Here’s a common statement from someone seeking therapy for sexual pain:
“Everyone always says sex is the best thing in the world, but not for me. It hurts. I always just want it to be over as fast as possible.”
Do you find yourself dreading or avoiding sex because of the pain that you experience during sex?
Sexual pain creates these experiences in two ways. The first is more obvious: when you experience pain, it makes you fear pain in the future. This causes you to tense up, which likely increases sexual pain on future attempts. The second way sexual pain compounds itself is less obvious. Sexual pain often comes with emotional pain like shame, which leads to not talking about it, avoidance of sexual intimacy, and sometimes a loss of connection to the partner.
A person knowledgeable about the potential causes of sexual pain and who treats you with respect and kindness through the process of assessment and treatment is essential to successfully addressing it. Especially because there are different causes of sexual pain.
Common Causes of Sexual Pain
Medical problems (e.g., Bartholin gland cysts), medication interactions, injuries, trauma, relationship problems, significant time without experiencing penetration, or peri-menopause/menopause may all contribute to sexual pain. You need a therapist with the capacity to discern the causes (or to know when they need to refer you to another provider).
This is so important because these different causes require different interventions from the talk therapy for sexual pain. With some regularity, a talk therapist will also need to coordinate your care with a pelvic floor specialist or another medical provider.
Talk Therapy for Sexual Pain
So what happens in talk therapy for sexual pain? As I mentioned above, it varies by cause, but here are some of the common interventions:
- Assessing your goals for sex. For example, are you trying to conceive, satisfy a partner sexually, focus on your experience of sexual pleasure, or some combination of these?
- Homework exercises to reduce pain, when possible and desired by the client.
- Empowering education about other ways the client may try to reach their sexual goals to empower the client to decide how to address the experience of sexual pain.
- Empowering ideas about how to approach sexual activity that may reduce pain.
- Supporting the partner, see below.
I Help Your Partner Understand and Respond More Compassionately
One of the most common reasons clients seek talk therapy for sexual pain from me is my ability to work with the partner. How partners respond to your sexual pain can make the pain worse, less, or damage the relationship in unnecessary ways. I help partners:
- Open their hearts and their ears so they can cultivate compassion about how your experience of pain affects you and your desire.
- Get on the same page as the partner with sexual pain, so the couple can address it as a team instead of you v. me.
- Grieve the loss of their expectations so they can engage in reality with more flexibility.
- Learn about your particular manifestation of sexual pain, so they can be your best possible lover.
I always do an initial phone consult before scheduling an appointment. This is a good opportunity for you to ask questions, find out if you feel comfortable talking to me, and there’s never a commitment to schedule an appointment. Contact me now to find out if I feel like a good fit for you (and maybe your partner) for talk therapy for sexual pain.
