For urologists and sexual medicine clinicians
When the medication helps, but sex still isn’t working
I’m Joseph Maron, MS, LPC, a sex therapist seeing Pennsylvania adults by telehealth. While you provide the medical care, I work alongside you on the anxiety, avoidance, and strain that medication doesn’t reach.
Immediate openings
Telehealth only · Adults in Pennsylvania · $195 per 50-minute session · Private pay, superbills provided
The consult is for your patient. The call button is for you. More practice details
Consider a referral when your patient…
Improves on medication but still isn’t satisfied.
In trials, adding therapy to medication improved satisfaction.
Describes anxiety or self-monitoring during sex.
Anxiety and erection difficulty can feed each other.
Has started avoiding sex or intimacy.
Avoidance often spreads to affection and closeness.
Is distressed about early ejaculation.
Medication plus behavioral therapy looks most promising.
Is adjusting to sex after prostate cancer treatment.
Sexual rehabilitation after prostate cancer includes counseling; outcome evidence is still thin.
Reports shame, relationship strain, or past trauma.
Some men describe shame around erection difficulty and say they want counseling as well as medication.
Common reasons to refer
- Erection concerns, even on medication
- Early ejaculation
- Delayed ejaculation or orgasm difficulty
- Low or changed desire
- Changes after prostate or pelvic cancer care
- Concerns tied to diabetes, heart disease, or chronic illness
- Trans and nonbinary patients, including after surgery
Tandem care, not a hand-off
Your care
The medical care stays with you: the workup, hormone evaluation, and treatment with medication, injections, devices, or surgery.
Sex therapy
I work with your patient on performance anxiety, avoidance, shame and self-esteem, and talking with a partner.
A first conversation can simply be about whether a referral might fit. Please wait to send records or identifying details until we’ve set up a secure way to share them.
To refer
Your patient requests a free 15-minute consult at JosephMaronLPC.com. Or call 215-804-9315. Want to talk a referral through first? Call me at the same number.
Telehealth only · Adults in Pennsylvania · Private pay, superbills provided
Tell your patient: sex therapy is talk therapy. No touch, no exam.
Doctoral student in human sexuality, Widener University · Certificate in Affirmative Therapy for Transgender Communities · ADHD-CCSP · LGBTQ+ affirming
A referral does not confirm availability or establish a treatment relationship. This practice is not an emergency or crisis service. Call or text 988, or call 911 for an emergency.
Handouts to print or share
One page for you and a two-sided handout for your patient. The patient handout is also a web page, so you can send a link instead of printing.
-
For patients in urologic care
When sex has become something to worry about
Erections, ejaculation, and desire involve your body, your mind, and your relationships all at once. Sex therapy can work alongside your urologic care.
Why it fits
In a meta-analysis of men with erectile dysfunction, psychological treatment plus a PDE5 inhibitor outperformed either alone.1 For early ejaculation, adding behavioral therapy to medication is the most promising approach.2 Psychological treatments, including CBT and mindfulness-based approaches, improve sexual function and sexual distress compared with no treatment in controlled trials.3 Trials are small; after prostate cancer, outcome evidence is weak.
1 Schmidt et al., J Sex Med 2014; Atallah et al., Arab J Urol 2021. 2 Althof, Transl Androl Urol 2016; Li et al., Andrology 2025. 3 Frühauf et al., Arch Sex Behav 2013; Liu et al., J Sex Med 2026.
What I tell your patient about sex therapy
Sex therapy is talk therapy about sexuality, intimacy, and relationships. There is no touch, no exam, and nothing physical happens in sessions.
Sex therapy does not replace medical care or the care you provide. New or sudden changes deserve a medical check. If a medication seems to be affecting someone’s sex life, I ask them to talk with their prescriber before making changes.