Hi, I’m Madelyn.

Sexual concerns are rarely just about sex.

What begins as a change in desire, difficulty with arousal, pain during intimacy, or a medical diagnosis often becomes intertwined with questions about identity, connection, confidence, grief, and meaning. By the time many people seek support, they're not only trying to understand what is happening—they're trying to understand what it means about themselves, their relationships, and their future.

My work focuses on helping individuals and couples navigate these conversations with curiosity, compassion, and practical direction.

I am an AASECT-Certified Sex Therapist and Supervisor (CST-S), Licensed Professional Counselor, and founder of Esposito Sexual Health Consulting, LLC. In addition to my private practice, I developed and lead Wisconsin's first integrated Sexual Health Clinic within an academic medical center, where I work alongside physicians, pelvic floor physical therapists, nurses, and other healthcare professionals to address the complex ways sexuality, relationships, and health intersect.

My approach integrates relational, psychological, and medical perspectives. Whether concerns stem from menopause, chronic illness, pelvic pain, erectile difficulties, desire discrepancies, life transitions, or relationship challenges, I believe meaningful change begins with understanding the full context of a person's experience.

I also have extensive experience training therapists, supervising clinicians pursuing AASECT certification, developing interdisciplinary sexual healthcare programs, and educating healthcare professionals across disciplines. These experiences continue to shape my clinical work and deepen my appreciation for the complexity of human sexuality.

At the heart of my work is a simple belief: people deserve a space where they can talk honestly about sexuality without shame, judgment, or assumptions. Together, we work to better understand what is happening, identify what matters most, and create a path forward that feels thoughtful, realistic, and sustainable.

My mission, both personally and professionally, is to improve accessibility to sexual healthcare.

Too many people spend years searching for answers, feeling misunderstood, dismissed, or believing they are alone in their concerns. At the same time, healthcare professionals often receive limited training in sexuality despite the profound ways sexual health influences quality of life, relationships, identity, and overall well-being.

Throughout my career, I have worked to close that gap.

Whether providing therapy to individuals and couples, developing interdisciplinary sexual healthcare programs, supervising future sex therapists, consulting with healthcare professionals, or educating medical providers, my goal remains the same: to make evidence-informed, compassionate sexual healthcare more accessible.

I believe sexual concerns deserve the same curiosity, expertise, and thoughtful care as any other aspect of health. Conversations about desire, intimacy, pleasure, pain, identity, and relationships should not be limited by shame, misinformation, or a lack of resources.

Improving access means more than increasing availability. It means helping people find language for experiences that often feel confusing or isolating. It means creating spaces where difficult conversations can happen openly and respectfully. It means supporting healthcare professionals in developing the knowledge and confidence to address sexual health concerns within their own disciplines.

Every aspect of my work—from clinical care and supervision to consultation, education, and program development—is grounded in the belief that sexual health is an essential part of overall health and that people deserve access to informed, affirming, and compassionate support.

My Approach

Curiosity, clarity, and meaningful movement.

Whether I am working with a couple, supervising a clinician, consulting on a complex case, or helping develop a sexual healthcare program, my approach begins with the same question:

What is happening, and what is most likely to create meaningful movement?

Many people seek support because they feel stuck. Sometimes that means a couple struggling to reconnect. Other times it means a clinician feeling uncertain about a complex case, or a healthcare system trying to better address the sexual health needs of its patients.

Rather than rushing toward solutions, I focus on developing a clear understanding of the factors contributing to the concern. Together, we identify patterns, clarify goals, explore opportunities for change, and direct energy toward the conversations, experiences, and interventions most likely to create progress.

My work is collaborative, structured, and informed by relational, psychological, and medical perspectives. I value curiosity over assumptions, thoughtful assessment over quick answers, and practical change over insight alone.

While the specific goals may differ, the process remains consistent: helping people better understand what is happening, identify what matters most, and move forward with greater confidence and clarity.

Curiosity Creates Movement

When people feel stuck, the impulse is often to search for answers immediately. My work begins with curiosity. Together, we explore patterns, assumptions, relationships, and opportunities for change to better understand what is happening and identify meaningful paths forward.

Pleasure as the Measure

Sexual health is often evaluated through the lens of dysfunction, symptoms, or diagnosis. While these concerns matter, I believe healthcare should also make room for pleasure, connection, meaning, and quality of life. Improving sexual health is not simply about reducing distress — it's about helping people move toward experiences that feel fulfilling, authentic, and aligned with their values.

Credentials

  • AASECT-Certified Sex Therapist and Supervisor (CST-S)

  • Licensed Professional Counselor (Wisconsin)

  • Adjunct Clinical Faculty, University of Wisconsin Department of Psychiatry

  • Founder, Esposito Sexual Health Consulting, LLC

  • Founder and Program Manager, UW Health Sexual Health Clinic

  • Clinical Supervisor, Couples Therapy Training Clinic, University of Wisconsin

  • Clinical Supervisor, Sex Therapy Training Clinic, University of Wisconsin

Areas of Expertise

  • Couples & Sex Therapy

  • Erectile & Ejaculatory Difficulties

  • Out-of-Control Sexual Behavior

  • Low Sexual Desire & Desire Discrepancy

  • Menopause & Midlife Sexuality

  • Pelvic Pain

  • Chronic Illness & Sexuality

  • Disability, Neurological Conditions, & Sexuality

  • Healthcare Professional Consultation & Supervision

Media Mentions

Madelyn’s work and expertise have been featured in:

  • CNN Health

  • WebMD

  • Men’s Health

  • VICE News

  • BRAVA Magazine

  • Doctor Radio, SiriusXM