‘We are all sexual beings; employers need to normalise the conversation about sex for all our good’

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Bola Ogundeji is a psychosexual therapist, as well as her ‘day’ job as Deputy Director of Workforce and Organisational Development at Moorfields Eye Hospital, London

Her Saturday clinic got particularly busy during the pandemic and, over the last few years, she has seen clients privately in Kent.

She has experience working with diverse clients with varied sexual and relationship therapeutic goals.

Alongside being an individual and couple’s therapist, Ogundeji has over 24 years of experience in Human Resources and Organisational Development and deeply understands the effects of life, relationship and work transitions on people. 

She aspires to help her clients find meaning through a more peaceful and hopeful experience and has believes that employers could also play a key support role when it comes to employee sexual wellbeing.

We spoke to her about why she believes it’s so important that sexual wellbeing is considered as part of the wellbeing mix at work.

You’re a psychosexual therapist in your spare time, as well as your fulltime job. Why do you think it’s important to consider someone’s sexual wellbeing as part of their entire wellbeing picture, even at work?

We are all sexual beings, but we almost forget that now. And, although it’s an invisible part of us, when we come to work it’s still very much there, it’s very much linked to our psychology and to what is happening in our lives. Our work can even sometimes affect our sexual functioning. Similarly, if there’s a problem with our sexual functioning, this can also impact on the way we present at work, psychologically or relationally.

Can you give me any examples?

Yes. So I might have a client who comes to me with an ejaculatory disorder, premature ejaculation or erectile dysfunction, for example. They might be telling me they don’t know where it’s come from but, when you start talking, it turns out that this person is at risk of redundancy.

Or you start looking at the timeline and realise that they started experiencing these symptoms when there was something significant going on at work, like a big project deadline or pitch for a new business.

They’ve been preoccupied by worrying about it and the body has to absorb this stress in some way, has to find an outlet for it, and sometimes that is via its sexual functioning. There’s a great book about our bodies can hold the symptoms of negative experiences of traumatic events, called The Body Keeps The Score.

That’s counter intuitive in some ways, is it not, as sex is thought to be a great stress reliever?

For some people, sex can be a way of soothing, especially if they have a healthy or supportive relationship. But if there’s stress at work, and then stress at home, that could lead to the body not functioning well.

So that just compounds the feeling of stress, then?

Yes. Especially with men who can tend to think that it’s just them that this is happening to. They don’t realise often that one out of four, up to 33% of men, will experience an erectile disorder or dysfunction in their lifetime. They feel bad about their sexual performance and this can lead to performance anxiety.

Can this often then affect their performance at work?

Yes, absolutely.

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If someone has performance anxiety in their sex situation, it can often affect their self-esteem and how they feel about themselves.

They feel ‘less than’ and put a lot of pressure on themselves, forgetting that their sexual self is just a part of them, not the entirety of them. But those feelings of worthlessness can get internalized and people can get depressed and lose confidence at work too.

It makes it all worse that this is a topic that is not talked about openly and has much embarrassment attached to it.

What have you learnt about talking to men in particular about sex?

It’s important to normalise it as much as possible and raise awareness of how common these problems are, because there’s relief that comes from that. It’s also important to help them understand that these conditions are very treatable and the goal is to understand what is causing them.

My therapy is psychosexual and relationship therapy. So it looks holistically at your psychological makeup, and how that can inform your sexual functioning or dysfunction.

There are some things that are caused physically, by medication or co-morbidities, for example. So if someone has diabetes, for example, that can eventually trigger sexual dysfunction in men. What’s causing the problem then informs treatment.

What role can the workplace play in this area  – sexual wellbeing – if at all, given it can impact work?

This is one of those areas where you don’t want to take people’s agency away from them. Their sex lives are their private business. Providing psychosexual education is important and powerful. Companies could help normalize the conversation.

We are now, in companies, looking at health much more holistically. We’ve considered physical health for years. Now we’re much better at considering mental health and financial wellbeing is growing as a focus, too.

Why not sexual wellbeing? That’s also an important part of our wellbeing mix. Companies need to make sure they can signpost people to more information.

It’s also important to realise that sexual health can affect fertility, which is also another big focus for companies today.

We’ve heard that a mismatch of libidos between men and menopausal women can be an issue. Have you seen that before?

Yes, absolutely. We’ve actually just starting training menopause advocates at my workplace and I’m going to be doing a session for some of our staff on these psychosexual and relationship issues related to life transitions, like menopause.

With menopause we know a lot about hot flushes, etc, and mood swings, but it can almost impact bodily function, with things like vaginal dryness and vaginal atrophy, which can make sex painful.

This can also impact the men. Their dysfunction might arise because their wives – for whatever reason, physiological or psychological – don’t want to have sex.

If she’s experiencing pain, he could develop performance anxiety because he is worried about causing her pain, for example, and that could lead to self-esteem issues for him, as we already discussed.

You’ve helped couples before with this issue. How do you do that?

You help them create room for this newness in their relationship, and the fact that their sex life may not be the same as before.

We’ve talked a lot about male self esteem related to sexual wellbeing. But what about women, especially menopausal women. Have you noticed anything about their experiences?

Yes. I’ve had a lot of menopausal women come to see me. Of course, you can’t generalize. However, I would say women tend to wait a much longer time to discuss sexual problems than men. It’s usually reached a point where, say, the relationship is at risk. In the cases I have seen, the men have sought  help much more quickly than the women if there’s sexual problems.

My job is to get to the bottom of understanding why, and ensuring male partners understand what is going on with their partners (if it’s couples therapy). Sex lives tend to be different when we’re in our 40s to our 20s and it’s about developing empathy for each other.

We look at the barriers or the blocks in the relationship. Is it the menopause, for instance? And what can be done to make things better? Comparing sex lives to when people were in their 20s is often not helpful.

We work towards agreeing the kind of sex that would work for both of them, rather than the sex that might be in their imaginations of what it ‘should’ be.

Do you think it’s unrealistic for a man to expect a woman who’s menopausal to want to recreate the kind of sex life they had in their twenties?

It’s human but not necessarily realistic. Obviously it depends on the context. But yes sometimes people have unrealistic expectations of their partners, and themselves, thinking about what they ‘used’ to do or what they ‘should’ be doing.

Media, and porn, don’t always portray a helpful image of what ‘good’ sex looks like. What’s ‘good’ for one, may not be for another, it’s not one size fits all. And it doesn’t mean because one person’s having ‘vanilla’ that that is boring, or if someone is having ‘spicy’ that that’s exciting. It might just be what each wants and needs and it’s just for them to be relationally happy.

If it works for you, it’s good for you.

One thing I work on in therapy is helping people not to see sex in a purely linear manner and more circular. By that I mean, we often see it as starting at ‘A’ and ending at ‘B’ with ‘B’ meaning, for heterosexual couples, penis in vagina. Often at times in relationships, there’s a need to re-imagine sex and thinking about what else could be enjoyed.

Do you think culturally there’s still a lot of shame around women in saying you even enjoy sex?

Yes I think so. There’s added complications, too, if you think about the intersection of religion, race, and other characteristics. For example, in some cultures, the woman is only meant to be the receiver, not the giver in any way. She’s meant to just be passive.

That might for some people be a barrier to their sexual expression or their sexuality. As for men, there’s still a culture of relating sex to performance.

But, at the end of the day, this is not about gender; it’s about being a human being with a healthy sense of sexual self. Companies could definitely help employees understand their own sexual template better, because we all bring our own to relationships and it affects our wellbeing.

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