One of the most common questions I get asked is if sexual function and anxiety play into one another. If one can cause the other then why do we recommend using medical intervention and not just therapy? This makes the assumption that sexual function is not a physiological problem and does not need to be treated medically. You have heard me mention the biopsychocial approach multiple times and again this shows the interconnectedness of the mind, spirit, heart, and body when it comes to sexuality.
Common scenarios might be that patients comes to us complaining of low libido, decreased sexual response, erectile dysfunction etc. and, after a full medical workup, we conclude that the problems are caused by an underlying anxiety disorder. Every patient situation presents differently but we must still rule out underlying physical causes. This patient might have symptoms of anxiety in other parts of their life, even if they never recognized them. Anxiety displays itself in many ways in different people. This is why it’s important to take a biopsychosocial approach and possibly consult a mental health professional, a medical provider, and a pelvic floor physical therapist to discover what else might be going on.
If anxiety is an underlying problem, we refer for treatment of the anxiety. This can often be a combination of talk therapy as well as medication to help control the levels of anxiety. We are careful to work with patients who may get prescribed antidepressants so that they will have minimal sexual side effects. We also encourage patients to learn stress management by recognizing what is causing stress and ways to respond to stress. This can be done with us in sex counseling or referral when needed to a sex therapist.
When it comes to sexual function, we have a three-pronged approach: 1) We manage and treat the acute condition and stabilize the patient. 2) We simultaneously teach behavior modification and education to help with sexual concerns. 3) and lastly we work with the areas best healthcare providers when other areas of biopsychosocial response need referral. When it comes to sexual function, we need to prevent re-traumatizing situations which can vary per person.
The biopsychosocial approach from the psychological component has patients individually or with their partner engage in therapy to talk about choices they are making about sexual activity and possible blame or anxiety they are adding to themselves. In sex counseling we explore new ways to approach sex that allow it to be fun, playful, connecting, and fulfilling.
Eventually, when anxiety about sex has dissipated, if the patient is on medication they maybe able to wean off the medication. It is vital to not let the difficult moments define who you are sexually. Our goal is to treat the whole person – medically, psychologically, and physically. If you are suffering from sexual dysfunction and feel that you would benefit from this integrated approach to treatment please contact us for your free 10-minute consult.