Sex, Desire and Intimacy

Sex changes. Desire rises and falls, bodies change, and things that once felt easy can start to feel pressured, complicated or absent. It’s one of the most common reasons people come to see me, and one of the hardest things to talk about.

If that’s where you are, you’re not alone, and you’re not broken. Most sexual difficulties start to make sense once we look at the context they’re happening in: your body, your history, your relationship, your stress levels and the messages you’ve absorbed about what sex is supposed to look like.

I’m a COSRT-accredited psychosexual therapist with a Level 7 Diploma in Clinical Sexology. I work online with individuals and couples across the UK, and my approach is sex-positive, trauma-informed and neurodivergent-affirming.

This page brings together the themes I see most often, with articles I’ve written on each. Take what’s useful and leave the rest.

When desire changes

Low desire, mismatched desire and sex that has quietly stopped are all incredibly common. They’re rarely about a lack of love or attraction. Desire is shaped by stress, tiredness, health, hormones, medication, how connected you feel and how safe you feel.

For many people, desire isn’t spontaneous at all. It builds in response to the right conditions. Getting curious about your own conditions, rather than judging yourself for what isn’t happening, is often the first step.

When your body isn’t doing what you hoped

Difficulty reaching orgasm, unreliable erections, painful sex or difficulty with penetration can bring a lot of worry and self-blame. Bodies respond to context. Pressure, anxiety and the ways we’ve been taught to think about sex can all get in the way, and there are lots of things that can help.

I also work with vaginismus and other kinds of sexual pain. You can see the full range of issues I work with on my psychosexual therapy page.

Shame, trauma and the stories we were given

A lot of what gets in the way of pleasure isn’t physical at all. Trauma, religious upbringing, purity culture and rigid ideas about gender can leave people feeling guilty, anxious or disconnected from their own bodies. For many men, emotional shutdown and depression show up first as a loss of desire.

Healing tends to start with understanding where those beliefs came from, and moving at a pace that feels safe. There’s no need to go into detail about what happened unless you want to.

Desire and neurodivergence

For autistic, ADHD and AuDHD people, sensory needs, overwhelm, distractibility and masking can all shape the experience of sex. If that resonates, my guide to neurodivergent couples therapy goes into more depth.

How sex therapy can help

Sex therapy is talking therapy with sex at the heart of it. Sessions are conversations, sometimes with exercises or reflections for you to try at home. They’re online and confidential, and you don’t need to arrive knowing exactly what’s wrong. Together we’ll explore what’s happening, where it comes from and what might help, at a pace that feels manageable.

I offer weekly 50-minute sessions: £120 for individual therapy and £170 for couples. If you’d like to explore on your own first, my resources include workbooks on understanding desire, decoding desire for AuDHD women and building confidence with erections. Or book a free consultation and we can talk about what’s bringing you here.

More on desire and sex