As part of my ongoing passion for sexual health and my work as a therapist, I am committed to staying at the forefront of the most recent data and research in the field. The information shared here reflects findings from recent peer-reviewed studies which I use as a point of reference to inform my therapeutic practice on psychosexual matters. Every question includes a research backing at the end of the answer.

A Note on Research Context It is important to approach this data with a degree of scientific caution. Human sexuality research is deeply influenced by specific variables, including:

  • Geography and Culture: Findings in one region may not translate to others.

  • Sample Demographics: Factors such as age, gender identity, and socioeconomic status vary between studies.

  • Methodological Limits: I have selected research that I feel best represents the specific question, but no single study can capture the full spectrum of human diversity.

The scientific understanding of human sexuality is dynamic and evolves as new research emerges. I encourage a discussion around alternative findings; these insights should be treated as a vital snapshot of what rigorous science currently suggests, rather than a definitive or final answer.

While this research offers a scientific look at general trends, your individual experience is uniquely valid. Clinical studies represent averages across a group, but your body, your history, and your relationships are unique.

FAQ’s backed by research

Categories:

Psychosexual
Sex
Kink/BDSM
Relationships

  • Difficulties can stem from physical or psychological factors. Physical causes include chronic illnesses like diabetes or heart disease, hormonal imbalances, and side effects of medications. Psychological causes often involve stress, relationship anxiety, depression, or past sexual trauma.

  • Sexual dysfunction can be any problem that prevents a person or couple from experiencing satisfaction from sexual activity. Up to 43% of females and 31% of males report some degree of sexual dysfunction.

    Source: Cleveland Clinic. (2023). Sexual Dysfunction: Types, Causes, Symptoms & Treatment. https://my.clevelandclinic.org/health/diseases/9121-sexual-dysfunction

    A 2024 systematic review and meta-analysis sought to update our understanding of the global prevalence of sexual dysfunction, screening over 4,000 studies published between 2017 and 2022.

    The study estimates that the global prevalence of sexual dysfunction is 31% in men and 41% in women. This indicates that roughly one in three men and nearly one in two women experience difficulties with sexual function.

    Study: Ramírez-Santos, J., Cristóbal-Cañadas, D., Parron-Carreño, T., Lozano-Paniagua, D., & Nievas-Soriano, B. J. (2024). The problem of calculating the prevalence of sexual dysfunction: a meta-analysis attending gender. Sexual Medicine Reviews, 12, 116-126. https://doi.org/10.1093/sxmrev/qead058

  • Phosphodiesterase type 5 (PDE5) inhibitors, such as sildenafil (Viagra) and tadalafil (Cialis), remain a primary first line treatment. Research shows that about 60% of patients find these effective for regaining a satisfactory sexual life. However, nearly 40% of users may not see a significant effect, particularly those with conditions like diabetes or severe vascular disease, which is why new alternative therapies are being explored.

    Reference: Yao, W-J. et al. (2025) ‘Advances in erectile dysfunction treatment research: a narrative review’, Translational Andrology and Urology, 14(7), pp. 2106-2117. doi: 10.21037/tau-2025-193.

  • Psychosexual therapy is particularly powerful for psychogenic ED, with group psychotherapy showing a 95% response rate in some studies. Interestingly, the research indicates that combining psychological intervention with medication like sildenafil often yields significantly better results than using medication alone.

    Source: Yao, W. J., Dong, J. T., Jiang, T. P., & Nie, J. N. (2025). Advances in erectile dysfunction treatment research: a narrative review. Translational Andrology and Urology, 14(7), 2106-2117.

  • Which Vaginismus intervention actually works best? If you have been navigating the confusing world of dilators, physiotherapy, and psychological support, trying to find the definitive "cure," a new 2025 systematic review finally offers a clear roadmap.

    Vaginismus, the involuntary contraction of pelvic muscles that makes penetration painful or impossible, is a true mind-body condition. This research compared success rates across 18 studies involving 863 patients to find the optimal strategy.

    The Key Finding: The study revealed that Combined Psychosexual Interventions (integrating psychological therapy and physical treatment) had the highest therapeutic success rate at 86%.

    This was closely followed by Botulinum Toxin and Pelvic Floor Physiotherapy, both achieving 85% success.

    The Crucial Nuance (The 1% Difference):

    While that 1% difference in success rates may look minor, it highlights a crucial clinical reality: the Combined Intervention (86%) works by healing the underlying issue. It teaches the brain that penetration is safe (Psychology) while simultaneously training the muscles to relax (Physio).

    This comprehensive approach is what often leads to a more complete, permanent healing because the patient learns to control their own bodily response, building long-term confidence and reducing the risk of relapse. The single-focus interventions (like dilators alone, at 78%) rarely address this full mind-body loop.

    Important Context: This data should be used to guide your consultation, not dictate your treatment. All modern interventions show high success rates (above 78%), validating that recovery is highly probable. The goal is always to find the combination of support that works best for your body and your history.

