The Intimate Health Workshop series was created with the intention to empower your personal wellness journey while improving your intimate connection with yourself. Each workshop at Comprehensive Therapy Services includes a yoga flow, a health education talk, and a Q&A with Courtney and a CTS Physical Therapist.





Saturday, May 11th, 2019 from 10am-12pm
Early Bird Special! SIGN UP NOW


Saturday, May 11th, 2019 from 1-3pm
Early Bird Special! SIGN UP NOW

Courtney Avery has her Masters of Public Health, is an E-RYT200 certified Yoga Instructor, and Birth Doula. She combines practical health education with body awareness and the healing practice of yoga to improve your sexual and reproductive wellness.


Check out for all of Courtney's offerings.



Learn More About Courtney & Upcoming Workshops


Bladder and Bowel Basics

Wednesday, April 10 from 2-3pm

Talking about bowel and bladder function can be tricky.

Many women never discuss these sensitive topics with friends. Even the medical community often falls short when discussing such personal issues. At CTS we specialize in all things bowel and bladder and have your most personal questions answered. 
Reservations only. Contact Anne Shea at or
858-457-8419. Click to Learn More »

Vulvodynia Support Group
Saturday, April 13 from 10am - 12pm

Do you or someone you know...

Suffer from chronic vulvar and/or vaginal pain? Have pain with intercourse? Been diagnosed with interstitial cystitis (IC)? Have pelvic floor dysfunction? If so, please join our support group! Contact Cindy at or  858-457-8419 to RSVP.  Click to Learn More »

Men's Pelvic Pain Support Group

Tuesday, April 16 at 6pm

1 in 12 men suffer from pelvic pain and most suffer in silence.

Let's gather together and share our experience and resources. Together we can heal & help others get on the road to recovery. For more information, contact Milan at or 858-457-8419. Click to Learn More »

Just like money, our time and energy are finite resources. Recognizing that we have to budget our time and energy is a lesson I have struggled to learn over the years.

If you are like me, you may have a tendency to say yes to everything and everyone without a second thought.

I used to say yes to every friend, show up to every work event and conference. I felt stressed and I felt busy but I didn't really think there was another way, "I have to see everyone and do all the things because I said I would, right?!"

After many years of saying yes to all the things I was exhausted, I didn't stick to a consistent exercise routine and I barely ever had down time to relax and recharge at home with my partner. What I struggled to realize is with every yes I said, I was actually saying no - no to time with my partner, no to my weekly dance class, no to having the time and energy to clean my house or cook a healthy meal for myself. It may be something big or it may be something small but it was always a no to something.

Now, instead of automatically saying yes like I used to I stop and ask myself two powerful questions.

1. "If I say yes to this, what will I have to say no to?"

2. "Do I really care about this? Does this actually matter?"

These 2 questions have changed my life. It is a constant struggle not to go with my initial instinct and say yes but each time I stop to ask myself these questions it gets easier. This next time you have an opportunity to say yes, ask yourself these two questions and email me at to let me know if your answer changes!
Rose Schlaff, PT, DPT
We value a team approach at CTS and often feature complimentary practitioners. Enjoy this informative article by Dr. Lori A Futterman highlighting the relationship between mood and sexual functioning.

Mood and Sex Can Work Together

What role does mood play in sexual functioning? A distinction needs to be made between a mood state and a mood disorder. Consideration of the type and severity of the mood state or mood disorder is essential in evaluating its impact on sexual functioning. The result may be one of inhibition or activation of the psychoneuroendocrine system and will have an effect on the sexual response cycle (Wierman, et al., 2010). The result will likely be a change in desire, arousal and/or orgasmic functioning (Wierman, et al., 2010). It is not uncommon to feel some excitement and notice inner tension which acts to enhance our sexual responses. This would be an example of a mood state. Mood disorders, on the other hand, are persistent and tend to interfere with everyday life, including one's sexual responses.

