It’s Never Too Late For Now: When Should I Seek Sex Therapy?

Let's Talk About Sex Therapy

“This is my last resort.” It’s not just a Papa Roach song. It’s most people’s approach to therapy. I often hear clients come in with an all too familiar request: “We have tried everything, and nothing has changed. This is our last attempt before we break up. Please help us.” They have argued and built up years of resentment; they have tried “everything,” and they hope that I will be able to save their relationship. While I believe in the power of talk therapy, this expectation is a tall order for even the best therapist.

Instead, upon deciding when to start sex therapy, think of sex therapy as your best wing person- or the foreplay to getting your ultimate desires met. Imagine getting to know yourself and your relationships on an even deeper level. Just as you learn to ride a bike or drive a car, why not learn how to have even better sex and relationships? Your partners, play partners, or sub (whatever your flavor) will thank you. In addition, using sex therapy as a preventative measure or early learning experience can become a foundation for any future personal or relational obstacle. With the tools you may learn in sex therapy, you can be prepared to communicate your sexual desires, preferences, and limitations early in dating.

What is sex therapy?

Sex therapy is essentially like regular talk therapy where we actually talk about sex and sexuality! Sex therapists, or those training to become sex therapists, have studied and gained more specific knowledge about issues relating to sex, sexuality, and intimacy. If you are reading this on SwingTowns, chances are you have already begun exploring some out-of-the-box fantasies and desires. Especially if you are in a non-monogamous relationship, finding a therapist who understands your situation (and doesn’t assume that all of your problems stem from the fact that you like to get spanked by your boyfriend while your husband watches) can be challenging. The sad truth is that most health-care practitioners have only had one class about sex and sexuality, if at all.

It can be daunting to find a sex therapist who is right for you; it is much like dating in that you sometimes have to try a few before finding the right fit. Some good questions to ask when researching the right professional for you may include “Are you poly and/or kink affirming and informed?” There are some wonderful educators and coaches out there who are not trained therapists, but remember that anybody can call him/her/themselves a sex coach. And in some states, any therapist can say that they do sex therapy and not need any additional credentialing or training. So, do your homework and due diligence if you have decided that sex therapy may be right for you. (*Stay tuned for a longer, future Blog about how to choose the right sex therapist for you).

Are you ready to do the work?

Though there are many reasons that you might want to begin sex therapy, a good measure of when to start has to do with your desire and willingness to put in the work. Therapy is not something to half-ass; it is hard work! Sure, it can be helpful to have an hour a week to talk about what is going on in your life; yet for many people, sex is the aspect that we put the least amount of time and energy into, yet many of us expect therapeutic results to be life-changing and for our sex lives to be great without any prior work. It’s as if our sexualities are rosebushes that we have planted in a desert and we expect them to grow and flourish without watering them. So if you are ready to take your sexuality and your relationships to the next level and get even more out of your intimacy, signing up for sex therapy can be a great opportunity. Aside from using sex therapy as a preventative prospect to explore and start the conversation about your sexual journey, sex therapy can also help with myriad additional presenting issues.

Other common reasons to begin sex therapy:

Navigating a new relationship or new kink

On paper, the fantasy you have always wanted to explore may seem like a no-brainer to try. From swinging to BDSM, introducing a new flavor into your life or relationship can feel so exciting that it may be easy to overlook potential issues. For example, a sex therapist’s job should not be to change your mind about bringing a third into your relationship, but instead help you explore your own desires, reasoning, and boundaries.

It can be even safer and more fun and fulfilling for all parties involved to play with other people outside of one’s relationship if your current relationship(s) is (are) solid. If you are looking outside of your relationship to fix something that has been unaddressed, chances are you won’t ever find it, and it could jeopardize the potential to meet other prospective partners. This is different, however, from being in a healthy and consensual non-monogamous situation and the notion that we can’t always get everything we want from one partner.

Mismatched desires:

Let’s say one of you prefers it quick and dirty in the early AM, everyday. And, as in most relationships, your partner (or one of your partners) likes it slow in the afternoon and only on the weekends. This mismatch in time, frequency, and desired location can be a necessary issue to navigate in most partnerships.

Lack of or low desire/ libido:

Most of us have experienced ebbs and flows of our desire or libido over time. In some cases, low desire could mean something physical is going on (ie menopause, medications, etc) or it could be a barometer of how things are going in a relationship or on a personal level.

Cheating- boundary crossing:

Remember, this issue can occur even in non-monogamous relationships. Open relationships or non-monogamous relationships are not always just free-for-alls; in fact, they often require more communication!

Trouble with ejaculation or orgasm:

This can be solo or partner specific and medical or emotional in nature.


The following are a few additional reasons one might seek sex therapy. Remember, though, nothing has to be wrong to seek sex therapy, and the following list does not indicate that one is broken and needs fixing. If, however, you are struggling with any of the following, sex therapy can help or at least provide additional resources and referrals to aid you in going from surviving to thriving.

  • Issues with gender identity
  • Sexual Pain
  • Guilt or shame about your sexual preferences
  • Orientation confusion or shame
  • Varying ability / Persons with disabilities trying to navigate fulfilling sex lives and pleasure
  • Those with chronic illness or other medical issues that have affected intimacy or sexuality (ie breast cancer, blood pressure, antidepressants)
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Nicoletta Heidegger
As a published author, Nicoletta, has contributed to columns, podcasts and blogs about sex and sexuality including the Stanford Daily, Sex Talks with my Mom, The Positive Results Corporation, and Wine with Dr. Wendy Walsh. When she is not seeing clients, Nicoletta delivers information focused on the latest sex facts, education, and research via her short and long form videos, “Staying On Top” on Instagram and YouTube. Nicoletta also serves on the board for the Compton Jr. Posse, a group that keeps troubled youth on horses and off the streets.

Nicoletta is a registered Marriage and Family Therapy Intern (# 88163) practicing in Los Angeles. She works in Private Practice and sees clients at the nonprofit Center for Individual and Family Counseling in North Hollywood. Nicoletta received her BA in Psychology from Stanford University and her MA in Clinical Psychology from Pepperdine University. Nicoletta is currently pursuing her PhD in Human Sexuality from Widener University. Visit Nicoletta Heidegger for more information.
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