Do I need to see a pelvic floor therapist too?

I strongly recommend it because sexual pain is both physical and emotional. Sometimes it's inflamed muscle or a nerve that's over firing. Going to see your medical providers can help with that. I can help you find someone if you need a referral.

What if my doctor says nothing is wrong?

Happens all the time. Doesn't mean the pain isn't real. Sometimes the anticipatory and emotional components are driving most of the experience. Doesn't mean you won't benefit from Pelvic Floor PT and therapy. We work with what your body is doing, not what a test says.

If we are doing individual therapy, I have found it helpful to have one or two sessions to encourage healthy communication. I do work with couples where one experiences sexual pain, especially if the sexual pain is creating a mismatch in libido.

I've been avoiding sex completely. Is that okay?

Makes complete sense when something hurts. You can't experience pleasure if you're in unwanted pain.

How is this different from pelvic floor therapy?

They work with the muscles, tissue, and physical patterns. I work with the fear, the relational stuff, the identity piece, and the nervous system responses wrapped up in the pain. Different layers, same problem.

Sex & Relationship Therapy for

Low Libido

Your sex drive disappeared for a reason

Let’s find out why

Multiple overlapping images of human hands, creating an abstract visual.

“Something’s wrong with me”

That's the sentence I hear most. You may have already run Googled what's normal, counted the weeks, or watched your partner's face fall one too many times. And underneath is usually a quieter fear, that the desire is gone for good and it's somehow your fault.

You've probably tried the standard prescriptions. Date nights. New lingerie. Deciding, very firmly, to want it more. If one more person tells you to schedule date nights, you have my permission to leave the brunch. Scheduling sex turns it into another obligation, and obligation is where desire goes to die.

Here's the reframe this work starts from: low desire is a symptom, not a character flaw. Your body is reporting something, about stress, about the sex itself, about what it costs you to be touched right now. There's a part of you that turned desire down for a reason, and it's probably a good one. Nobody here is going to talk you into wanting more sex. The job is to help you hear the report.

Periods of low libido is normal, and one of the most common things brought to sex therapy.

Here's the short version of what nobody taught you: most desire, especially in long-term relationships, shows up after pleasure starts, not before. If you've been waiting to want sex out of nowhere like the movies promised, you've been grading a working system with the wrong ruler.

The rest of the picture is usually just your life. Kids on your body all day, meds, sex that's boring, a New York schedule that leaves nothing in the tank by 10pm. Desire responds to all of it. Before we call your desire broken, one question is worth sitting with: what if your low libido is the part of you telling the truth?

Desire isn't a decision, so we stop treating it like one.

You can't order wanting the way you order effort. Desire responds to conditions: safety, rest, pleasure, novelty, a body that isn't running on override. So which condition has been missing longest?

Two people smiling and laughing closely together, showing their teeth and eyes.

38.7% of women report low sexual desire,

the most common sexual problem women name

(Shifren et al., 2008, Obstetrics & Gynecology, n=31,581)

What low libido feels like

It's flinching when your partner's hand lands on your shoulder, because you know where the hand is hoping to go. Doing the math on how long it's been and rounding down when you say it out loud. Wanting to want it, which is its own special grief. Wondering whether you're broken, or asexual, or just done, and being afraid of every answer.

Sometimes it's simpler and worse: the sex you’re having is boring, or it hurts, or it was never built around your body in the first place, and your desire is the only honest one in the room.

How I can help

First, rule-outs. Medications and medical causes move desire: SSRIs, blood pressure meds, hormonal shifts, anything systemic. If your libido changed suddenly, your doctor is the first call, and I'll be the one insisting on it.

Then we work somatically: rebuilding your capacity for pleasure in a body that's been running on override, starting small and nowhere near the bedroom. Sessions are experiential, and you'll leave with personalized practices that fit your real week instead of worksheets. This page describes individual work, by telehealth in New York and Oregon. If desire is the gap between you and a partner, that's mismatched desire, and it may be work for both of you.

WHERE YOU ARE NOW

You're monitoring your desire like a stock that keeps falling, measuring it, apologizing for it. The pressure to want has crowded out any room to notice what you do respond to. Wanting has become one more job you're failing at.

WHERE WE’RE GOING

We take the pressure off and get curious instead. What is your desire responding to, and what is it refusing? You rebuild pleasure as a capacity, in small doses, in a body that's allowed to say no, because a body that can't say no can't fully say yes either.

WHAT THAT LOOKS LIKE in practice

When did you last feel pleasure that had nothing to do with sex? What kind of touch do you never get around to asking for? If your libido could write you one honest sentence, what would it say?

Those are the questions we work with.

No more pushing through.

Free 20-minute call. We'll talk about what's going on and whether this is the right fit.

BOOK A CONSULT

Rate & Fees

$250 for 50 minute individual sessions

I don’t accept insurance and am private pay only, with superbills for out-of-network reimbursement.

Longer sessions available by request for a pro-rated fee.

FAQs

I strongly recommend it because sexual pain is both physical and emotional. Sometimes it’s inflamed muscle or a nerve that’s over firing. Going to see your medical providers can help with that. I can help you find someone if you need a referral.
Happens all the time. Doesn't mean the pain isn't real. Sometimes the anticipatory and emotional components are driving most of the experience. Doesn’t mean you won’t benefit from Pelvic Floor PT and therapy. We work with what your body is doing, not what a test says.
If we are doing individual therapy, I have found it helpful to have one or two sessions to encourage healthy communication.
I do work with couples where one experiences sexual pain, especially if the sexual pain is creating a mismatch in libido.
Makes complete sense when something hurts. You can’t experience pleasure if you’re in unwanted pain.
They work with the muscles, tissue, and physical patterns. I work with the fear, the relational stuff, the identity piece, and the nervous system responses wrapped up in the pain. Different layers, same problem.

Low libido therapy in Brooklyn, NY I work with New York clients via secure telehealth, in person coming soon. If you've been quietly running the "what's wrong with me" audit, let's talk instead.

Low libido therapy in Portland, OR Licensed in Oregon, seeing Portland-area clients virtually. If your desire changed and nobody has taken it seriously as information, I'd love to connect.

You might also be navigating

Mismatched Desire - when the desire gap lives between you and a partner

Neurodivergent Sexuality - when understimulating sex is reading as low desire

Chronic Pain & Illness - when your body has nothing left to give by 9pm

People Pleasing - when wanting was never your assignment