Everything a Sex Therapist would Like You to Know

Couples worried about “mismatched” libidos. People struggling to orgasm. Lovers wondering if they’re having a “normal” amount of sex. Sex therapists, educators and researchers tend to see these issues over and over again.

We reached out to several of them to ask: What do you wish more people knew about sex and intimacy?

Here’s what the experts had to say.

1. Comparison is the thief of sexual joy.

Lori Brotto, a psychologist and professor at the University of British Columbia who is the author of “Better Sex Through Mindfulness,” spends a lot of time trying to persuade people to discard the concept of a “normal” sex life when it comes to how and how often they get intimate.

The frequency with which couples have sex is not a meaningful measure of sexual health, she said, even though it is something “people get really hung up on.” It doesn’t tell you anything about whether individuals are actually enjoying time with their partners, and the sex they’re having, she added.

“I have worked with couples who are having sex every night and are miserable together,” echoed Casey Tanner, a sex therapist based in New York City and author of “Feel It All.” Conversely, she has worked with couples who feel deeply connected and who have sex maybe three times a year.

Let go of the numbers game, Ms. Tanner urged, and instead focus on how each sexual experience feels.

2. It may be time to update your definition of “sex.”

We have a tendency to think of sex as an action, said Esther Perel, a couples therapist and author who is launching a new online course about desire. But she reframes it for her clients and audiences. “Sex isn’t something that you do,” Ms. Perel tells them. “Sex is a place where you go.”

She often asks questions like: “What do you want to experience there? Is this an experience, for you, of transcendence? Of spiritual union? Of deep connection?” Or, “is it an experience where you can be mischievous and for once not a good citizen?”

Acknowledging that a joint orgasm isn’t the only destination during sex can help couples become unstuck, Ms. Perel finds.

Candice Nicole Hargons, an associate professor at Emory University and author of the forthcoming book “Good Sex,” encourages her clients to think about the idea of a “sexual menu.”

“Most of us get this really unseasoned sexual menu kind of handed to us when we’re kids,” she said.

The types of sex on our menu may be influenced by media, sex education classes and what we pick up socially. But she encourages her sex therapy clients to create a more flavorful, personalized menu — “to say for themselves what their yeses are, what their noes are, what their maybe-sos are.”

The only nonnegotiable? Pleasure should be the main course.

“You’d be surprised by how many people I talk to on a day-to-day basis who don’t understand that sex isn’t supposed to be painful,” said Jessica Ross, a sex therapist based in Michigan. “Orgasm? Optional. But pleasure is mandatory.”

3. There is more than one type of desire.

Sexual desire, as it’s portrayed in TV, movies and pornography, is invariably spontaneous — a sudden, overwhelming urge to have sex. But there is another, equally valid type of desire, known as responsive desire. It emerges in response to deliberate pleasure or erotic stimuli, said Lauren Fogel Mersy, a psychologist and sex therapist based in Minnesota and an author of “Desire.”

People who tend to experience responsive desire should feel reassured that “there is nothing wrong with them,” she said. “They’re not broken.” They might simply need to put in a bit more work to understand what kind of erotic stimulation helps them feel open to the possibility of intimacy, like touch, for instance.

Also, couples need to let go of the expectation that they should be aligned in how and when they experience desire. “Desire discrepancy is the norm rather than the exception,” Dr. Fogel Mersy said.

4. Never underestimate the power of the clitoris.

“The clitoris is the powerhouse of the female orgasm, and the vast majority of the sensitive nerve endings that contribute to pleasure are located on the surface of the vulva, not inside the vagina,” said Ian Kerner, a sex therapist based in New York City and author of “She Comes First.”

Most intercourse positions don’t provide a lot of clitoral stimulation, he said, which is a major contributor to the pleasure gap among heterosexual couples. In taking a more “clitoral approach to sex,” activities that are typically thought of as foreplay, like manual and oral stimulation, are not just a precursor to something else. They are the main event, Dr. Kerner explained.

That said, there are women who can orgasm during intercourse, said Debby Herbenick, a professor at the Indiana University School of Public Health and author of “Yes, Your Kid: What Parents Need to Know About Today’s Teens and Sex,” whose research suggests 18 percent of women orgasm from penetration alone. “For women who do want to have an orgasm during vaginal penetration or intercourse, it’s OK to want that — and there are ways to try,” she added.

5. Men are not light switches.

There are many clichés about male sexuality: among them, that all men think about sex constantly, and that “all it takes is a strong breeze for a guy to get an erection,” Dr. Kerner said.

“What gets lost is the bigger truth that male sexuality is as complex and variable as female sexuality,” Dr. Kerner said. Desire discrepancy is the No. 1 issue he sees in his practice, and men are just as likely to be the low-desire partner as women, he said. Often, his male clients feel a lot of shame and embarrassment that they are not initiating sex the way they’re “supposed to.”

“Men are not light switches when it comes to sex,” Dr. Kerner said. “They don’t just turn on and off.”

6. Intimacy should be on the calendar, not just sex.

Putting sex on the calendar is well-worn sex therapy advice, but Ms. Tanner believes it can backfire. “The pressure of having to keep a sexual appointment can actually decrease sexual desire,” she explained. “Rather than putting sex on your calendar, schedule an activity that opens the door for intimacy.”

What that means will vary from couple to couple, said Jessa Zimmerman, a sex therapist in private practice in Seattle, who offers the same advice to her clients. Perhaps it’s a date night. Perhaps you get into bed a bit earlier than usual and see what happens.

“It’s so different than, OK we’re going to have sex every Sunday night. Because, oh my gosh, it’s not too long before the lower-desire person is starting to avoid that or dread that,” she said.

7. It’s possible to overthink good sex.

Sara Nasserzadeh, a social psychologist and author of “Love by Design,” who works with clients around the world, said she sees a tendency among some of her North American clients to feel as if they must talk about sex ad nauseam.

“It’s ridiculous to me, because sex is something that involves the bodies,” she said. “It involves the somatic.”

That doesn’t mean her motto is “Just Do It,” but sometimes you have to let your bodies connect and “talk” for you, Dr. Nasserzadeh said.

Put another way: Sex should momentarily rob you of your intelligence, said Dr. Stephen Snyder, a sex therapist based in New York City and author of “Love Worth Making.” It should make you a bit selfish and maybe even regress a bit, he said.

“Good sex makes you dumber,” he said with a chuckle. “And great sex makes you really, really stupid.”