Overcoming Painful Sex Through Somatic Coaching
Why would your body open to something it doesn't feel safe receiving? For those living with dyspareunia, painful sex isn't just a physical hurdle—it's a sign that your nervous system is stepping in to protect you. One of the sexual concerns that clients can see a sex coach to help with is dyspareunia (painful sex). Clients have usually already seen a doctor regarding the pain and have not found medical treatments successful.
Conditions related to Dyspareunia
Conditions that are associated with painful sex include dyspareunia, vaginismus, and vulvodynia.
Dyspareunia - Dyspareunia is painful sexual intercourse that is commonly on the external surface of the genitalia or deeper in the pelvis.
Vaginismus - Vaginismus is a condition where the pelvic floor muscles involuntarily contract around the vagina opening. This tightening of muscles can make it difficult or impossible to insert anything into a vagina. This includes tampons, penises or toys during sex, or during medical examinations. When there is an attempt to insert something, you may feel pain, discomfort or a burning sensation.
Vulvodynia - Vulvodynia is a chronic pain syndrome that affects the vulva area without an identifiable cause. If you are experiencing this, you may have a burning sensation or irritation.
While the physical symptoms of these conditions are noticeable, they often originate from psychological causes. These conditions are rooted in the mind even though they manifest in the body. Consequently, dyspareunia can significantly affect your emotional well-being, self-image and intimate relationships.
How common is genital pain that affects sex?
Genital pain that results in painful sex is common in three subgroups: younger women, older women and men. Research shows that the prevalence of genital pain for young women is between 14% and 34%, and it is more common in older women, with it affecting between 6.5% and 45% of the population. Genital pain affects between 5% and 15% of men.
What Causes Genital Pain that Affects Sex?
Genital pain is rarely caused by a single factor but rather a combination of several. These include anticipating pain, relationship dynamics, past experiences, cultural messages about sex and medical issues. At its core, dyspareunia and related conditions often stem from fear, a lack of safety and a feeling of not being in control of one’s body and its future.
Understanding the underlying causes of your body’s protective response is important for moving away from pain. Some common contributing factors include:
Fear of Pain
Relationship Dynamics
Personal History and Psychological Influences
Cultural and Religious Factors
Other health difficulties
Lack of education
How Somatic Sex Coaching Can help dyspareunia
Somatic sex coaching offers something pelvic floor physiotherapy often overlooks: the integration of arousal, pleasure and partnered dynamics. While physiotherapy focuses on mechanically relaxing muscles (an important part of the work), somatic sexology recognises that arousal is necessary for penetration to feel welcoming rather than threatening. Why would your body open to something lacking pleasure?
As a qualified somatic sexologist, I have a deep understanding of arousal and actively incorporate it into my approach. This helps you understand how it works in your body, how partnered dynamics influence your responses and how to regain a sense of safety, predictability and control in the bedroom.
When working together on dyspareunia, we will likely look at the following components:
Mind-body relaxation techniques
Sexual Anatomy Education
Work with fear, emotions and beliefs
Create predictability, safety and control
