Couples Therapy for Mismatched Sexual Desire & Desire Discrepancy ● AASECT-Certified Sex Therapist ● Practicing Therapy Since 1988
Sex Therapy for Couples with Mismatched Sexual Desire on the North Shore of Massachusetts
Online sex therapy for Massachusetts couples in Marblehead, Swampscott, Beverly, Manchester-by-the-Sea, and nearby North Shore towns
Mismatched sexual desire: Sex therapy for North Shore couples
Since your bodies started changing in midlife, one of you has wanted sex more often than the other does. Before menopause and new prescriptions, the difference in sexual desire between you felt insignificant. Now sex happens rarely, and when sex does happen, each of you worries about how your body will respond.
Menopause can bring night sweats that wake you up and vaginal dryness that makes sex uncomfortable. Some antidepressants lower libido, and some blood pressure medicines and antidepressants can cause erection problems.
After a few nights when sex hurt or an erection didn’t last, the two of you started turning away from kissing and cuddling in bed.
You still enjoy each other’s company. On a cold Saturday morning in November, the two of you walk the dog on Singing Beach in Manchester-by-the-Sea and hold hands the whole way back to the car.
At home that night, you sleep with your backs to each other. Neither of you brings up how your bodies have changed, and each of you wonders whether the other partner still wants sex.
Desire discrepancy is the clinical name for an ongoing difference in how much sex two partners want. Menopause, medications, and erection changes in midlife can widen a difference in sexual desire that used to feel small.
The two of you can still enjoy sex with the bodies you have now. There’s hope. With sex therapy, many couples find kinds of touch and sex that feel good after menopause and medication changes, and they start enjoying sex together again. The two of you can, too.
Kate McNulty, LCSW, LICSW | AASECT-Certified Sex Therapist & Certified Gottman Method Couples Therapist
I help North Shore couples enjoy sex together again after menopause, medication changes, or erection changes.
I’ve worked as a therapist since 1988, and for more than fifteen years, I’ve focused on sex therapy for couples.
When body changes affect sexual comfort or arousal, couples sometimes become hesitant about physical intimacy. I use my training in sex therapy and couples therapy to assess both the sexual concerns and any relationship difficulties that have developed alongside them.
As a sex therapist certified by AASECT, the American Association of Sexuality Educators, Counselors and Therapists, I treat low desire and other problems with sex itself, including the worry and avoidance that can follow body changes. As a certified Gottman Method couples therapist, I help partners stay close while their bodies and lives change, using an approach built on research with couples. I also train other therapists, as an AASECT Approved Supervisor and a Gottman Method trainer, and I combine sex therapy and the Gottman Method in our sessions.
I see the two of you together during sex therapy sessions because the difference in sexual desire shows up in how you each respond to the other partner’s body changes. I help each of you explain what has changed in your body and how you feel about sex now so that you’re not left to guess or assume.
Here’s what you can expect from me as your sex therapist:
We talk about sex directly, in plain words, and sex stays at the center of our sessions.
I’ll assess what’s contributing to your difficulties before recommending treatment. Depending on what we discover, I may help you address sexual discomfort, changes in arousal, or concerns about physical intimacy, including using structured touch exercises when they’re appropriate. We’ll choose an approach that respects both partners’ comfort and sexual interests.
I take both of your experiences seriously, whether you’re the partner who wants more sex or the partner who wants less. The partner who wants more sex won’t be told that wanting sex is the problem, and the partner who wants less sex won’t be asked to say yes when they don’t want to. Together, we work toward sex you both look forward to.
We meet by secure video, and you’ll both need to be in Massachusetts during each session.
How your relationship changes after sex therapy with me
In our first sessions, I ask each of you what has changed in your body and what sex feels like for you now.
While one of you talks, I help the other partner listen without taking the body changes as a sign of rejection. Many couples learn that both partners stopped cuddling in bed for the same reason: each partner was trying not to disappoint the other.
After menopause, a chronic health condition, or a medication change, what you know about your partner’s body and desire may be out of date.
In our sessions, each of you asks the other partner questions, such as “What kind of touch feels good now?” and “What worries you before sex?” Each answer gives you current information about your partner.
Once I understand what’s contributing to your difficulties, I’ll recommend treatment based on what each of you needs. That may include addressing concerns about arousal or pleasure, helping you adapt sexual activities to physical changes, or using structured touch exercises when they’re appropriate.
If physical discomfort, medication effects, or erection difficulties require medical attention, I’ll recommend appropriate care alongside our sessions.
We’ll review how the changes are working for both of you and adjust treatment as we learn more about what makes intimacy comfortable and satisfying.
For example, if erection difficulties have made sexual intimacy stressful, I’ll assess what’s contributing to the problem and how it’s affecting both partners.
