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Sex Without Pain: A Self-Treatment Guide To The Sex Life You Deserve was written by Heather Jeffcoat, DPT, a physical therapist with countless successes in treating pain of this type. Women with vaginismus, overactive pelvic floor, painful intercourse, vulvodynia, vulvar vestibulitis, vestibulodynia, dyspareunia, interstitial cystitis have all benefited from her unique program. Heather uses her orthopaedic background to approach treatment of these muscles like they are....muscles! She utilizes a self-treatment tool called a dilator to provide massage and other muscle relaxation and stretching techniques in a gentle fashion to return a women's muscles back to a resting, rather than guarded, state.

Sex Without Pain: A Self-Treatment Guide To The Sex Life You Deserve

What Others are Saying About "Sex Without Pain ":

I have seen Heather's treatment program work time and time again with my patients. Her unique approach to treating women with painful intercourse through a combination of hands on skills, patient education and the thorough home program outlined in this book has surpassed the results of her peers. Her techniques and expertise have been an invaluable resource to my practice."

- Kerri Parks, MD (Associate Professor Ob/Gyn USC Keck School of Medicine)


I will use it frequently for clients who cannot afford pelvic floor PT or for those who cannot find pelvic floor PT any where near them! I have so needed this resource. The clarity of each step and the drawings are so helpful - I don't know of any other resource that will be as effective for self-help."

- Joyce Penner, RN, MN (Sexual Therapist, Educator and Co-author of The Gift of Sex, Restoring the Pleasure and numerous other publications)


Sex Without Pain is an essential book for any woman suffering with pelvic or sexual pain. Heather's approach is simple and clear. She empowers the woman and her partner with the resources needed to lead a healthy and pain free sex life. A great read for patients and professionals alike."

- Jennifer Briggs, DPT (Women's Health Physical Therapist, Pennsylvania)


• To order "Sex Without Pain" in paperback from Amazon for $24.99, click here.

• To order an electronic read-only non-printable PDF copy of the book for instant download at $19.99, use the button below:

• To schedule an appointment at one of the Femina PT offices, click here.

• For a list of other trusted health care providers, click here.

A 2019 study by Towe et al., found that certain medical issues including metabolic syndrome, obesity, and eating disorders have an effect on female sexuality. The study also found evidence that incorporating of healthy dietary patterns into everyday life may positively influence female sexuality.

Metabolic Syndrome and Obesity May Cause Female Sexual Dysfunction


According to the Mayo Clinic, Metabolic Syndrome is a “cluster of conditions that increase the risk of heart disease, stroke, and diabetes. Metabolic syndrome includes high blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol levels. The syndrome increases a person's risk for heart attack and stroke.” Those with Metabolic Syndrome often have apple or pear shaped bodies.

In addition to increasing risk for heart disease, stroke, and diabetes, metabolic syndrome can affect the function of endothelial cells, which help the body create lubrication including vaginal lubrication. Studies have also found that Metabolic Syndrome can also affect sexual dysfunction by decreasing sexual activity, desire, and satisfaction (Towe, 2019; Trompeter, 2016).

Obesity can be a component of Metabolic Syndrome and has also been linked to decreased female sexual function in other studies including Aversa (2013) wherein the study found that holistic intervention for obesity resulted in an increase in sexual function as measured by desire, arousal, lubrication, orgasm, satisfaction, and lack of pain.

Eating Disorders and Sexual Dysfunction

Studies have found that eating disorders including bulimia and anorexia can negatively affect sexual function.

Bulimic patients tend to be more impulsive and engage in higher risk sexual behaviors, while people who have anorexia report decreased arousal, lubrication, worse orgasmic function, and other effects on the menstrual cycle (Towe, 2019).

Specific Diets that Have been Found to Positively Affect Female Sexuality


The Mediterranean diet has been shown in a few studies to improve sexual function, specifically for women who also have obesity, diabetes, and metabolic syndrome (Esposito, 2007; Towe, 2019).

