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Painful Sex & The Mind Body Connection | Image Courtesy of Jared Rice via Unsplash
Painful Sex & The Mind Body Connection | Image Courtesy of Jared Rice via Unsplash

Exploring the Mind-Body Connection to Painful Sex

Pain during sex isn’t in your head… but it can ‘get into your head’.

The medical community recently had a major a-ha moment about painful sex. It’s something the women who suffer from it have always known – but the results of a recent study about it could be a game-changer for treatment.

Whether you have a clinical diagnosis like vaginismus or dyspareunia, or you just know that sex hurts, painful sex is a common problem - almost half of all women will experience it at some point in life. More than 20% of premenopausal women say sex is painful; the prevalence is higher in women under 30. For some, it’s difficulty during intercourse; for others, it’s significant pain upon penetration. Still, others may not be able to experience penetration at all.

For years, doctors told women the pain was ‘all in their heads’; a conclusion that not only misdiagnosed the problem but also led to scattershot psychological and physical ‘treatments’ – from a glass of wine with sex to surgery - that did more harm than good. The emergence of women's physical therapy focusing on sexual function has helped the medical community understand the pain is real, and it’s often in the pelvic floor muscles. But there is no denying that painful sex takes an emotional toll on every patient.

Results from Research on the Mind-Body Connection and the Impact on Painful Sex

Inspired by an increased focus on the mind-body connection regarding general pain management, European researchers recently looked at the connection between the physical and psychological aspects of painful sex. Their study – the first of its kind, believe it or not! – followed a group of women aged 25-76 years. They were selected from among participants in a broader study about female sexual health who also reported sexual pain, and the results were further compared to other studies about chronic pain in general. Here are just a few key takeaways: the physical pain is real. The team concluded that multiple medical conditions can lead to painful sex, including “endometriosis, muscle tension, pelvic infection, pelvic injuries, pelvic trauma”. The pain can be localized in the genitals or felt more widely throughout the pelvic region and other parts of the body. Sex shouldn’t hurt. If it’s painful for you, any one or more of these treatable issues could be the cause. Don’t assume it’s all in your head, and don’t let a medical professional convince you that’s the case. Ask them to screen for every possible physical cause. The psychological risk is real, but it’s not ‘one size fits all’. 

Past research shows that “untreated anxiety, depression, stress, and/or a history of sexual and physical abuse” are just a few of the psychological and social risk factors for sexual pain and other kinds of sexual dysfunction. But these researchers focused on just three specific psychological issues reported along with painful sex – depression, fear/avoidance, and pain catastrophizing (the mind’s tendency to magnify the pain or inability to stop thinking about it). For each category, and even within categories, they found differences between the type and severity of physical pain, the amount of time it lasted, and which treatments worked best. Their conclusion – psychotherapy is often helpful in addition to physical treatments in much the same way it helps patients deal with other types of chronic pain. And, just like in those non-sexual cases, there is no benefit to figuring out which symptom came first. As they noted, whether a psychological symptom “represents the cause or the consequence of pain”, treating it is key to managing the pain itself.

Early Intervention and Treatment Are Important in Addressing Painful Sex. 

Early intervention and treatment are important. A unique part of this study was the researchers’ decision to look at short-lived pain (painful sex within only the previous four weeks) and chronic pain (painful sex from four years to throughout a woman’s sexual history). Of course, different issues led to different outcomes; however, women with higher levels of short-lived sexual pain tended to report that later painful sex was magnified, and/or that the pain became chronic. The team highlighted their recommendation of “early intervention to decrease pain levels in order to prevent chronification or magnification of pain”.

If you suffer from painful sex, the struggle is real – in both the physical and the psychological sense. But what matters most is getting a real diagnosis and treatment targeted to your needs as soon as possible. At Femina PT, we are happy to refer to and work with our trusted network of mental health professionals who understand the many dimensions of sexual pain… while we also work with providers to diagnose and treat your physical symptoms. Don’t wait to reach out for help. The sooner you get started on your journey to healing, the easier that journey will be for your mind and body.

Click here to schedule an appointment with one of our therapists and get your sex life back on track!


Burri A., Hilpert P., and Williams F. 2019. Pain Catastrophizing, Fear of Pain, and Depression and Their Association with Female Sexual Pain. The Journal Of Sexual Medicine 17:2  279-88.