Evidence exists that Major Depressive Disorder is associated with a higher incidence of sexual dysfunction (Sobecki-Rausch, 2018; Angst, 1998; Kennedy, Dickens, Eisfeld, & Bagby, 1999; Laumann et al., 2005). There is a high correlation between the severity of the depression and the severity of sexual dysfunction (Fabre & Smith, 2012). Brotto, Petkau, Labrie, and Basson, (2011) found that mood was the strongest predictor of sexual dysfunction and sexual distress. This research supported the idea that psychiatric history is the sole variable over demographics and hormonal variables. Anxiety disorders, depressive disorders, bipolar disorder, psychotic disorders and personality disorders strongly predicted severity of sexual dysfunction (Brotto et al., 2011).

The relationship between sexual dysfunction and depression is complicated by the use of antidepressant therapy as part of a treatment regimen.
(Basson & Gilks, 2018; Ferguson, 2001).

These psychotropic medications carry sexual liability with them (Clayton, 2002; Derogatis, 2009; Kanaly & Berman, 2008; Kennedy, Eisfeld, Dickens, Bacchiochi, & Bagby, 2000). Selective Serotonin Reuptake Inhibitors (SSRIs) are the most common medications associated with sexual dysfunction. Sexual dysfunction commonly occurs during antidepressant treatment. Seventy percent of patients who classify themselves as female, on antidepressants experience loss or delay of orgasm with reduced sexual desire and arousal (Basson & Gilks, 2018; Clayton, 2002; Derogatis, 2009; Kanaly & Berman, 2008). The reported rates of sexual dysfunction vary across antidepressants (Clayton et al., 2002). In the overall population of men and women of newer antidepressants it was seen that bupropion IR (22%) and SR (25%) and nefazodone (28%) were associated with the lowest rates for sexual dysfunction, whereas selective serotonin reuptake inhibitor (SSRI) antidepressants, mirtazapine, and venlafaxine XR were associated with higher rates (36%-43%) (Clayton et al., 2002). Clinicians tend to be underestimated the prevalence of antidepressant-associated sexual dysfunction (Clayton et al., 2002).

If depression is untreated, there is a 50% reduction in sexual desire and arousal and a 15-23% delay in orgasmic functioning.
(Kennedy et al., 1999; Ekselius & von Knorring, 2001).

Longer periods of untreated depression may predispose women to increased rates of FSD (Kennedy et al., 1999; Ekselius & von Knorring, 2001). There is no empirical evidence on untreated anxiety and FSD. It is possible that any form of mental disorder would negatively impact sexual functioning.

State-anxiety has been shown to be arousing for most women, independent of sexual orientation and gender status, unless they suffer from a sexual dysfunction or mood disorder (Levin et al., 2016; Sobecki-Rausch, 2018). There is a high comorbidity of Anxiety Disorders and Sexual Disorders (Aksaray, Yelken, Kaptanoglu, Oflu, & Ozaltin, 2001; Bonierbale, Lançon & Tignol, 2003; Bradford & Meston, 2006; Corretti & Baldi, 2007; Figueira, Possicente, Marques, & Hayes, 2001; McCabe et al., 2010; Palace & Gorszalka, 1990; van Minnen & Kampman, 2000). Lack of subjective arousal and orgasmic functioning can be linked to trait anxiety (Basson & Gilks, 2018). If one is suffering from a traumatic event, the sympathetic response generated by sexual arousal can be associated with fear, similar to the traumatic response, rather than sexual pleasure. The most common type of sexual pain is 10 times more common in women with previous diagnoses of anxiety disorder (Basson & Gilks, 2018).

Psychotherapeutic treatments that work to enhance well-being are psychodynamic and cognitive-behavioral (CBT) approaches. These may include clinical hypnosis and eye movement desensitization reprocessing (EMDR), mindfulness training and many others to enhance mood, cognition, sexual responses and produce a sense of inner balance.

Dr. Lori Futterman is a clinical psychologist in private practice and Clinical Assistant Professor of Psychiatry at UCSD, Dept. of Psychiatry, who specializes in sexual medicine and women's health. She is dedicated to helping both men and women achieve their highest potential and overcome difficulties with sex and intimacy and achieve inner balance and overall well-being.

Lori A. Futterman R.N., Ph.D. PSY8636
(619) 297-3311 | |
591 Camino De La Reina Ste. 705, San Diego, CA 92108
By Lori A, Futterman R.N., Ph.D.