If you’ve experienced sexual pain, you may be afraid it’s “all in your head.” It’s not so useful to try to untangle body and mind differences. Whatever the qualities of the pain bothering you, (aching, burning, soreness or sharp pain) sex should never hurt. If it does, something’s wrong and it’s important to pay attention. In therapy we’ll get to the specifics of exactly what you’re feeling in order to develop some hypothesis about what is going on.
Sexual pain can involve complex bodily systems. This doesn’t mean we can’t find answers, but it often takes some patience. Nevertheless, please believe that you don’t have to live with this condition. We use a model for thinking about pain in terms of layers in the body and the psyche. Your pain might have emotional, neurological or muscular roots; the more precisely we define what happens when you’re in pain, the better your chances of getting relief.
Understanding why you experience pain is not necessarily the first step to feeling better. We’re likely to help you achieve some improvement by observing and carefully identifying how you feel and exactly what you experience. This may provide clues to why you hurt, but you don’t need to figure that out before you can move forward with your quest for an enjoyable and comfortable sex life.
Working one-on-one might be the best approach for you, or involving your partner in sessions might be effective. Each person’s situation and preferences are different. However the body’s reaction to any type of pain is predictable; the sensation of pain results in muscles contracting. This produces tension and self-protection, which unfortunately only increases the sensation of pain. This also reduces blood flow, so during sexual activity it interferes with the body’s ability to produce lubrication and arousal. Distressing thoughts result, which typically reduce interest in sex. This whole cascade of body processes affects your own sense of your sexuality and your relationship with your partner.
We have many resources for treating this problem. A team approach may be needed, so I collaborate with doctors and physical therapists who understand the various aspects of this condition.
Education and information about desire, arousal sexual anatomy and orgasm can make a difference. You may wish to try breathing exercises to work with pain symptoms and relaxation techniques.
Realistic goals are to reduce pain, to manage any negative consequences the pain has created in your life and relationships and to establish a pleasurable association with sexual activity.
If you’d like to know more, please feel welcome to get in touch with me.
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