What We Treat: Sex Therapy for Individuals and Couples in Utah

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Covenant Sex Therapy helps individuals and couples with the full range of sexual concerns. No list could cover every sexual challenge people face, so below are the concerns we see most often, what each one is, and how therapy helps. These are common examples, not the limits of what we treat. If your concern isn't here, reach out and we'll tell you honestly whether we can help. We see clients in our Provo and Pleasant Grove offices and by telehealth anywhere in Utah, in English and Spanish.

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Desire concerns

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​Low sexual desire

Low desire means little interest in sex, or interest that has faded, in a way that bothers you or your relationship. In women the diagnosis is female sexual interest/arousal disorder, and in men it is male hypoactive sexual desire disorder. Stress, depression, medications, hormones, pain, distance in the relationship, and shame can all play a part, so therapy looks at each of them. For many people, learning how responsive desire works changes a great deal.

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Different sex drives in a marriage

When partners want sex at different frequencies, it is called desire discrepancy. It is one of the most common concerns couples bring to therapy, and it often turns into a painful cycle of pressure, rejection, and avoidance. We help couples understand that cycle and build a sexual relationship that works for both people. Dr. Anthony Hughes's doctoral research focused on couple attachment and sexual desire discrepancy.

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Sexless marriage and sexual avoidance

​Some couples rarely or never have sex anymore, or one partner avoids sex altogether. Avoidance usually has reasons, like pain, anxiety, resentment, or past hurt. We help you understand what is driving it and find a way back to physical closeness.

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Relationship and communication concerns

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Talking about sex

Many couples have never learned how to talk openly about sex, what they enjoy, or what isn't working. We help partners have these conversations without blame or embarrassment.

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Initiation, rejection, and pressure

​Who initiates, how often, and what happens after a no can become a source of hurt for both partners. We help couples reduce pressure, handle rejection with care, and make initiating feel safe again.

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Arousal and orgasm concerns

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Erectile dysfunction

Erectile dysfunction, diagnosed as erectile disorder, is trouble getting or keeping an erection. It can have medical causes, so we recommend a check-up with your doctor. It also has psychological causes, especially performance anxiety. Therapy works well on its own for anxiety-driven concerns and alongside medical treatment for the rest.

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Premature and delayed ejaculation

Premature ejaculation means ejaculating sooner than you want. Delayed ejaculation means it takes much longer than you want, or doesn't happen. Anxiety, medications, and habits can all contribute. Research suggests therapy works best combined with medical care for these concerns, and we coordinate with your doctor when that helps.

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Arousal difficulties

Some people want sex, but their body doesn't respond, or arousal fades partway through. We look at physical, emotional, and relationship factors together instead of treating the body and mind as separate problems.

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Orgasm difficulties

Female orgasmic disorder means orgasm is delayed, infrequent, or absent in a way that causes distress. Accurate information about how bodies respond often helps a great deal, and therapy adds skills, practice, and a place to talk openly.

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Pain with sex

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Painful sex and vaginismus

Pain with intercourse, vaginismus, and pelvic pain fall under genito-pelvic pain/penetration disorder. This includes couples who haven't been able to have intercourse since their wedding. A medical evaluation comes first. Even after medical treatment, anxiety and fear of pain can keep the cycle going, and that is where therapy helps. We work alongside pelvic floor physical therapists and physicians. Research supports both couples therapy and pelvic floor physical therapy for this concern.

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Pornography, compulsive sexual behavior, and betrayal

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Pornography use that feels out of control

Many people come in worried about pornography use or masturbation, and some call it porn addiction. We start with a careful assessment. Some people have a true loss of control, while others mainly feel distress because the behavior conflicts with their values. Both are real, and they call for different kinds of help. Compulsive sexual behavior disorder is recognized by the World Health Organization in the ICD-11.

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Affair recovery and betrayal

Infidelity or hidden sexual behavior can break trust at the deepest level. We work with the partner who was hurt, the partner who caused the hurt, and the couple together to decide what healing looks like and to rebuild trust when both people want that.

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Anxiety, shame, and trauma

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Sexual anxiety and performance anxiety

​Worry about performing, being judged, or doing it wrong can shut down desire and arousal. Therapy helps you understand the anxiety and practice staying present instead of watching yourself.

