I’m not saying that we all should go running to a sex therapist at the first sign of trouble but for God’s sake if you’re married and you haven’t had sex in five years and you’re not talking about it get some bloody help.

“Most people wait too long to get help” says Tobi Klein a certified marriage couple and sex therapist in Montreal. “They wait until the situation becomes a crisis until they are totally depressed or can’t function or until one person threatens to leave the relationship. When it comes to sex problems people wait until they turn into relationship problems.”

I certainly know how easy it is to leave things to the last minute but really you might want to deal with the fact that your husband can’t come inside you before you start thinking about having a baby.

Retarded ejaculation (not being able to come during intercourse) along with premature ejaculation and erectile dysfunction (a kinder term for impotence) are the three most common problems among the men Klein sees. For women the biggies are lack of orgasm lack of interest in sex and painful sex.

The sad thing is that the longer you wait for treatment the harder it is to correct the problem. Premature ejaculation for example is one of the easiest conditions to treat but most couples have a hard time even admitting it’s a problem says Klein. “You have a guy who comes really quickly and the woman isn’t happy about it but she doesn’t want to hurt his feelings so she doesn’t say anything” Klein explains. “He doesn’t feel there is a problem. Sure he knows he comes a little fast but it’s not the end of the world.”

That is not until she gets sick of it and stops having sex with him or he starts giving her a hard time because she never wants to have sex. One way to at least curb this resentment is to make sure she’s satisfied first. Then he needs to learn how to control his ejaculation using stop-start method or the squeeze technique (when he stops ejaculation by squeezing the base of his penis when he’s about to come).

Klein says the hardest problem to deal with (quite literally) is the aforementioned retarded ejaculation. This problem often doesn’t get dealt with because the woman initially thinks she’s got Joe Stud on her hands. Eventually the chafing gets a little hard to take and the couple seeks help. Klein says being unable to come inside a woman often results from a phobia such as fear of pregnancy fear of losing control or fear of infection. She had one case of an epileptic who was afraid of coming because he likened it to a seizure.

These men can usually ejaculate while masturbating but they need to get over their fear of coming inside a woman. During treatment Klein will encourage the couple to get the man aroused then have her get out of bed while he comes. Eventually she sits next to him on the bed while he comes; next he might let himself ejaculate on her stomach working his way up to that big ‘old scary place her vagina.

Vaginas can be scary places for some women too. Many of the women who come to see Klein because they have never experienced orgasm have also never masturbated.

So Klein teaches them.

Unlike some teaching methods however there are no hands-on demonstrations in Klein’s therapy much to the disappointment of some patients. One guy was so upset that treatment didn’t involve actually having sex with Klein that he slapped her.

Sometimes sexual differences can’t be resolved like the married guy who suddenly developed a deep desire to wear diapers around the house on weekends. His wife was furious and wanted nothing to do with it threatening to leave if his fetish continued. He had to decide what was more important his marriage or his Huggies.

If you’re considering sex therapy Klein recommends you first go for a checkup to make sure nothing physical is contributing to the problem. Be sure your therapist is certified with a recognized professional association.

Sex therapy is not covered by provincial health care but ask about a sliding scale. Even then it ain’t cheap. Expect to pay $100-$200 a session and consider that some problems can take up to a year to solve. But as Klein rightly points out even at a minimum of eight sessions at $200 each it’s still cheaper than divorce.