Sex Therapy
Sex should be something you can talk about, but that doesn't mean it's always easy to know where to start.
Maybe your desire has changed, and you don't understand why. Sex has become uncomfortable, stressful, or something you avoid. You and your partner want different things, or intimacy doesn't feel the way it used to.
Perhaps pregnancy, postpartum changes, menopause, body image, neurodivergence, relationship dynamics, or cultural expectations have changed the way you experience sex.
Or maybe nothing is obviously "wrong." You simply want to understand your sexuality better and feel more comfortable talking about what you want and need.
As an AASECT Certified Sex Therapist specializing in women's sexual health, I work with individuals and couples to explore sexual concerns without shame, judgment, or assumptions about what a fulfilling sex life is supposed to look like.
Sexual Health Can Change Throughout Your Life
Sexuality isn't static. Your body changes. Relationships change. Hormones change. Stress changes. Your understanding of yourself can change too.
Something that worked for you in one stage of life may feel completely different in another.
You don't need to decide whether your concern is "serious enough" before talking about it. If it's affecting the way you feel about yourself, your sexuality, or your relationship, it's worth understanding.
Sex therapy can provide support for concerns related to:
Changes in sexual desire or differences in desire between partners
Difficulty communicating about sex
Sexual anxiety or avoidance
Body image and sexual confidence
Pregnancy and postpartum changes
Fertility and reproductive experiences
Menopause and hormonal changes
Pain or discomfort affecting intimacy
Neurodivergence and sexuality
Cultural or religious messages about sex
Sex Therapy for Women's Sexual Health
Women's sexual health can be affected by physical, emotional, relational, hormonal, and cultural factors — often several at the same time.
You may have spent years receiving messages about what you're supposed to want, how you're supposed to look, how frequently you're supposed to have sex, or what a "normal" sex life should be. Then your actual life happens.
Pregnancy. Parenthood. Stress. Relationship changes. Aging. Menopause. Body changes. Career demands. Medication. Health concerns. Exhaustion.
Sex therapy gives you a place to talk honestly about what you're experiencing without assuming that there's one correct version of sexual wellness.
Sexual Health During the Reproductive Years
The reproductive years can bring significant physical and emotional changes that affect sexuality and intimacy.
Depending on what you're experiencing, therapy can include conversations about fertility, contraception, pregnancy, postpartum adjustment, body image, changes in sexual desire, relationship dynamics, or reconnecting with your sexuality after becoming a parent.
For some women, the concern is physical. For others, sex has simply become one more demand competing with work, children, relationships, and everything else they're responsible for. Often, it's a combination.
Sex Therapy During Perimenopause & Menopause
Perimenopause and menopause can change sexual desire, comfort, arousal, body image, and the way you experience intimacy.
You may be navigating decreased libido, discomfort, hormonal changes, sleep disruption, changing body confidence, or frustration that your sexuality suddenly feels unfamiliar.
These changes can affect your relationship too, especially when partners don't understand what's happening or interpret changes in desire as rejection.
Sex therapy provides space to talk about those changes, understand how they're affecting you and your relationship, and explore what intimacy and sexual wellness can look like in this stage of life.
Sex, Intimacy & Neurodivergence
Neurodivergence can influence sexuality and intimacy in ways that aren't always acknowledged in traditional conversations about sex.
Autistic people, people with ADHD, and other neurodivergent adults may experience differences related to sensory processing, communication, attention, emotional regulation, routines, touch, or the way intimacy is initiated and experienced.
For couples, one partner may interpret those differences personally without realizing that the other person is experiencing intimacy very differently. Sex therapy can help you explore:
Sensory preferences and sensitivities
Differences in desire or initiation
Understanding boundaries and preferences
ADHD-related attention or executive functioning challenges
Reducing shame around sexual differences
Creating forms of intimacy that work for your actual relationship
Different doesn't automatically mean dysfunctional. The goal is to better understand how you experience sexuality rather than forcing yourself into someone else's definition of what sex or intimacy should look like.
Sex Therapy for Multicultural Couples
Culture can shape what we're taught about sex long before we have our first relationship. Family expectations, religion, gender roles, privacy, shame, communication, and beliefs about intimacy can all influence what partners bring into their sexual relationship.
For multicultural couples, those messages may be very different.
One partner may be comfortable talking openly about sex while the other grew up in an environment where sexuality was rarely discussed. You may have different expectations around desire, initiation, gender, affection, privacy, or what intimacy means within a committed relationship.
Sex therapy is about helping you understand the beliefs and experiences underneath those differences so you can communicate more openly and create a sexual relationship that belongs to the two of you.
What Working Together Can Look Like
As an AASECT Certified Sex Therapist, I approach conversations about sexuality with curiosity, openness, and respect for your individual experiences, relationships, identity, and values.
Therapy is collaborative and tailored to what's actually bringing you in. We can explore the emotional, relational, cultural, or psychological factors affecting your sexual well-being while also working on communication, expectations, boundaries, body image, intimacy, or patterns that have developed over time.
If you're coming to sex therapy as a couple, we'll look at the dynamic between you without assuming one partner is "the problem."
And if you're coming individually, you don't need to be in a relationship to explore concerns about sexuality, desire, intimacy, or your relationship with your own body.
Do I Have to Talk About Everything in Sex Therapy?
No. You get to decide what you're comfortable discussing and when.
It's completely normal to feel awkward talking about sex, especially if you grew up in a family, culture, or environment where those conversations didn't happen openly.
You also don't need to know the clinical terminology for what you're experiencing or walk into therapy with a perfectly articulated goal.
We can start with what's bothering you, what's changed, or what you wish felt different. You don't need the perfect words to talk about something that matters to you.
What If My Sexual Concern Might Be Medical?
Sexual concerns can have psychological, relational, hormonal, physical, or medical contributors, and sometimes several factors overlap.
Sex therapy can help address the emotional, behavioral, relational, and psychological aspects of sexual health, but it doesn't replace appropriate medical evaluation or treatment.
If something you're experiencing may have a physical or medical component, we can talk about the role other healthcare providers may play alongside therapy.
Online Sex Therapy in DC, MD, VA, NY, NJ, CT, IL & FL
Crystal Counseling & Coaching provides online sex therapy for individuals and couples in Washington, DC, Maryland, Virginia, New York, New Jersey, Connecticut, Illinois, and Florida, with in-person office locations available in select areas.
As an AASECT Certified Sex Therapist, Dr. Lida provides specialized support for women's sexual health, reproductive and postpartum changes, perimenopause and menopause, neurodivergence, intimacy, relationship concerns, and multicultural couples.
Your Sex Life Doesn't Have to Look Like Anyone Else's
Whether something has changed, intimacy has become difficult, or you simply want a better understanding of your sexuality, sex therapy gives you a place to talk about it openly.
We can start with what you're experiencing now and work toward a version of sexual health and intimacy that feels right for you.
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