A topic that comes up all too often in sex therapy is women reporting they use alcohol in order to “tolerate” sex with their partner.

A recent MSN Living article cites a European survey that revealed half of German women prefer to have sex after a drink. Fifty-five percent like to be tipsy, 7 percent want to be completely intoxicated and 6 percent admit to never experiencing sex while sober. One-in-6 reported they didn’t have the confidence to have sex with someone unless they were drunk.

I hear numerous reasons from my female patients for why they “need” alcohol prior to sex. One patient uses it to “numb herself out” because sex reminds her of a high school rape. Another believes it makes her less aware of her poor body image. And one woman tells her husband, in a therapy session, that she uses alcohol to minimize the pain caused by intercourse. Her husband was shocked, then frustrated, that she had experienced pain throughout their marriage and hadn’t told him.

These examples and emotions are common and include situations where partners and spouses become frustrated when learning that alcohol is needed.

You deserve to experience enjoyable and sober sex. Here are a few tips if you’re struggling:

• Explore why you feel alcohol is needed before sex and ask yourself if you’re willing to work through it.
• Communicate your concerns with your partner. Talk about ways the two of you can create a safe and comfortable space for intimacy.
• Learn to set boundaries with sex, including occasions where the two of you are intimate without intercourse.
• Give yourself permission to say no to sex when you aren’t willing or comfortable.
• Talk with a gynecologist about pain or discomfort. They’ll be able to treat the problem or refer you to a specialist.
• Visit a certified sex therapist, either individually or as a couple, to help overcome fears, learn to feel present and stay connected during sex.
• If your partner needs alcohol to have sex, compassionately confront the issue. Don’t encourage the behavior. Be supportive of reaching out for help if needed.

Continually relying on alcohol for sex can lead to depression, anxiety, post-traumatic stress disorder and relationship problems. Not to mention the medical issues that can come along with substance abuse.