Pain with sex: A patient story

Meet Jess

Jess was 34 when I met her and had never been able to have intercourse. She hadn’t been in a relationship for longer than 6 months in the past 5 years. She painstakingly described the shame she felt each time a relationship progressed and then abruptly ended as “nothing fitted”.

Jess’s history was interlaced with elements of a less than happy pelvic floor that she hadn’t ever pieced together.

Jess’s history

• She was prone to constipation (has a big impact on pelvic floor tension)

• An intolerance of gluten and dairy (which increases over all inflammation)

• She had a fall onto her tailbone when she was 10, following which she was unable to sit for a week.

• She’d never managed to use a tampon

• Her family viewed sex before marriage as dirty

Jess had spent months previously using dilators (dildo shaped devices that come in varying sizes which you place at the entrance of the vagina that stretch the tissue to allow it to accommodate penetration), but struggled to get past the middle sized one.

Like so many of the ladies who come to see me, she had lots of factors contributing to her difficulty in tolerating (let alone enjoying) intercourse.

She had also met a guy who she adored. They had only been on a handful of dates but she just knew they had a connection. “I would usually end it now to avoid embarrassment” she said. “ But I just can’t this time”.

My treatment approach for Jess

Jess was motivated and fascinated by the more holistic approach I believe in.
We worked on improving her constipation, she tidied up her diet to avoid foods that inflamed her and introduced more probiotics and fermented foods. I helped her with connecting to her pelvic floor and “letting go”; with internal massage release but more importantly taught her to do self-releases at home. She had come to dread her dilators and her pelvic floor muscle tone increased at the mention of them. So we abandoned the dilators and got her to use her fingers and a pelvic wand for stretches instead. 

She began seeing a therapist to address any underlying fears and resistance regarding intercourse and we got her to connect to her pelvic bowl through visualisations and mediations.

She began a yin yoga class once a week and did daily stretches and breathing exercises to help to lengthen her pelvic floor and became aware of when she was holding her breath during the day. Jess also managed to move teams at work as we realised how much her manager was impacting on her daily stress and overall well being. She began journaling and writing poetry again stopped agreeing to social events she didn’t really feel like attending. 

I treated Jess 4 times in my clinic and she kept me updated via email on her progress. She was equipped with some tools for her toolbox and she honed them like a master craftsman.

6 months after we first met, she emailed me to say she and her new fiancée were incredibly happy. “My body is now working the way it’s supposed to!” she wrote. “My therapist doesn’t think we need any more sessions for now, I’m still following all we put in place and I am just SO happy!”

What we can learn from Jess

When someone has pain with intercourse there are often a whole host of factors that are contributing to the pain. We are more than just a body; our thought patterns, our history and our daily lives all effect our body. Therefore treatment should always be holisitic, taking the whole being into consideration.

But the biggest lesson we can learn from Jess is the strength in her vulnerability. She was strong enough to not leave out any of the details that could be contributing to her pain. She was brave enough to try new and different things.

Pain with sex is not something that should be ignored or even endured. There is help out there. I urge you to seek out a pelvic health physio if this is something that resonated with you. You are not alone.