GUEST POST BY CHELSEA NEWTON FROM, PHASES OF THE MIND THERAPY
Expert Advice on Managing Sexual Pain from a Sex Therapist in Denver, CO
Painful sex is common, but that doesn’t mean you have to accept it as “normal.” In this post I will define sexual pain. I will discuss the common causes for sexual pain for people of all genders. I will explore how working with a sex therapist can help you reduce pain during sex. A pain-free, pleasurable sex life is possible. If you are struggling with painful sex, this post is for you!
Sexual pain can be difficult to cope with!
For many of my sex therapy clients in Denver, CO they come to me after they have explored all other options for getting rid of pain during sex. They’ve seen doctors and specialists. They have tried every pill, creme, or lube known to humankind. But, they are still in pain when they have sex.
Dyspareunia, the medical term for painful intercourse, is common, but it’s not normal.
I’m not saying you’re an abnormal weirdo, you’re not. But I want my sex therapy clients to know that sex should not be painful. There is just one exception, which we’ll get to later. That’s right, sex should not be painful. So, if you are experiencing pain with sex (any kind of sex, not just intercourse) I would love to support you.
What is sexual pain?
You do not need a sex therapist or expert to define sexual pain. If you experience pain related to sex (before, during, or after) you are experiencing sexual pain. Sexual pain can happen in various areas of the body including the genitals, pelvis, or abdomen. Any level of intensity or duration of pain is considered sexual pain.
For many of my sex therapy clients in Denver, CO they question if their sexual pain is “bad enough” to warrant professional help. The answer is, yes. If you have painful sex, you deserve relief and support.
Common Causes of Sexual Pain
Sexual pain can have physical, psychological, or relational causes.
Many conditions can cause pain during sex. Unfortunately, talking about sex or sexual pain is still stigmatized, but I am rooting for you to speak up. If sex is painful or you believe you may have one of the conditions listed below, please tell your doctor.
Dryness: Dryness, or lack of lubrication, is the most common cause of sexual pain. For some, this could be a simple fix, for others it might be more complicated. Dryness can be caused by a lack of foreplay, “under producing” vaginal lubricant, or hormonal issues. Again, I’m rooting for you, talk to your doctor about your sexual pain. And, if you’re not using lube, I am also rooting for you to use lube! Just be sure to use a lube that is compatible with your needs. Do you research to avoid messing with your vagina’s natural pH balance. Generally speaking, you want your lubricant to be between a pH of 3.5-4.5 at the max, unless you’re trying to conceive. Sperm can be pretty resilient, but in general they survive better in more basic environments so using a lubricant that matches the pH of semen or is labeled as fertility friendly is your best bet.
Vulvodynia: Vulvodynia is persistent pain at the opening of the vagina. This might include burning, stinging, soreness, itching, rawness and pain during sex. ‘Dynia’ as a root means pain with innocuous touch. So pain to touch that shouldn’t be painful in the vulva is a way to distinguish what is going on. Just because it is nerve pain, however, doesn’t mean it is all in your head. To read more on this topic, and to get an even clearer picture between Vaginismus and Vulvodynia, check out this blog.
Pelvic Floor Dysfunction: Your pelvic floor muscles are the ones you tighten when you want to stop peeing quickly. These muscles can become painfully tight for people of all genders. A tight pelvic floor can cause an achy pelvis and pain with insertion. The fun part is that nearly anything could contribute to an overactive pelvic floor and therefore dysfunction: poor posture, sucking in your stomach, or chronic stress for example. It can be very hard to distinguish in ourselves what muscle is tight, what nerve is overactive, how to correct posture and so forth. Working with a skilled pelvic floor physical therapist here is key. With the right training, a pelvic floor PT can help you learn more about your specific body, but also help you build a long term home program to fix it.
