We all like to think we like to gab about sex, but Dr. Jenni Skyler, the director of the Boulder-based Intimacy Institute, says we don’t do it nearly enough, especially with our partners. A practicing sex therapist since 2006, Skyler believes sexual health is a critical yet often overlooked component to a person’s overall well-being. We talk with the board-certified sexologist about when you should see a therapist, the hottest research in sex, and the most common problems she sees.

5280 Health: What is sex therapy, anyway?

Dr. Jenni Skyler: It’s psychotherapy related to sexuality, intimacy, and relationships, which includes all aspects of human sexuality, including gender and sexual orientation, alternative behaviors, and compulsivities.

Why do people come to see you?

Couples inevitably come for desire discrepancy. Men come in for erectile dysfunction or premature ejaculation. Women come in with a struggle to orgasm. I also have clients with sexual compulsivity, sometimes called sex addiction.

Do people have a difficult time talking about this stuff?

Yes. It’s easier to have sex with the lights off than to talk about it with the lights on. Most people have shame around sex so they don’t talk about it, even when they need to. The majority of people get silence on the subject as they grow up. And silence speaks volumes. It’s saying you’re not supposed to talk about it.

But it’s important for overall health to have a healthy sex life?

Most people don’t think about it that way, but yes. They think of their sex lives as other. But it’s important to integrate it. Sex is what makes us human, yet we deny that part of our identities. There are a lot of theories on why we relegate our sexualities to the proverbial basement.

Do you have a theory?

I think it’s our messaging. Many religions say sex is a sin. They say to control it and save it for marriage, which is fine, but there’s never a message about the importance of sexual pleasure. Another messaging problem is within families. If Great-grandma didn’t talk about sex, then Grandma didn’t talk about it, and then Mom won’t talk about it. So we end up ignoring it for generations. Then there’s the hypersexualized media. We’re bombarded with sexual messages, but not about healthy sex.

If you could solve one of the mysteries of human sexuality, what would it be?

The desire discrepancy. There isn’t a couple in the world that doesn’t struggle with that. He wants it four times a week; she wants it four times a month. I have tools that sometimes help, but mostly I just normalize it for people. They think something is wrong when really it’s just normal.

I thought the drug companies were working on the female desire pill.

You can’t manufacture desire. You could maybe do the female arousal pill, if you’re literally talking about blood flow. But it doesn’t matter how engorged your genitals are, your brain has to be on board. Arousal is how you turn the body on; desire is turning the brain on. So to all these drug companies that say they’ve found the desire solution, I’m kinda like, Really? You’ve figured out all of our psychological complexities with a pill?

When should someone visit a sex therapist?

There is no “right” time, but it’s better to come in before you’ve hit the crisis point. If clients come in before they’re in crisis, I’m thrilled because their relationship is still in a good place. They still have good emotional intimacy so it’s easier to get their sexual intimacy back on track. But people usually come in at the crisis point. Sometimes they get to such a bad place that their emotional intimacy crumbles. Then they’re coming in with emotional and sexual intimacy issues, which is more difficult. If you’re feeling the drain sexually and emotionally, you definitely need to make an appointment.