When Sex Hurts: What You Need to Know About Female Sexual Pain

The Big O should never stand for OUCH, yet countless women experience pain during sex at some point. In some cases, the pain and related symptoms become chronic or even debilitating.

Last week, I had the pleasure of interviewing Heather Jeffcoat, DPT, owner of Femina Physical Therapy, which has two Los Angeles offices and offers one-on-one treatments with licensed physical therapists. As you’ll see in our interview, Jeffcoat cares deeply for her patients, aiming consistently to give them the time and care they need. (For sexual and pelvic pain conditions, Femina Physical Therapy does 90 minute evaluations and 60 minute followups.)

*Because Jeffcoat primarily treats cisgender women, we used female pronouns throughout the episode to refer to people with vulvas. If you’re a non-binary or trans guy with a vulva, much of it will apply equally to you!

Here are a few highlights from our chat! To stream or download the full episode, see below, or find it on iTunes or iHeartRadio. 

Pelvic pain is not “all in your head.” 

While emotional factors can contribute to pelvic and sexual pain, symptoms of common and legitimate physical conditions are too often disregarded as “no big deal” or “all in your head” by health practitioners who haven’t learned differently.

“I’m not the first or second person that this woman has seen when she walks into my office. I’m like the seventh, the twelfth,” Jeffcoat said. “I’ve had people move from out of state to be treated by my office—myself and my staff—because this kind of treatment is not available everywhere.”

In one case, one of Jeffcoat’s patients sought her guidance after her OBGYN told her her condition was incurable and she’d have it forever, merely giving her lidocaine to mask her symptoms. Luckily, she had the wherewithal to dig deeper and a supportive family who helped her find her way to Jeffcoat and her center where she was properly diagnosed.

Pain that interferes with sex and intimacy is not shameful.

Many people experience intense shame around pelvic pain, according to Jeffcoat, though it’s not even a little bit shameful. And as you can imagine, being told your symptoms are imaginary or unimportant can really exacerbate these feelings.

“Women feel like less of a women, less of a wife or less of a girlfriend because they can’t engage fully to the intimate level that they want to,” she said, “and they’re physically blocked because of pain.”

Oftentimes, patients leave her office feeling better already, having had their pain validated—knowing that they have a physical problem that Jeffcoat could identify and begin treating. 

If you’re experiencing pain that interferes with sex, you’re far from alone.

While people are often led to believe that the painful sex disorder they’re dealing with is rare, that’s far from the case, said Jeffcoat. Research has indicated that conditions such as vulvodynia in 10 to 23 percent of women, she said, which is undoubtedly low, considering how often symptoms go unreported. If you don’t have a painful sex disorder, someone you know likely does.

Conditions that cause pelvic or sexual pain are hugely worthy of treatment.

Sex should never be painful. While  occasional or mild discomfort from an awkward position or too little foreplay or lube can typically be managed or avoided on your own (and side note: if sex hurt, it’s important to stop, communicate about it with your partner or immediately shift gears), address pain or discomfort that keeps you from enjoying physical intimacy with a healthcare practitioner who specializes in pelvic and sexual pain. 

“If your knee started hurting and you wanted to go on a hike and you couldn’t hike anymore, you’d go to see somebody to get something done about that,” said Jeffocat. “You need to treat the pelvic floor like the rest of your body… The function of that muscle does everything from keeping you from peeing on yourself to supporting your  pelvic organs to allowing for sexual pleasure and allowing you to enjoy intercourse.”

To learn much more about pelvic and sexual pain, symptoms of common conditions, including vulvodynia, vaginismus and interstitial cystitis, when to seek support and more, stream the episode on iTunes, iHeartRadio, Stitcher Radio, Google Play, SoundCloud or here below! The episode also features:

• Facts (and a true story) about penis fractures
• Dr. Megan Fleming’s thoughts for a listener who broke her boyfriend’s penis and is struggling to move forward