When appropriate, I may recommend temporarily taking intercourse off the table so you can enjoy other kinds of physical intimacy without making an erection the goal.
If you’re the partner who wants more sex, you can feel more confident approaching intimacy because you and your partner have found ways to enjoy being sexual together that accommodate your bodies as they are now.
You understand what your partner enjoys, and you can share pleasurable experiences without making intercourse or a particular physical response the measure of success.
If you’re the partner who wants less sex, you can enjoy sexual experiences that reflect your own comfort and pleasure. You can tell your partner what feels good, what you’d like to do differently, and what you don’t want.
Both of you can feel good about the intimacy you choose to share, even when your levels of desire differ.
Who is a good fit for sex therapy for Couples with desire discrepancy?
Sex therapy for desire discrepancy works best when both partners attend sessions and both want a more satisfying sex life together.
You don’t have to agree on what caused the desire gap or feel equally motivated to close it. You only need to be willing to try.
I also work with couples where one or both partners are autistic and/or have ADHD, and LGBTQIA+ and polyamorous or open-relationship couples and individuals, since standard sex therapy frameworks were built on neurotypical, heterosexual, monogamous, cisgendered assumptions that don’t fit every relationship.
If there’s ongoing domestic violence in your relationship, sex therapy isn’t the right starting place; individual therapy is safer.
A certified sex therapist and couples therapist with more than 15 years treating differences in sexual desire
I’m Kate McNulty, LCSW, LICSW
I’ve been a therapist since 1988, and for more than 15 years, I’ve helped couples whose differences in sexual desire have become a source of frustration, hurt, or uncertainty about their relationship.
As both an AASECT-certified sex therapist and a Certified Gottman Method Couples Therapist, I bring two areas of specialized training to your treatment. I can assess how sexual desire, arousal, physical health, sexual satisfaction, and relationship difficulties influence one another, including concerns that aren’t immediately obvious to either partner.
Couples can spend years trying to improve their sexual relationship without understanding why their desires differ. I’ll help you identify what’s contributing to the problem and address those issues so you can build a sexual relationship that feels satisfying to both of you.
If the description on this page sounded like your relationship, I’d like to help.
Logistics
Pricing, scheduling, and online sex therapy sessions
All sessions are conducted by secure, HIPAA-compliant video. I work with couples across the North Shore and the rest of Massachusetts.
Sessions are private pay, billed at $500 per hour and $750 for 90-minute sessions. Extended sessions (3+ hours) are available for couples who want to make faster progress.
I am not in-network with insurance and cannot bill them directly. For more information about pricing, please see the pricing page.
How to get started in sex therapy
To schedule your first appointment, please choose a day and time on my secure, HIPAA-compliant calendar using the button below.
After I approve your request, typically within one business day, you and your partner will receive new client forms via email, which you’ll both review and digitally sign before we meet.
Areas served on the North Shore of Massachusetts
I’m licensed in Massachusetts as a Licensed Independent Clinical Social Worker (LICSW1144781), and I see couples by secure, HIPAA-compliant video across the North Shore.
Along the coast, I see couples in Nahant, Swampscott, Marblehead, Beverly, Manchester-by-the-Sea, Essex, and Ipswich.
Inland, I see couples in Danvers, Lynnfield, Middleton, Topsfield, Boxford, Hamilton, and Wenham.
If you’re anywhere on the North Shore, I can work with you.
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In our sessions, we work on kinds of touch and sex that feel good to both of you. I’ll also suggest that you see your doctor or a menopause specialist, who can treat dryness and pain. You can get medical treatment and come to sex therapy at the same time.
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Some medicines, including antidepressants and blood pressure medicines, can cause erection problems, so I’ll suggest a visit with your doctor.
In our sessions, the two of you find ways to enjoy sex that don’t depend on an erection, which can ease the worry that can make erection problems worse.
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Yes, for both of you. If you’re the partner who wants less sex, I won’t push you toward sex you don’t want. We look at what has made sex hard to want and hard to talk about, and we work toward sex you want to have, at a pace that feels okay to you.
If you’re the partner who wants more sex, wanting sex with your partner is normal, and I take your experience as seriously as your partner’s. We work on how to bring up sex without pressure and how to hear no without assuming the worst.
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Yes. You’ll sign on to the same secure video link. For example, one of you can join from an office in Boston and the other from home. You just need privacy and a reliable internet connection.
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No. I’m not in-network with any insurance company, and I don’t provide Superbills for couples sessions. You’re welcome to use an HSA or FSA card for our sessions if you like.
Questions About Sex Therapy for North Shore, MA Couples with Desire Discrepancy —
Still have Questions about sex therapy for desire discrepancy?
Please contact me using the button below. I will respond within 2 business days.