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OCD and sexuality​

Obsessive-compulsive disorder often shows up in sexual and religious life: unwanted intrusive sexual thoughts, religious scrupulosity, constant doubt about your worthiness or your relationship, and checking, confessing, or reassurance seeking that brings relief for a moment and then starts again. Intrusive thoughts are not desires, and treating them as evidence about who you are makes them stronger. We use exposure and response prevention, the treatment with the strongest research support for OCD, and we coordinate with your doctor when medication is part of the plan.

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Sexual shame and religious guilt

Shame about sex sometimes gets tangled up with faith. Research links sex guilt with lower sexual satisfaction, and it links seeing sex as sacred with higher satisfaction. We help you separate shame from your values so you can keep your faith and enjoy intimacy in your marriage.

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Body image and sexual confidence

Feeling uncomfortable with your body, or unsure of yourself sexually, can keep you from relaxing and enjoying intimacy. Therapy helps you build confidence and comfort with your own body.

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Sexual trauma

Past sexual abuse or assault can affect intimacy years later. Our therapists help survivors heal at their own pace and rebuild a sexual relationship that feels safe.

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Life changes and health

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Dating and dating anxiety

Dating raises real questions: nervousness about physical closeness, what to share about your sexual past and when, and how your values shape your choices. We work on dating anxiety, sexual confidence, relational skills, and intimacy, including with people dating after a divorce, so those are in place before a relationship rather than after a problem.

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Engaged and newly married couples

Many couples spend years learning what not to do, then find the switch doesn't flip after the wedding. We help engaged and newly married couples prepare for and build a healthy sexual relationship with less pressure and more understanding.

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Pregnancy, postpartum, and infertility

Pregnancy, recovery after birth, and the stress of trying to conceive can all change a couple's sex life. We help couples stay connected through these seasons.

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Aging, menopause, and health changes

Menopause, aging, chronic illness, cancer treatment, and medication side effects, including from antidepressants, can all affect sexual function. We work alongside your medical care to help you adjust.

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Improving your sex life

Many couples come in with no diagnosis at all. Nothing is technically wrong, but they want more connection, satisfaction, and fun. That is a great reason to see a sex therapist.

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Don't see your concern listed?

​We treat many more sexual concerns than any page can list, including unwanted or intrusive sexual thoughts, differences in sexual values or preferences between partners, sexual concerns connected to anxiety or depression, and gaps in sexual education. If you're facing a sexual challenge that isn't described here, reach out. We'll listen, tell you honestly whether we're the right fit, and help you find someone who is if we aren't.

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How sex therapy works at Covenant

Starting is simpler than it feels. Fill out our contact form, and we'll usually get back to you within one business day to match you with the right therapist. Your first sessions clarify what's contributing medically, psychologically, and in the relationship. Then we build a plan together.

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Our therapists draw on evidence-based approaches, including sex therapy, emotionally focused therapy (EFT), the Gottman Method, acceptance and commitment therapy (ACT), cognitive behavioral therapy (CBT), mindfulness-based approaches, internal family systems (IFS), EMDR, and motivational interviewing.

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Common questions about treatment

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​Do I need a medical evaluation first?

For erectile concerns, pain with sex, or sudden changes in desire, we usually recommend seeing your doctor too, because physical causes are common. You can start therapy at the same time.

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Can I come without my spouse?

Yes. Many concerns are treated individually, and one partner starting often helps the whole relationship.

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Do you offer care that respects the Latter-day Saint faith?

Yes. Covenant was founded by a member of The Church of Jesus Christ of Latter-day Saints, and our therapists respect your faith and values. Everyone is welcome, whatever your beliefs.

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Do you offer therapy in Spanish?

Yes. Therapy is available in Spanish.

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Is there anything you don't treat?

We don't provide treatment for sexual offenses, which usually necessitates specialized certification. If we aren't the right fit, we'll help you find someone who is.

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Written by Dr. Anthony Hughes, PhD, LMFT, AASECT-Certified Sex Therapist and author of You, Me, and We. Last reviewed September 2026.