| Tara Langdale
There are many pelvic pain causes, which means there are many possible solutions. Lots of women experience pelvic pain with intercourse, but they don’t always know exactly what is causing it. When the problem is mainly psychological, you may benefit from meeting with a sex therapist. Although discussing sexual problems can be challenging, sex therapy has many benefits and can lead to seemingly miraculous results.
Sex therapy is essentially sex counselling. Your sex therapist won’t physically touch you – that is the domain of pelvic floor physical therapy or a medical professional. A sex therapist coaches you verbally and helps you to understand and transcend psychological issues. Even though it may not be obvious, traumas and perceptions are sometimes the causes of pelvic pain.
Where does your pelvic pain come from?
Pelvic pain in women refers to vaginal, perineal or anal pain. It also covers tailbone, sacroiliac joint and pubic symphysis pain. The same goes for pain from sitting for too long or exercising.
Debilitating conditions like vaginismus can be psychological in origin; likewise, anxiety can cause dyspareunia (painful sex), or another type of pelvic pain. Pinpointing the cause of the pain is important, and if it is psychological, finding a good sex therapist may be the answer.
The body and mind work synergistically, so what goes on in the mind can affect the body, and vice versa. For instance, studies have concluded that as 40% to 50% of patients who experienced sexual abuse will go on to experience chronic musculoskeletal pain. That’s quite a high number!
Why see a sex therapist for pelvic pain?
A good sex therapist will be a licensed provider with a master’s degree (or above) in counselling or therapy. They will also have had sex therapy training. Going to a more general physician might not yield the best results. Sometimes even gynecologists and urologists won’t get into the details of your sexual problems. This might be because they are not trained to, they don’t have the time, or they don’t feel comfortable.
When a woman has chronic pelvic pain, she is likely to experience dyspareunia at the very least. If you choose a qualified and capable therapist who specializes in solving sexual problems, it will save a lot of time and for many, perhaps even embarrassment.
Conversely, painful sex leads to habitual negative anticipation. By gritting your teeth and bearing it, you start to associate sex with pain. The pain may even worsen as fear increases. Sex therapy can help with this.
What does a sex therapist do?
A sex therapist uses a range of techniques to locate and transmute the causes of pelvic pain. They study the patient’s sexual history and health, as well as their belief systems and concerns. The therapist understands the discomfort patients can go through and does everything possible to make them feel safe.
Sex therapists will also give advice and information, such as:
- Education on anatomy, biology and related sexual functioning
- Experiments with sexual positions and sex aids
- Techniques for focus and changing perspective
- Emotional and sexual communication techniques
- Techniques to improve sensations and reduce anxiety
- Advice on touch and progression to intercourse
- Advising partners on supporting the patient with sexual issues
Couples are likely to be given exercises and activities to try at home.
What should I do if pelvic pain persists?
Once you have completed a course of sexual therapy, you should find that your psychological issues have diminished. When anxiety fades, problems like dyspareunia and vaginismus should at least become more manageable. However, You may need pelvic floor physical therapy in conjunction with sex therapy if you have developed persistent pelvic pain symptoms.
For example, myofascial trigger points in the vaginal walls may be causing your dyspareunia. These are similar to the knots you develop in your shoulders when you become stressed. If anxiety is making you tense, you might experience spasms and tightness in the vaginal muscles. If in doubt, read about the benefits of pelvic floor physical therapy, as this may be the final part of the equation. Good luck!