What Our Patients Have to Say


Testimonial by R.D., age 38

"I had a severe tear during childbirth that was not stitched together correctly and therefore healed poorly. Even after having a surgery a year later to remove the scar tissue, I was still having pain, and no one could explain why -- there was no overt 'reason' to explain the pain. I had tried other 'specialists' and even saw another physical therapist who had me do hip / leg stretches -- what a joke! I was about to give up and just 'live with it' until thankfully I kept searching online and found Heather.

Read more: Testimonial by R.D., age 38

Testimonial by M.N., age 28

A personal journey and testimonial from one of my patients:

I was diagnosed with vaginismus 4 years ago. I never heard of such medical condition until after I got married. At first my husband and I didn't know what to do, we didn't know what the issues were or how to overcome it. Being born and raised in Armenia and being Christian I wasn't that open about talking to sex with others and so it wasn't easy to seek help. But eventually I went to an Ob-Gyn and luckily she knew about the medical condition (not many doctors know). She referred me to a physical therapist and I couldn't believe it and thought it's something I can handle myself. I ordered a kit from vaginismus.com and started practicing with dilators. There was some small progress but wasn't much helpful.

Read more: Testimonial by M.N., age 28

Testimonial by Y.L. (mom of 2)

After having my second baby via C-section I searched for months to try to find help for my lower back pain and separated abdominal muscles. I finally came across Heather Jeffcoat via a mommy blog. I reached out to her via email and set my first appointment. My first appointment went amazing … she listened to what my symptoms, check my separation and explained to me in detail what the next steps would be. Not only did my abdominal separation go from 3 to about 1 -1/2 but my back has pain has significantly reduced. I’m personally recommending all my mommy friends to Heather!

Y.L. (mom of 2)

Testimonial by Julie T.

Femina PT (née Fusion Wellness & Physical Therapy) has honestly changed my life. Before receiving treatment at Femina, I was going doctor to doctor to try and find the answer to my pelvic pain. It has taken me YEARS to find someone that can help fix this. It wasn't until my gynecologist recommended your clinic that I finally felt relief. My pelvic pain is almost gone, and granted I still have a lot more to work on with Laureen (my PT), my original problem is nearly cured. I am so grateful to her.

What is even better is she gave me practical exercises to do at home that were not tedious and provided instant (and lasting) relief. Although I mainly work with Laureen, my interaction with the owner (Heather) has been great. She is very generous, kind, and committed to her business.

It hurts to know there are women out there suffering who will never know or have the opportunity to work with women like Laureen and Heather because this issue is hardly talked about and this field is so rare. I hope more doctors and physical therapists see the value in this work and can relieve more woman of their pain.

-- Julie T., 12/4/16 via Yelp!

Testimonial by R.M., Age 40

I can’t speak highly enough of the theapists at Femina Physical Therapy and how much they have helped me grow, discover, and love my body. I had had painful sex for my entire life, and didn’t know that there was anything that could be done about it. It was at the point where my husband and I were not having sex for MONTHs, because it was just too frustrating, and I hated feeling like I was the ONLY woman out there who had this problem, especially at my age. I finally brought it up to my doctor because I was turning 40 and my husband and I were barely having enough sex to conceive. And she brought up pelvic floor, PT. I didn’t even know this was a “thing”.

Read more: Testimonial by R.M., Age 40

Testimonial by A.B.

Before I was referred to Heather Jeffcoat I was living in a nightmare. I had been married to my husband for three years and I was suffering from Vaginismus. That all changed when I visited my OBGYN and she said she knew of someone with a great success rate. To be honest I was hesitant at first because my first doctor had already told me that all I needed to do was order dilators from the internet and I should overcome my problem. She was wrong because I had followed the book on how to use the dilators with absolutely no advancements in my condition. However, that all changed when I went in for my first visit and Heather took the time to explain my condition and how we were going to work together to overcome it.

I remember leaving her office with a glimmer of hope that I could live a normal life. As my sessions continued I began to see immediate results. With only four sessions and a strict dedication to my home programs I was cured of Vaginismus. In the beginning of this process I was made aware that my health insurance company might not cover the costs, which was disappointing but today I can say one hundred percent that it was the best money I ever spent. Now thanks to Heather I am finally enjoying my life to the fullest with my husband. Thank you Heather, I can’t begin to tell you how much I appreciate all that you have done for me. I will never forget it. Those who are suffering from these types of conditions don’t be afraid because she makes you feel so comfortable and the end result is worth it. Good luck to you all and I hope you experience the success I have.
-- A.B.

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