Pelvic Floor Injury: Like any other muscle group, there are truly so many ways to injure the pelvic floor. From constipation, to aging, to childbirth, pelvic floor injury happens. Any type of injury to the pelvic floor can cause pain during sex if that injury is never properly rehabilitated. If you had an injury to the pelvic floor, it is worth seeing an expert in rehabilitation such as a pelvic floor PT to help you recover. Bodies are excellent at healing, but sometimes they need the right environment, the right exercise, the right amount of blood flow to do it, and that sometimes needs to be taught.
Vaginismus: Vaginismus is the involuntary spasm of the muscular tissue that makes up the vagina. The uncontrollable squeezing of the vagina happens when something tries to penetrate it. This could be a finger, a tampon, sex toy, or penis. Some sex therapy clients describe Vaginismus as “hitting a wall.” Meaning, their vagina is closed, even in instances when penetration has been enjoyable in the past. The good news? Vaginismus is treatable! Working with a pelvic floor physical therapist and/or sex therapist is a great place to start. If you’re not sure where to start, a medical exam is a great place to get a foundation and expand from there. A multimodal approach of your physician, your PT, and your sex therapist is a great team to ultimately build but that doesn’t have to come all at once.
Endometriosis: My sex therapy clients with Endometriosis tell me that the pain of sex outweighs any pleasure they might get from it. As a sex therapist, I help clients with Endometriosis find ways to enjoy sex. This might mean using lube or trying a new position. It might mean taking intercourse off the table for a period of time. My work as a sex therapist in Denver, CO is to support you as a unique individual. Based on your concerns and needs, we will work together to find pleasurable sex.
There is only one exception when it comes to sexual pain:
Ok, I said we would get to this later, and here we are. There is ONE and only ONE exception to pain being ok during sex. Ready for it?
ENTHUSIASTIC CONSENSUAL PAIN DURING SEX IS THE ONLY TIME PAIN DURING SEX IS NORMAL.
Into BDSM? Cool. Kinky? Cool. Does consensually melting hot wax onto your body bring you pain and pleasure? Cool. If you are enthusiastically consenting to pain during sex with yourself and/or partner(s), enjoy.
Any kind of pain that is enthusiastically consensually agreed upon during sex is absolutely normal and should not be considered a problem. Outside of this one exception, you do not need to have painful sex. I would love to support you in achieving a pain-free, pleasure filled sex life.
Addressing Psychological Factors of Painful Sex
As an LGBTQ+ affirming sex therapist in Denver, CO, I help people manage and eliminate sexual pain. Sex therapy addresses psychological and emotional factors that may contribute to painful sex. Sex therapy addresses sexual dysfunction and/or sexual dissatisfaction by exploring your specific needs.
In sex therapy, we might explore performance anxiety, body image concerns, trauma, or relationship issues that impact your sexual experience. By addressing emotional and psychological aspects of sex, you can manage and eliminate pain with sex.
To be clear, painful sex is not “all in your head.” But I hear it from my sex therapy clients all the time. They think that because their doctor or other medical professional cannot find anything physiologically “wrong” with them, that it must be purely psychological. In my experience as a sex therapist, this is rarely the case. The body and mind are connected. When getting professional help for sexual pain, the body and the mind must be considered equally.
Professional Help for Overcoming Sexual Pain
Sex therapy can take time. When seeing a sex therapist in conjunction with a pelvic floor physical therapist, you may need time and patience to see results. Your holistic treatment may include exercises that take time to see results. Working with sex therapist is helpful because I can support and guide you through the process. I help my sex therapy clients set realistic expectations, cope with setbacks, and stay motivated. Treatment for sexual pain is often a journey. I would love to support you along the path.
About the Author:
Chelsea is the Founder and Therapist at Phases of the Mind Therapy. She’s a queer Social Worker and Sex Therapist who is passionate about helping baby queer and other LGBTQ+ people experience sexual pleasure and queer joy. She’s based in Colorado, and when she’s not providing therapy, she can usually be found in her backyard sipping hot tea and watching the birds.
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