Women's Sexual Health Therapy | Paula Kirsch, LCSW, CST | NY, CT & MI
Women's Sexual Health

Your body changed.
Your desire matters.

Many women spend years quietly managing sexual concerns — pain, low desire, changes after menopause, the loss of intimacy they once had — before they find care that meets them where they actually are.

This is that care.

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"Sexual concerns are some of the most common and most underserved issues women face across their lifetimes. They deserve more than a pamphlet and a referral."

What Brings Women Here

These concerns are
more common than you think.

Women often arrive having already ruled out medical causes, been told everything looks fine, or simply having never had a place to talk about this honestly. Therapy offers something medicine alone cannot: the space to understand what's actually going on, and why.

Desire & Arousal

Low or Absent Desire

Desire that has faded, was never quite there, or disappears under stress, life transitions, or relationship strain. This may be situational or longstanding, and it's rarely as simple as just not being in the mood.

Menopause & Perimenopause

Sexual Changes During Menopause

Hormonal shifts during perimenopause and menopause affect desire, arousal, lubrication, and how sex feels physically and emotionally. These changes are real, they're not inevitable, and they're absolutely treatable.

Pain & Physical Response

Sexual Pain and Vaginismus

Pain during sex, difficulty with penetration, or a body that tightens involuntarily in anticipation of pain. These experiences often have both physical and psychological components, and therapy addresses both.

Postpartum & Medical

Intimacy After Birth or Illness

Pregnancy, childbirth, breastfeeding, cancer treatment, surgery, and chronic illness all change the body and change the relationship to sexuality. Rebuilding intimacy after a medical event takes time and the right support.

Arousal & Response

Arousal Difficulties

Difficulty becoming aroused, orgasm that has changed or become elusive, or a disconnect between wanting sex and the body's response. These are common, often treatable, and rarely talked about with enough honesty.

Desire Discrepancy

Mismatched Desire in Relationships

When partners want sex at different frequencies, or when your own desire has changed and the relationship is feeling the strain. Desire discrepancy is one of the most common couples concerns, and one of the most workable.

The Approach

What therapy for
women's sexual health
actually looks like

Sex therapy is talk therapy. There are no physical exams, no exercises you're required to do in session, and nothing that would feel out of place in any other clinical setting. What's different is the willingness to go directly to the things most therapists skirt around.

Sessions are 55 minutes via HIPAA-compliant telehealth video. We work together to understand what's happening, where it came from, and what might actually shift it, using evidence-based approaches tailored to your specific concerns.

What we may work on
  • Understanding the psychological, relational, and physiological factors contributing to your concern
  • Addressing anxiety, avoidance, or body shame that has built up around sex over time
  • Rebuilding a sense of agency and connection in your own body
  • Navigating desire discrepancy with a partner, if applicable
  • Processing medical events, hormonal changes, or trauma that are affecting intimacy
  • Developing practical strategies that are realistic for your life
  • Working toward goals you define, not ones prescribed by a norm

Referred by your OB/GYN or another provider?

Many clients come through referrals from OB/GYNs, gynecologists, physical therapists, and other medical providers. If you were referred and aren't sure what to expect, the free 15-minute consultation is a good place to start. You don't need to have done any reading or preparation beforehand. Just reach out and we'll take it from there.

"Most of my clients dealing with sexual health concerns have already been told that everything looks normal. The issue isn't that nothing is wrong. It's that the right kind of help hasn't been available."
Paula Kirsch, LCSW, CST
Who This Is For

You don't need to have
a diagnosis to begin.

Many of the women I work with have been managing these concerns quietly for a long time. They've done the research, seen the doctors, maybe tried a few things that didn't help. What they haven't had is a space where they could talk about it directly, without having to educate the person across from them or soften what they're actually experiencing.

You don't need to arrive with a diagnosis or a clear description of the problem. You might have a specific concern you've been sitting with for years. You might just know something feels off and haven't found the words for it yet. Either way is a fine place to start.

I work with women individually and with couples where sexual health concerns are affecting the relationship.

You may be in the right place if
  • You've been told medically that everything is fine, but something still feels wrong
  • You've noticed your desire has changed and you're not sure why or what to do about it
  • Menopause or perimenopause has shifted something in how you experience your body or sexuality
  • Sex has become painful, difficult, or something you avoid
  • You had a baby, a surgery, or a health event and intimacy hasn't felt the same since
  • You and your partner are experiencing significant desire discrepancy
  • You've never had a space where you could talk about this honestly
Ready to Start?

A free consultation
is always available.

Reach out through the contact form and we'll schedule a free 15-minute call. It's a low-stakes conversation, a chance to ask questions, talk briefly about what's bringing you in, and decide whether this feels like the right fit. I typically respond within 24 to 48 hours.