MD Sex Therapist NY – Sex Therapy Consultations for the Most Difficult and Complex Problems

Specialized care when other treatments fail

New Yorkers are lucky to have medical experts in every specialty—even in sexual medicine. The city has urologists, gynecologists, endocrinologists, internists, and even physical therapists with special interest and experience in sexual issues. Often, they can solve the problem, but not always.

What do these specialists do when previous treatments haven’t worked well enough? Often they call me. They trust me for sensible, knowledgeable advice. They’ve seen results: people feeling better.

Talk to a Top-Rated NY Sex Therapist

As a Sex Therapist for 25 years in NY, I’m often asked to consult in complex situations, or when previous psychotherapy or sex therapy has not been successful. As a physician, I’ve found new ways of combining medical and psychological treatments for sexual problems. My medical background allows me to determine if, how and which medications are affecting sex drive or performance.

If you’ve struggled with a difficult sexual problem . . . even if you’ve had previous sex counseling . . . if you haven’t found the results you hoped for, then I invite you to search through this website and consider making an appointment for a consultation. Read more about my practice

When Couples Sex Therapy Hasn’t Helped

It’s astonishing how many people have wasted years of time (not to mention thousands of dollars) on couples therapy without talking about what really goes on in the bedroom. Many couples have sat patiently in couples therapy for years listening to theories about what’s wrong with their marriage, but are still unable to articulate why sex is boring them to tears.

What’s often called for is some fearless questioning about really goes on during lovemaking. The actual who-does-what-to-whom, and how-does-it-really-make-you-feel.  That’s not an easy discussion for most couples to have, but it’s essential. It calls for an expert with years of experience helping people put into words what they actually experience in bed together.

When Traditional Sex Therapy Hasn’t Helped

Traditional sex therapy, pioneered by Masters and Johnson, relied on home behavioral exercises such as “sensate focus” that involved exchanging pleasurable touch, free from any pressure to perform for one’s partner. Sensate focus was revolutionary at the time and helped many people. But many couples today find sensate focus too clinical. It also takes a lot of time and doesn’t fit easily with the pace of modern life. More couples are helped by learning to simmer, which only takes a minute or two.

My view is that behavioral exercises should have a much more limited role in sex therapy, and that the sex therapist’s primary role should be to help people understand their real sexual feelings and needs.  Sensate focus sometimes serves to promote healthy differentiation in couples, but often it doesn’t. I see many couples whose previous sex therapist’s tool-kit was limited to behavioral techniques and who weren’t able to shift gears when sensate focus didn’t fit that couple’s needs.

I enjoy helping couples figure out why their previous attempts at sex therapy weren’t helpful. Sometimes the previous sex therapist’s evaluation didn’t take enough account of constitutional factors such as depression, adult ADHD, or specific anxiety problems. Being an MD helps. So does being a psychiatrist. Sometimes the previous sex therapist didn’t understand both people’s actual feelings about the sexual encounter, or about the treatment. When sex therapy hasn’t helped, it’s usually a good idea to consult with someone who has a broad experience analyzing treatments that worked and ones that didn’t.

Sex Therapist NY seeing happy couple

When Viagra Hasn’t Helped

Viagra revolutionized sex therapy in 1998.  The Phosphodiesterase Type 5 (PDE5) Inhibitors Viagra, Cialis, Levitra, Staxyn, and Stendra have enabled many more couples to get better results from sex counseling, especially when the male partner’s erection problems have had some physical basis. This is particularly common when the man is over 50.

But sex is more complicated than that. Medications for erections often fail, and the reasons are frequently psychological. Even when medications do their job well, often the prescriptions don’t get refilled. Couples’ interactions are complicated, and many couples who can now physically have sex no longer find it satisfying to do so.

I enjoy helping people figure out why medications haven’t helped. As an MD sex specialist, I know these medications well, and I know the common pitfalls associated with their use. As a sex therapist, I know about the complexities of erotic life and can help people integrate medical and psychological approaches for maximum benefit. I can now help many more individuals and couples than ever before.

Make an appointment with me to see how Sex Therapy can benefit you.

 

Sex and Psychiatric Conditions 

Many (if not most) mental health problems have repercussions in the bedroom. Many people with depression lose interest in sex, though a substantial number of men have the opposite experience and become sexually compulsive. Adult ADHD has well-documented implications for couples. And anxiety problems such as social anxiety frequently cause sexual inhibition.

I’ve been a Sex Therapist in NY for over 25 years, and have seen hundreds of patients with these conditions. In a 2010 talk at the Society for Sex Therapy and Research entitled “All Kinds of Sexual Minds,” I introduced the idea of evaluating “constitutional” causes of sexual problems (a summary of the talk is available here). Sex therapy colleagues frequently call on me to consult with their clients when concurrent psychiatric issues such as depression, anxiety, and ADHD have contributed to stalemates in treatment.

Sex and Psychiatric Medication

Antidepressants such as Prozac, Zoloft, Lexapro (among others) often cause sexual side effects. Managing medication-induced sexual problems such as loss of desire and inability to climax is both an art and a science. Chemical antidotes or waiting for the problem to resolve on its own are rarely effective. Patients often stay too long on medications that cause sexual trouble. Instead, clinicians should ask early and often about sexual side effects, and should be ready to switch medications quickly if sexual problems occur.

Sex and Medical Illness

Many medical conditions affect sexual life.  People with disability from conditions such as stroke, cerebral palsy, spinal cord injury, traumatic brain injury, and arthritis often benefit from special counseling to learn how to adapt lovemaking for their situation.

Often patients are unaware of potential risks to their sex life from medical treatment. For instance, oral contraceptives sometimes reduce libido. This effect can persist for months or years after stopping the medication. Men who take Propecia to prevent hair loss sometimes encounter erection problems or loss of sex drive. It’s been increasingly recognized that these side effects can sometimes become permanent.

Contact me today with any questions and make an appointment.

 

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Call me for an appointment
212-875-9800