    Study Reference: Zulfikaroglu, E. (2025) ‘Vaginismus treatment: a systematic review and meta-analysis of contemporary therapeutic approaches’, Journal of Sexual Medicine. doi: 10.1093/jsxmed/qdaf295.

Psychosexual Issues

Relationships

  • Research finds that the intensity of romantic love - including feelings of passion and commitment - was not actually associated with how often couples had sex. This suggests that while love and sex are often linked in our minds, the "frequency" of intimacy is driven by many other factors beyond just how much you love your partner.

    Source: Bode, A., Kowal, M., Aghedu, F. C., & Kavanagh, P. S. (2025). SSRI use is not associated with the intensity of romantic love, obsessive thinking about a loved one, commitment, or sexual frequency in a sample of young adults experiencing romantic love. Journal of Affective Disorders, 375, 472-477.

  • There are 0 medical diagnoses for Sexual Desire Discrepancy.

    In the therapy room, couples often arrive with the assumption that the partner with lower desire is the "patient" who needs to be fixed.

    However, a significant 2020 Position Statement from the European Society for Sexual Medicine (ESSM) challenges this view. They confirm that Sexual Desire Discrepancy (SDD) - the difference in desire levels between partners- has zero official diagnostic codes in the DSM or ICD classifications.

    The experts define SDD as a "relative and dyadic concept" rather than an individual trait. This means the issue is not about one person having "too little" or "too much" desire, but rather a relationship dynamic where two different needs are colliding. SDD is described as an "inevitable feature" of long-term relationships because desire naturally fluctuates over time and rarely syncs perfectly between two people.

    Considerations:

    Distress is Key: A difference in desire does not necessarily require treatment. It only becomes a clinical problem when it causes distress to the couple or the individual.

    Individual vs. Relational: While SDD is a relational dynamic, there are cases where an individual may genuinely suffer from Hypoactive Sexual Desire Disorder (HSDD). However, the paper warns against "pathologising" normal variations in desire by using the high-desire partner as the benchmark for what is "normal".

    Gender Bias: The authors note that women are often assumed to be the "low desire" partner, but this is not supported by solid evidence. Men also experience low desire, but gender stereotypes (the myth that men are always ready for sex) can make SDD more distressing when the male partner has lower desire.

    The "Spontaneous" Myth: The paper emphasises that desire is often responsive (reactive to intimacy) rather than spontaneous (out of the blue). Waiting for spontaneous desire can create unnecessary gaps and distress.

    Sour    ce: Dewitte, M. et al. (2020) ‘Sexual Desire Discrepancy: A Position Statement of the European Society for Sexual Medicine’, Sexual Medicine, 8(2), pp. 121–131. doi: 10.1016/j.esxm.2020.02.008.

  • Researchers suggest that sexual frequency is complex and influenced by many "extrinsic" factors. These can include:

    • Career demands and work schedules.

    • Physical health and energy levels.

    • General life stress and daily responsibilities.

    • Differences in individual sexual desire, regardless of the love felt for a partner

    Source: Bode, A., Kowal, M., Aghedu, F. C., & Kavanagh, P. S. (2025). SSRI use is not associated with the intensity of romantic love, obsessive thinking about a loved one, commitment, or sexual frequency in a sample of young adults experiencing romantic love. Journal of Affective Disorders, 375, 472-477.

  • Not at all. Research shows that love intensity and sexual frequency are not strictly tied together, a lower frequency is not a reflection of a lack of love or commitment. The "quality" of the connection and the "intensity" of the bond can remain very high even when life's circumstances limit how often you are physically intimate.

    Source: Bode, A., Kowal, M., Aghedu, F. C., & Kavanagh, P. S. (2025). SSRI use is not associated with the intensity of romantic love, obsessive thinking about a loved one, commitment, or sexual frequency in a sample of young adults experiencing romantic love. Journal of Affective Disorders, 375, 472-477.

  • No. The most recent science consistently shows that the etiology of kink is not associated with psychopathology. While it is a common myth that kink is motivated by childhood trauma, studies generally find that rates of trauma among kink practitioners are actually infact slightly lower than those in the general population.

    Source: Williams, D. J., & Sprott, R. A. (2022). Current biopsychosocial science on understanding kink. Current Opinion in Psychology, 48, 101473.

  • Yes. The research highlights that kink desire (fantasies and interests) can exist independently of kink practice. Many people score high in desire but have low practice scores due to a lack of a partner or access to a community, yet they still feel a strong internal kink orientation.

    Source: Stowers, K., Stephenson, K. R., & Stermac, L. (2024). The Kink Orientation Scale: Developing and Validating a Measure of Kink Desire, Practice, and Identity. Archives of Sexual Behavior, 53, 309-325.

  • Kink is a spectrum. In a study of 200 university students not specifically recruited from kink communities, researchers found that no one scored the absolute minimum of 18. The lowest score recorded was 26, suggesting that everyone in the sample possessed some level of non-normative sexual interest, desire, or practice.