In Esposito’s 2007 study, participants were asked to adhere to a Mediterranean diet for 24 months with the following guidelines:
Diets were compromised of

  • 50-60% complex carbohydrates
  • 15-20% of proteins -less than 30% total fats
  • less than 10% saturated fats

Subjects consumed at least 250–300 g of fruits, 125–150 g of vegetables and 25–50 g of nuts per day. Additional guidelines included consuming 400 g of whole grains daily (legumes, rice, corn and wheat) and to increase the consumption of olive oil. Women were also advised to increase consumption of fish and to reduce intake of red or processed meat.

By the end of the 24 month trial, those following the Mediterranean diet in the Esposito study reported better sexual function in the areas of sexual desire, arousal, orgasm and pain.

The Ketogenic diet is described by the National Cancer Institute as a “diet high in fat and low in carbohydrates (sugars) that causes the body to break down fat into molecules called ketones. Ketones circulate in the blood and become the main source of energy for many cells in the body.”

In Castro’s 2018 study, women placed on a low calorie ketogenic diet for 4 months reported improved sexual function in the realms of arousal (excitation) and lubrication. The study also reported that some women reported improved orgasmic function.

As pelvic floor therapists, it is outside of our domain to prescribe or counsel people through diet changes. Please check in with your doctor, a registered dietician, and/or a licensed nutritionist for more information.

Resources

Aversa A, Bruzziches R, Francomano D, et al. Weight loss by multidisciplinary intervention improves endothelial and sexual function in obese fertile women. J Sex Med 2013;10:1024- 1033.

Castro A, Gomez-Arbelaez D, Crujeiras A, et al. Effect of a very low-calorie ketogenic diet on food and alcohol cravings, physical and sexual activity, sleep disturbances, and quality of life in obese patients. Nutrients 2018;10:1348.

Esposito, K., Ciotola, M., Giugliano, F. et al. Mediterranean diet improves sexual function in women with the metabolic syndrome. Int J Impot Res 19, 486–491 (2007). https://doi.org/10.1038/sj.ijir.3901555

Towe, M., La, J., El-Khatib, F., Roberts, N., Yafi, F. A., & Rubin, R. (2019). Diet and Female Sexual Health. Sexual Medicine Reviews. doi:10.1016/j.sxmr.2019.08.004

Mayo Clinic, Metabolic Syndrome

https://www.mayoclinic.org/diseases-conditions/metabolic-syndrome/symptoms-causes/syc-20351916

Trompeter, S. E., Bettencourt, R., & Barrett-Connor, E. (2016). Metabolic Syndrome and Sexual Function in Postmenopausal Women. The American Journal of Medicine, 129(12), 1270–1277.e1. doi:10.1016/j.amjmed.2016.03.039

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What Our Patients Have to Say

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Testimonial by A.M.

Months after giving birth, it was difficult for me to go from a sitting or lying position up to a full standing position without feeling that I had to remain hunched over until a bit of time had passed to get fully upright. However, after taking Heather’s course, I learned exercises to get my body back to normal. She also showed me correct ways to lift and carry my son as well as put him in/take him out of the carseat and stroller. This class was really beneficial and Heather is a wonderful teacher who made me feel very comfortable.

-- A.M.

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 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 Fritzette H.

I went to Heather after the birth of my third child. It was lucky, really, that I was referred to her, because my doctor had referred me to a surgeon for a possible hysterectomy or pelvic wall rebuild. Thankfully, I went to Heather before undergoing either surgery, she was able to fix the problem. She has studied extensively in women's health--even written a book about it--and was able to diagnose my problem, suggest a course of treatment (6 weeks), and then follow through with said treatment. By the end, as she said, I was as good as gold. Boy, was it worth it! Though uncomfortable to talk about, much less write about, it is worth getting the word out there. If you have painful intercourse, especially after birth or other trauma, the treatment may be as simple as Physical Therapy (with Heather, of course). I highly recommend her.

-- Fritzette H., 3/24/16 via Yelp!

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 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

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