Sexual Difficulties & Chronic Illness | Apex Psychological Services

Chronic Illness, Disability and Sexual Wellbeing

Chronic illness and disability affect sexual wellbeing in ways that are frequently profound and rarely adequately addressed within healthcare. Pain, fatigue, medication effects, changed body function, altered self-image, and the psychological weight of living with a chronic condition all shape a person’s sexual experience — often in ways that cause significant distress but feel too difficult to raise with a GP or specialist.

Sexuality is a fundamental aspect of human wellbeing and identity. Chronic illness does not remove this — but it often fundamentally changes the landscape of what is possible and how it is experienced. Psychosexual therapy provides specialist support for navigating that changed landscape with confidence and creativity.

TSpecialist support available: Sexual difficulties related to chronic illness are common, undertreated, and very amenable to specialist psychosexual therapy. With the right support, most people develop a sexual life that is genuinely satisfying — even if different from what it was before.

Conditions Commonly Associated with Sexual Difficulties

Multiple Sclerosis

MS can directly affect sexual response through nerve damage, as well as indirectly through fatigue, spasticity, bladder symptoms, and the psychological impact of a progressive condition.

Diabetes

Diabetic neuropathy and vascular changes can cause erectile dysfunction, reduced genital sensation, and delayed orgasm. These effects interact with the psychological impact of managing a lifelong condition.

Cardiovascular Disease

Heart disease and the medication used to treat it can cause erectile difficulties, fatigue, and anxiety about exertion during sex that significantly inhibits sexual activity.

Arthritis and Musculoskeletal Conditions

Chronic pain, joint stiffness, and mobility limitations can make established sexual positions painful or impossible and require creative adaptation of sexual activity.

Neurological Conditions

Parkinson’s disease, spinal cord injury, and other neurological conditions affect sexual response through both direct neurological mechanisms and through their broader impact on body function and self-image.

Mental Health Conditions and Medication

Depression, anxiety, and psychiatric medication (particularly SSRIs) frequently cause significant sexual side effects including low desire, delayed orgasm, and erectile difficulties.

How Psychosexual Therapy Helps

Comprehensive Assessment

A thorough understanding of the specific condition, its treatment, and its sexual effects — combined with a full picture of the psychological and relational impact on sexual wellbeing.

Creative Adaptation

Working with what is possible rather than mourning what is no longer available — exploring the full range of sexual activity, positions, timing, and aids that can make sexual life genuinely satisfying within physical constraints.

Pain Management in Sexual Contexts

Specific strategies for managing pain before, during, and after sexual activity — including timing, positioning, pacing, and the use of heat, massage, or medication.

Fatigue and Energy Management

Planning sexual activity around energy levels, using rest periods, and reframing what sex can be — reducing the pressure of performance while maintaining genuine sexual connection.

Body Image and Identity

Addressing the changed relationship with the body that chronic illness often creates — rebuilding a positive sexual self-image that accommodates the changed physical reality.

Partner Communication

Supporting couples in communicating about what has changed, what is needed, and how to maintain physical and emotional intimacy within the constraints of chronic illness.

What You Can Expect from Treatment

A satisfying sexual life : Most people develop genuinely satisfying sexual expression that works within their physical situation
Reduced distress : Address the grief, shame, and anxiety that chronic illness-related sexual difficulties often generate
Creative solutions : Discover adaptations and approaches that open up sexual possibility rather than simply mourning loss
Stronger intimacy : Rebuild physical and emotional closeness within the context of chronic illness

What our clients say

"My MS had made sex as it was before impossible. My therapist helped me think about what was still possible — very differently. That shift was everything. "

— Anonymous

"The antidepressants had removed my ability to orgasm entirely. My therapist had specific knowledge of this and genuine solutions. I had not expected that."

— Anonymous

"My partner had been protective to the point of not wanting to touch me. Couples therapy gave us a way to talk about this and find our way back to genuine intimacy."

— Anonymous

Our Therapists

Our COSRT-accredited therapists have specialist knowledge of the sexual effects of chronic illness, disability, and the medications used to treat them. This requires specific knowledge of physiology, pharmacology, and the psychological dimensions of living with a long-term condition — knowledge our therapists bring to every session.

Working with sexual difficulties in the context of chronic illness requires creativity, flexibility, and genuine respect for what the person is managing. Our therapists approach this work without assumptions and without a fixed idea of what a satisfying sexual life must look like — working instead from what is possible and meaningful for this particular person.

Your First Session

Your first session is a warm, confidential conversation about your experience — what you have been noticing, how long it has been affecting you, and what you hope to achieve. There is no pressure and no predetermined agenda. Your therapist will listen carefully and develop a personalised treatment plan collaboratively with you.

Between Sessions

Psychosexual therapy involves work between sessions as well as within them. Your therapist will discuss any tasks, exercises, or reflections that may support your progress. These are always agreed collaboratively and tailored entirely to your situation and pace.

No GP Referral Needed

You do not need a GP referral to book with us. You can contact us directly for a confidential initial consultation. We are happy to work alongside your GP or other healthcare providers with your consent.

If you are in crisis: Apex Psychological Services is not an emergency or crisis service. If you are experiencing a mental health emergency, please contact NHS 111, call 999, or attend your nearest A&E. Samaritans are available 24/7 on 116 123 (free, any phone).

Frequently Asked Questions

1. Do you have experience with my specific condition?

Our therapists have broad knowledge of the sexual effects of many chronic conditions and medications. Please mention your condition when you get in touch and we will confirm whether we can offer specialist support.

2. Can psychosexual therapy help if the cause is primarily physical?

Yes. Even where the primary cause is physical, the psychological response to that physical change — and the relational impact — typically requires attention. Psychosexual therapy addresses both dimensions.

3. Can you work alongside my medical team?

Yes. With your consent, we are happy to work collaboratively with your GP, specialist, or other healthcare providers. We can also provide written summaries of our work where clinically helpful.

4.What if penetrative sex is no longer possible?

A satisfying sexual life does not require penetrative sex. Psychosexual therapy takes a broad view of sexual wellbeing and helps people expand their sexual repertoire beyond what may no longer be available.

No referral needed: You can contact us directly without a GP referral or existing diagnosis. We respond to all enquiries within one working day, Monday to Friday.

Fees

Session Fees

Individual Sessions: £90 per session (50 minutes)
Couple Sessions: £130 per session (50 minutes)

Session Frequency

Most clients attend weekly or fortnightly sessions. You and your therapist will agree a frequency that suits your needs.
Both in-person and online appointments are available.

Please use our contact form to arrange a consultation. We respond within one working day.