    Source: Wignall, L., McCormack, M., Carpino, T., Owens, R., & Barton, T. (2024). The Kink Orientation Scale: Developing and Validating a Measure of Kink Desire, Practice, and Identity. The Journal of Sex Research, 62(3), 307–316. https://doi.org/10.1080/00224499.2024.2387769

  • The research is clear: the issue is not the kink practice itself, but the pervasive stigma and marginalisation that mirrors the experiences of other sexual minorities.

    Beyond physical injury, social stigma and marginalisation are major concerns. Because kink is often misunderstood, many practitioners experience "minority stress," which is associated with:

    • Fear of Disclosure: Nearly half of kink-involved individuals do not tell their doctors or mental health providers about their interests.

    • Delayed Care: Approximately 19 percent of people have delayed seeking medical care due to fears of being stigmatised or judged by healthcare providers.

    • Mental Health Impact: The stress of being part of a marginalised sexual minority can lead to higher rates of suicidal ideation and attempts compared to the general population.

    Reference: Williams, D. J., & Sprott, R. A. (2022). Current biopsychosocial science on understanding kink. Current Opinion in Psychology, 48, 101473.

  • It is quite common. The study found that 47.8% of women, 60.8% of men, and 71.1% of transgender and gender nonbinary (TGNB+) participants have enacted at least one of these behaviours on a partner. When it comes to receiving these behaviours with consent, 53.8% of women, 45.8% of men, and 72.3% of TGNB+ participants reported having done so in their lifetime.

    Source: Herbenick, D., Fu, T., Chen, X., Ali, S., Stanojević, I. S., Hensel, D. J., Wright, P. J., Peterson, Z. D., Harezlak, J., & Fortenberry, J. D. (2025). Prevalence and Demographic Correlates of "Rough Sex" Behaviors: Findings from a U.S. Nationally Representative Survey of Adults Ages 18-94 Years. Archives of Sexual Behavior, 54, 3435-3469.

Kink/BDSM

Sex Addiction vs Compulsive Sexual Behaviour

  • No, it is not. Neither "sex addiction" nor "pornography addiction" are recognised as valid mental health disorders by major diagnostic bodies like the American Psychiatric Association (APA) in the current DSM-5-TR. While these terms are common in popular culture and the media, the latest scientific statement suggests they lack sufficient evidence and should not be used by healthcare professionals

    Reference: Twist, M. L. C. et al. (2025). Statement from the journal of sexual and relationship therapy... Sexual and Relationship Therapy. DOI: 10.1080/14681994.2025.2578550

  • The World Health Organisation (WHO) has introduced a diagnosis called Compulsive Sexual Behaviour Disorder (CSBD) in the ICD-11. Crucially, the WHO classifies this as an impulse control disorder, not an addiction. Practitioners are advised that these terms are not interchangeable, as the underlying treatment models are significantly different.

    Reference: Twist, M. L. C. et al. (2025). Statement from the journal of sexual and relationship therapy... Sexual and Relationship Therapy. DOI: 10.1080/14681994.2025.2578550

  • The ICD-11 criteria for CSBD are quite specific and must be present for at least six months. They include a persistent pattern of failing to control intense sexual impulses, repetitive sexual activities becoming the central focus of life to the point of neglecting personal care, and continuing these behaviours despite deriving little satisfaction or facing adverse consequences. Importantly, distress that comes solely from moral or religious disapproval of one's sexual urges is not enough to meet this diagnosis.

    Reference: Twist, M. L. C. et al. (2025). Statement from the journal of sexual and relationship therapy... Sexual and Relationship Therapy. DOI: 10.1080/14681994.2025.2578550

  • Experts argue that the "sex addiction" framework is often based on unscientific ideas and moralistic biases rather than robust research. Traditional addiction treatments often focus on "sobriety" or abstinence, which can unintentionally pathologise healthy sexual diversity, such as being "kinky," polyamorous, or having a high sex drive. There is also a concern that the "addiction" label has been used to target and discriminate against racialised communities and LGBTQ+ individuals.

    Reference: Twist, M. L. C. et al. (2025). Statement from the journal of sexual and relationship therapy... Sexual and Relationship Therapy. DOI: 10.1080/14681994.2025.2578550

  • Modern psychosexual therapy recommends a "sex-positive" and sexological approach rather than a "sobriety" model. Several evidence-based frameworks exist to help people gain agency over their sexual lives without shame, including the Out-of-Control Sexual Behaviour (OCSB) model, the psychosexual three-phase model, Sexual Integration Therapy (SIT), and the Intuitive Sexuality (IS) model. These approaches focus on self-determination, ethical frameworks, and understanding the "why" behind your behaviour.

    Reference: Twist, M. L. C. et al. (2025). Statement from the journal of sexual and relationship therapy... Sexual and Relationship Therapy. DOI: 10.1080/14681994.2025.2578550