Individual Psychotherapy + Sex Therapy

Women & Painful Sex: Treatments

There are various ways to treat all the different types of painful intercourse, but most importantly with each of these types of pain, relaxation, mindfulness, and more playfulness are key. 

Usually, by the time a women goes to the doctor, or certainly by the time she reaches my office, she has suffered through painful sex repeatedly and she is now quite frustrated, very serious (for good reason), and may feel betrayed by her body. It is important for her to find pleasure and joy in her body again (or for the first time for some) and connect with her body with kindness and compassion that she may have never done before having this challenge.

Even though there’s very good reason for you to be serious about getting help and feeling better, this seriousness may cause more harm than good (and continued pain). Finding ways to engage with your partner in a more relaxed, playful way that you may have done prior to having this challenge is useful. This is difficult to accomplish though because the body is now conditioned to anticipate pain or discomfort with intercourse, so the muscles naturally contract in order to try and protect from the expectation of pain. This conditioning and anticipatory anxiety is often main problem.

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Photo by Juja Han on Unsplash

Try this Exercise #1:

Create a playlist of songs that you find relaxing. Set up a relaxing experience for yourself while listening to this music. Set up a ritual where you sit or lay down and breathe deeply and restoratively while listening these songs. Practice this frequently enough that you start to relax quicker and sooner as you listen.

Once you’ve created a relaxation response to this music, start to listen to the same songs while you’re with your partner just touching and maybe kissing, but do not consider sex together yet. Make sure your partner knows that sex is not on the table yet, but you’re getting closer. As you listen to the music and have time with your partner, notice if you feel more relaxed.

The relaxation response with your partner may take several weeks (more than a month) before you’re ready to attempt using it as a way of relaxing prior to sex with your partner. 

Exercise #2: What’s Your Relationship to Your Body and Vagina?

Explore your own vulva, labia, vagina. Find a diagram online and then find the same areas on your own body. Use a mirror and a flashlight to look at your own genitals – first notice the outer parts, then open your labia and look at the inner areas too. You don’t have to necessarily say, “Wow! I’m so beautiful,” but you do have to start finding a more friendly, or at least neutral, relationship to your own body.

Start to be more exploratory. Notice what thoughts and feeling arise for you. Are you disgusted by your sexuality? By your sexual organs? Are you surprisingly comfortable now that you’ve tried it? Is it just too difficult and you can’t manage to look at yourself?

Exercise #3: Self-Pleasure

Once you feel comfortable looking, then you’ll start to touch different areas and notice what feels good, neutral, painful, etc. Ideally, you’ll start to learn what you enjoy and what you need in order to orgasm. Many women don’t know this, but typically women need to know what works for them solo in order to help a partner provide them with an orgasm. Don’t expect your partner to know what works for you – it’s best if you know what works well for you.

For those who are new to orgasms or extremely anxious about self-pleasure, check out this great resource: OMGYes.com. It does cost about $40 for access, but this money goes toward more sex research and it is totally worth the fee if you don’t know what works well for you or how to give yourself an orgasm. You may also like to explore Betty Dodson’s website or read her books, which you can find at dodsonandross.com.

Exercise #4: Find Joy & Pleasure in All Kinds of Things

Lastly, what gives you pleasure and joy in life, in general? Find other areas of life when you feel a sense of joy/pleasure. Notice what this feels like. Where do you notice it in your body? What are the thoughts connected to the feeling? Start to get more comfortable with this feeling and try seeking it out as much as possible. The idea of pleasure or joy may seem foreign or undeserved. You must work through these feelings and recognize what is going on for you when faced with them in order to find relief from the psychological part of the pain during intercourse. Often women struggle with this idea and believe it is selfish or underserved.

If you find any of these exercises difficult and need/want support or help with any/all of them, you might find it useful to see a sex therapist.

Kimberly Atwood is a licensed psychotherapist and certified sex therapist specializing in women’s sexual health, intimacy and relationship issues.  She works in private practice in Princeton, NJ and provides online therapy with clients across the country (IN, MA, NJ, NY, PA).  For more information, please check out her website.

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