Sex is an important part of most people’s relationships, which is why couples will go to great lengths to keep it as fresh and pleasurable as possible. Unfortunately, poor communication and a lack of willingness to compromise often has a disastrous effect on the sex lives of ordinary couples.

And in many cases, this can end up ending the relationship for good, as one or both partners decide their relationship isn’t worth the total lack of satisfaction.

This certainly doesn’t have to be the case – sex-related issues are something that can be worked on with enough dedication and determination. If couples set aside enough time to talk about what it is they really want, – and what they don’t want – there is potential for it to improve.

However, when all else fails, booking a much-needed visit to a sex therapist is probably your best bet. And there’s really no need to be embarrassed or ashamed about it. From the most unusual fantasies to troubling and traumatic pasts – sex therapists have heard it all.

So, without further ado, here are 23 confessions from a sex therapist about things they have heard and learned from decades’ worth of experience in the profession.

1. They definitely don’t have sex with their patients

“You’re thinking of sex surrogates, and that’s a very different thing. Surrogates work closely with individuals who are having sexual problems, and part of that work can involve having sex with their clients. We just talk about sex – we don’t do it.”

Find out this sex therapist’s unexpected answer to the question, “Do you have sex with your clients?”

2. Sex therapists hate Fifty Shades of Grey

“Suddenly couples were showing up in our offices, often upset because one partner had tried to act out their Fifty Shades fantasies and the other didn’t want to. The novels don’t contain much clear or helpful information about how to start experimenting with BDSM. It should be approached very carefully and sensitively.”