Pain during sex? It might be Dyspareunia.

Mia Fine, MS, LMFT, CST, CIIP has written and instructing her remote course, Sexual Interviewing for Pelvic Health Therapists, with H&W on June 5-6, 2021. Mia (they/she) is a student of Queer Theory, Intersectionality, and Social Justice, and offers holistic, anti-oppressive, and trauma-informed therapy. This is a course intended for pelvic rehab therapists who want to learn tools and strategies from a sex therapist’s toolkit who work with patients experiencing pelvic pain, pelvic floor hypertonicity, and other pelvic floor concerns.

Let’s talk terms: Dyspareunia and Vaginismus

• Vaginismus: involuntary contraction of vaginal muscles preventing insertion/penetration
• Dyspareunia: pain felt during penetration

Symptoms (not limited to): pain - painful penetration, painful orgasms, painful periods, painful pelvic exams, inability to use tampons/cups, urinary or bowel hesitancy, feeling “too tight”

Causes (not limited to): stress, relationship concerns, mood concerns (anxiety, depression), insufficient arousal/desire/interest, trauma, side effects of meds, negative attitudes towards sex, and other pelvic pain concerns such as a tilted uterus.

The deal is, when it comes to dyspareunia and vaginismus there’s a cycle that can be difficult to break. The cycle is: you feel pain, then you feel broken (shame about feeling pain), then anxiety that pain will happen again, then you tighten your pelvic floor, and the cycle repeats. It becomes a self-fulfilling prophecy.

Often unwanted sexual pain goes unaddressed. Why? Because we are not taught about the interactions between feelings, relationships, and our body. We are not taught that sex should not be painful; that pain is (likely) our body giving us information that something is going on (Hello crappy sex education and the stigma of sexual health and body awareness!). It’s not uncommon that most people who experience sexual pain often feel they are broken.

You are not broken

How to heal from unwanted sexual pain? There’s a trifecta! Effective healing comes from working with a sex-positive medical provider, sex therapist, and pelvic floor PT. We will all collaborate!

Sex is not supposed to be painful. You are not broken.

Mia ️

#therapy #sextherapy #wellness #health #awareness #mentalhealth #bodyawareness