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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.

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What Our Patients Have to Say


Testimonial by R.H.

No one could tell me why I was having pain during sex--sharp pain, not just uncomfortable, pain. I was referred to Heather Jeffcoat after researching several different options. I had seen a specialist who told me physical therapy would not help and my only option was surgery. I really didn't want to go that route, so when we got a referral, I decided to try it--it can't hurt, I thought. I am so glad I did. She diagnosed the problem right away, which was a relief in itself.

To know why I was having pain eased my mind immensely. And to hear that she could fix it without surgery was another relief. She said she could fix the problem in 6 weeks. I think it was actually 4 for me. She was very methodical, and treated me as an intelligent human being capable of participating in my own recovery. I would absolutely recommend her to anyone. She did not try to prolong my session numbers, she worked hard to accommodate my schedule (and the fact that I had to bring a baby to sessions), and she was completely honest the entire time. It is so hard to find someone with these characteristics, much less a professional who is so good at what she does. She has my highest respect.

-- R.H.

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.

Testimonial by Ann V.

I wish i could give this place 10 stars!! 
I have been suffering from vaginismus for 5 years and never found the cure to it. I had seen an ob/gyn and he diagnosed me with vaginismus and told me i needed a surgery to cure my condition, which i refused to do. He also referred me to a PT that he works with, i had given them multiple calls and they never responded back to me, so i started searching yelp for another PT. I am SO HAPPY I found Heather's office! I was working with Laureen, and with her guidance and techniques i was able to be cured from vaginismus in only 2 1/2 short months!!! I couldn't believe how quickly their program worked for me! I am forever grateful and thankful from Heather, and Laureen! They are the absolute best at what they do!

Read more: Testimonial by Ann V.

Testimonial by Lauren B.

Femina PT (née Fusion Wellness & Physical Therapy) has been such an answer to prayer, i'm so glad I found them! I've been struggling with vaginismus my whole life, but didn't have a name for it until about 6 or 7 months ago. Even once I did have a name for it though, I didn't know where to begin in getting help. My OB/GYN had me get a set of dilators, but I couldn't even insert the smallest one by myself. Most times I tried I just ended up frustrated and in tears. I felt really alone, like I was broken and didn't have the energy to keep trying. When I got engaged a few months ago though, I realized I needed to get answers so i wasn't dreading my honeymoon.

Read more: Testimonial by Lauren B.

Testimonial by Jamie M.

I have been going to see Heather for a while now, and I can't tell you enough how much she has improved my quality of life. Heather specializes in issues like pelvic floor, but I see her for other orthopedic issues.

I have a lot of chronic joint pain and dysfunction issues (back, hips, neck) that require that have ongoing physical therapy maintenance. The effects of my problem joints/areas overlap and interconnect with each other in complex ways, so helping me requires really having a complete understanding of the entire skeletal and muscular system. Pain does not always appear where the problem actually is, the human body is a twisty, many-layered puzzle. I have an exercise program I do at home and I am very functional, but there are just something things I need a PT to help me out with.

Read more: Testimonial by Jamie M.

Testimonial by Amanda W.

Heather's unique physical therapy program literally changed my life! After years of struggling with vaginismus, a condition that made it impossible for me to have intercourse and very difficult to use tampons without pain, a gynecologist referred me to Heather. I was nervous for my first appointment, but Heather's professional and friendly demeanor put me at ease. She did a great job explaining each technique she was using to help my muscles relax. Heather uses a combination of internal and external stretches and exercises to relax the pelvic floor and build muscle strength. Her specially developed home program helped me quickly recover from an issue that seemed insurmountable before meeting Heather. She was optimistic about my progress and incredibly encouraging. Less than 6 months after my first session, I was able to have pain-free sex for the first time in my life! If you are suffering from vaginismus or any other pelvic floor issues, I highly recommend making an appointment with Heather and reading her book!

-- Amanda W., 2/15/16 via Yelp!

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