of a committed relationship.


At some level we assume the consent is implied because of the commitment. Yet for many people, they’re reluctantly going along with sexual activity without feeling like they can, or should, say no.


Other than the obvious issues of why non-consensual sex is a problem, it’s worth considering that going along with things that we don’t really want to do is a surefire way to develop resentment and a lack of safety in the relationship. These deeper problems are difficult to amend over a long period of time, and worth avoiding if it’s possible.


Being honest with yourself about what you are, and aren’t willing to do with your partner can bring up doubts and insecurities, such as “if I was a good wife I’d want to have sex with him” or “my wife will think I’m not attracted to her if we don’t have sex”. This makes saying no challenging to do, but having an understanding about what you do and don’t consent to can be the beginning of some healthy discussions about sex and ultimately, a path to reinventing your sex life.


2. Are you interested in sex, and do you think about sex or experience desire?


It’s incredibly common for interest in sex to wane. Much of the time we believe that there’s something wrong with us, or our partner, if they’re no longer interested in sex. The reality is that there’s often many reasons why this can happen, and oftentimes it’s nobody’s fault.

Common reasons include:


-Physical changes, such as age or menopause, have impacted our levels of desire

-We misunderstand how desire works and how to evoke it in our partner

-Unresolved psychological issues, such as stress and trauma, are inhibiting our desire


If you or your partner have a lack of desire, it’s worth considering that there are a multitude of reasons why this might be the case. Seeing a sex-informed couples therapist can help you to better understand why this is happening.


3. Does any kind of sexual touch feel uncomfortable or painful?


Experiencing pain during sex is a serious issue, and needs to be treated as such. It’s important to distinguish between intentional and consensual pain, such as spanking, versus pain which is unintentional or perhaps non-consensual. If pain is being caused but it is not welcome, it is considered non-consensual and should be discussed with a couples therapist.


Unintentional pain is something which needs to be raised with a doctor. There are many reasons for people experiencing pain during sex, and it can occur for both men and women. This is another example of something which people often ‘push through’ out of fear of upsetting their partner or ruining an experience. But pain that occurs during sex can lead to serious complications which will only contribute even less sex and intimacy, making it a top priority before other issues are addressed.


4. Do you experience body signs of arousal, such as flushing, increased heart rate, hardness/wetness?


Our bodies have all kinds of signals which indicate that we are aroused. It’s important to be aware of these and take stock of whether they do, or do not, occur.


At times the lack of bodily signs of arousal can be an indicator of deeper issues. Men who are having difficulties getting and/or keeping an erection are at risk for serious heart conditions and should consult a doctor, even if they are young or believe they have a healthy heart. Women who do not experience wetness before or during intimacy can experience pain or other serious issues if sexual acts cause excessive friction or tearing of the skin. When in doubt, it’s best to speak to a doctor about such matters to rule out any health complications.


After ruling out medical concerns, there can be several reasons why we do not experience signs of arousal. These include:


-Being anxious or fearful in intimate situations, rather than feeling relaxed and engaged.

-Physiological factors or changes, such as diet, lifestyle and age

-A lack of desire or emotional connection with our partner


5. Are you able to reach orgasm when you want to, with or without your partner?


As our society has become more sex-friendly, there has been a lot more weight attached to whether or not one achieves an orgasm during sex, something that is increasingly more of a priority for women. Research suggests that most men take between 3-5 minutes to orgasm from direct penile stimulation, while women take 25+ minutes to reach orgasm from direct clitoral stimulation.


As you can see, that’s a significant gap, one that can contribute to many women feeling dissatisfied in the bedroom, and perhaps that their partner doesn’t care about their orgasm. However, men aren’t solely to blame for this problem.


A healthy sex life means taking responsibility for your own bodily pleasure, including your orgasm. That’s not to say your partner can’t assist you in the process, but it’s up to you to know how your body works, what you respond to, and what helps you to reach orgasm. For example, less than 30% of women reach orgasm from vaginal penetration alone.


Rather than suggesting your partner isn’t big enough or doing enough to get you off, it might be that you’re unable to experience orgasm from vaginal penetration. Experimenting with different positions or using toys to stimulate the clitoris can increase the likelihood of reaching an orgasm, while taking a lot of pressure off your partner to please you.


6. At the end of a sexual interaction, do you feel satisfied, and would you do it again?


Having satisfying sex is important for many people in a relationship. How you define satisfaction might differ from the next person. Some people may only consider it satisfying if they had a mind-melting orgasm, while others might be content to have just spent time connecting with their partner.


One thing to consider is what you believe a ‘sexual interaction’ consists of. Many people are caught up in the ‘linear model’ of sex which suggests that the only thing that counts as ‘sex’ is penis in vagina penetration which results in one, or both partners, reaching orgasm. However, there are other ways to define sex, and what sex means to you and your partner is a conversation worth having.


7. What Do You Want To Experience That You’re Not Experiencing Now?


One of the most common issues I encounter in all couples is a lack of awareness around our needs. Many of us harbor a wish for our partner to be able to know exactly what we need and how to meet that need, without us actually telling them what we need and what we’d like them to do about it. Part of this stems from our experiences as children where we weren’t capable of voicing our needs, and the satisfaction we get from having that need met, sometimes called attunement. Other times, it stems from the romantic ideals Hollywood puts before us which suggest that “true romance” means our partner being able to meet our every need and wish effortlessly.


While this idea is nice it’s seldom realistic. Our partners are not mind readers, and they often do not know what we want unless we ask them. To make matters worse, some people react very negatively when their partner gets it wrong. Rather than having the intended effect, which might be to ‘motivate’ them to get it right next time, they instead become discouraged and give up on trying to meet your needs.


A better approach is to take some time to reflect on the current state of your sex life and try to figure out what it is that you wish to experience that you’re not experiencing right now. Is it more connection? More passion? More intimacy? And don’t stop there - telling our partner we want more connection doesn’t really help them to deliver on it.


Instead, try to get specific: “I would love for us to cuddle more”, “I really love it when you massage my back”, “I want you to tie me up”. This helps your partner know exactly what it is that would make you happy and, so long as they’re consenting, will likely lead to you actually getting your needs met.


Closing Thoughts


Having a healthy sex life is important for many people in a relationship. But it doesn’t happen automatically. While there’s something to be said for having ‘chemistry’, maintaining a healthy sex life requires work from both partners and a willingness to not only explore and try new things, but to also be open to honest conversations with their partner and hearing some hard truths.


If you and your partner are experiencing difficulties in the bedroom, you might like to try working with a sex-informed couples therapist like Shaun McMahon. He can help you to identify what’s causing problems for you in the bedroom and provide a space for you and your partner to solve the issue together, while receiving professional guidance. If you’d like to learn more you can book in a free and confidential 15 minute consultation with Shaun by clicking here.




Source: Martha Kauppi, Institute for Relational Intimacy



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