The Decisive Element in Healing Painful Sex

Dr. Caroline Gamwell, DPT shares expert advice and insight on managing sexual pain.

There are many different reasons someone may be experiencing sexual dysfunction. This could look like trauma to the tissues (either in the form of infections, surgery, childbirth, or assault). This could look like orthopedic compensation patterns, such as hips being too tight or having weak glutes. We even find sexual dysfunction in those who have never had ANYTHING happen to their pelvis, but their nervous system is haywire.

No matter who you are, or what your contributing factors are in regards to your symptoms, there are some fundamental truths to be addressed:

#1: You can heal. If you sliced your finger open, you wouldn’t question at all whether or not that wound would close and you’d feel better. You would give it the environment it needs to heal, such as a bandaid or not picking at it, perhaps washing your hands to prevent infection. At the end of the day, you wouldn’t question the healing. Broken bone? That will heal. So why is it that when it comes to pain with sex, we suddenly are doubtful about our body’s capacity to heal?

#2: Your success and your losses are your own. No one medical (or mental health) provider will fix you, you will fix you with their coaching. Having agency over your outcomes is key.

#3: The foundation of healing follows the foundation of living a healthy life: good sleep, nourishing foods, movement, and mental health and resiliency. 

Dr. Gamwell speaking with a patient regarding painful intercourse

Treating Sexual Dysfunction as a Pelvic Floor Physical Therapist in Denver, CO

When someone is in my office for vulvodynia, vaginismus, erectile dysfunction, pain, burning, and frustration they all look different. Different body types, different careers, lifestyles, cultural beliefs.

Anecdotally though, the individuals that get better are the ones who believe and know they will get better. Sounds familiar? This is the placebo and nocebo effect.

Infographic credit: Dr. Caroline Gamwell, DPT

The research we have in psychology and neuroscience over the years has provided insights into how beliefs and expectations can influence things such as pain perception and immune function.

Does this mean the pain is all in your head? Absolutely not. These findings do underscore the importance of psychological factors in healthcare outcomes, though, and highlight the potential for harnessing the placebo effect in clinical practice.

A patient’s beliefs about pain matter.

Pain perception is a subjective experience and it’s made up many factors, including sensory, emotional, cognitive, and behavioral.

• Have you ever found yourself frustrated because doctor’s or specialists can’t give you an EXACT diagnosis?

• Do you find yourself wanting a tangible, definitive, physical reason for your sexual pain or dysfunction?

I’m here to be honest with you.

We may not be able to accomplish that, and for good, complex reasons. Without having you in my office to talk specifics on your body, pain, and history, it’s difficult to set mutual, realistic expectations on treatment outcomes.

What I can say for certain is that it is not “all in your head.”

Ask yourself, if you felt better and had the sex life of your dreams, would it really matter to you in the end that what worked may have been pure placebo?

Pelvic floor physical therapy and sex therapy (talk therapy) work well together.

As a Pelvic Floor Physical Therapist, I primarily address the physical aspects of sexual pain and sexual dysfunction, but that doesn’t mean that the mental aspects are less important. Working with a sex therapist who specializes in supporting folx with sexual pain and sexual dysfunction allows you to explore and address the psychological aspects of sexual pain and dysfunction. The game changer, the variable that when present always, always, always means success (sooner or later), is the patient’s beliefs in what we are doing to treat them and what their outcomes will be.

Now, as a Pelvic Floor Physical Therapist, I’d love more than anything to tell you I had the secret modality or strategy to fix you. Of course my skill set is vast and beneficial, sure I could be more helpful than some stranger off the street. The game changer, the variable that when present always always always means success (sooner or later), is the patient’s beliefs in what we are doing to treat them and what their outcomes will be.

I offer a Pain-Free Sex Pelvic Therapy Course to help patients achieve pain-free intimacy from the comfort of their own homes.

Want a discount code? Email chelsea@phasesofthemindtherapy.com with the subject line: I WANT PAIN-FREE SEX!

We would be honored to support you in relief from sharp pain, burning pain, aching, soreness, or discomfort with sex.

Email chelsea@phasesofthemindtherapy.com for a discount code on my at-home, Pain-Free Sex Pelvic Therapy Course 💙