What is Sex Counseling — And Can It Help Your Relationship?

By Dr. Jess Relationships

When it comes to sex and relationships we tend to avoid seeking the support of professionals, as we’re reluctant to admit that we face challenges in the sexual realm. Though every single couple without exception is confronted with sexual difficulties at some point in time, a minority of couples receive pre-marital counseling. An even smaller percentage receive training specifically related to sex.

Research suggests that most people avoid seeking professional couples counseling or support for months or even years after the onset of a relationship issue, which may explain the alarmingly high divorce rate – how can we have satisfying relationships if we refuse to seek support when troubles arise?

You don’t need relationship issues to benefit from sex counseling

I firmly believe that all couples should see a sexuality and/or relationship counselor before problems arise if they have the resources to do so. Just as we take preventative measures to produce positive outcomes related to health and finances (e.g. we don’t only see doctors and financial planners when we’re sick or in debt), so too can we benefit from seeking the support of sexuality professionals to cultivate happy, fulfilling sex lives.

If you’re curious about how a sexual health professional might benefit your intimate relationship, check out my interview with sex therapist, Dr. Hernando Chaves, who sees clients at his Los Angeles practice and online.

Why might one seek the support of a sex counselor or therapist?

Dr. Chaves: There are a number of reasons a person may see a sex counselor or therapist. Some of the most common concerns and topics we address include communication around sex, sexual confidence, anxiety, relationship issues, difficulties with sex, navigating individual sexual identity, high or low sexual desire, arousal and orgasm difficulties, sexual orientation, and gender identity.

How do you know if you need the support of professional sex therapy?

Dr. Chaves: Ask yourself if you have concerns or challenges related to your sexual identity, expression, or relationship. If you experience stress or anxiety related to sex, it may be a sign that you should seek support.

Do happy couples who want to maintain their sexual intimacy and connection come to you for support to stay on track?

Dr. Chaves: It’s uncommon for clients to come to therapy unless they have specific challenges they want to address. BUT it is wise and encouraged to deal with issues before they become problems. Some people do come to therapy to explore and process emotions and others come as a matter of self-development.

Some clients see me just once a month or every few months to check in and maintain positive momentum — almost like a tune-up for the engine to keep the car running smoothly.

What are the most common issues/challenges you see in sexual counseling?

Dr. Chaves: The most common issues I see in my practice include performance anxiety, erection difficulties, premature ejaculation, intimate communication, and navigating masculinity.

With couples, I often work with those looking to explore open relationships (consensual non-monogamy), fetishes, and BDSM.

What is the difference between a sex coach, a sex counselor, and a sex therapist?

Sex coaches

Dr. Chaves: Sex coaches offer education, specific suggestions, advice, and support for people looking to enhance their sexuality, pleasure, or address their sexual functioning concerns, similar to a life coach for sex.

Sex counselors

Dr. Chaves: Sex counselors offer services similar to a sex coach and typically have academic, therapeutic and/or spiritual training in counseling skills.

Sex therapists

Dr. Chaves: Sex therapists offer services similar to sex coaches and counselors and often have clinical training in therapy to work with mental health concerns, sexual trauma, and other difficulties impacting sexuality.

Coaches, counselors, and therapists share the same goal of helping clients to boost sexual confidence, enhance pleasure and cultivate sexually fulfilling lives.


Whether you’re needing support in understanding a sexual orientation or relationship issue, seeing a certified sex therapist may help you through an individual sec therapy session. If you think you might benefit from the support of a sex counselor or therapist, you can search for professionals by region on AASECT’s website or contact us for assistance with a referral. We’re happy to help!



By Dr. Jess O’Reilly, ASTROGLIDE’s resident sexologist