Most men face a combination of communicative and internal issues when they think about or attempt to pursue sex therapy. There's the general complexity involved in understanding feelings about sex, pleasure and intimacy. A further problem arises when someone realizes they can't talk about them even if they do understand them because they don't have the vocabulary.

"So now you have to talk about feelings, which you're not comfortable with anyway and don't have a language for, and you're going to have to talk to another person about the fact that the thing that you define as your core masculinity, your core identity as a male, is not working," said Lawrence A. Siegel, M.A., a sexuality educator, consultant and therapist in Boynton Beach, Florida. He is certified by the American Association of Sexuality Educators, Counselors and Therapists (AASECT).

He pointed out that men's learned behavior differs significantly from how women often learn to relate to their emotions and their sexual needs and experiences.

"Women are not only taught but expected to have a relationship to their emotions," he said. "[Men] are basically