Sexual pain is not your fault

As a sex therapist and former physical therapist specializing in the area of sexual pain disorders  ( such as vulvodynia and vaginismus) and as a couples therapist specializing in unconsummated marriages, I commonly come across women who feel guilt and responsibility for being unable to “provide” sex to their partners. Leah is a 32-year-old mother of 2. She and her husband, Josh, came to see me after the birth of their second child. Leah reported loss of desire and painful intercourse. Leah had never really enjoyed intercourse but since this birth it had become painful. Leah had been to different therapists on her own, figuring this was “her issue”.  She had tried creams and lubricants and dilators and pelvic floor exercises. Leah was feeling really guilty about not wanting to have sex and Josh was frustrated and angry. “She never lets me touch her anymore.”Since Leah did not ever really enjoy intercourse, I asked Leah what she did enjoy, sexually. Turns out that in the past, Leah had considered herself to be very sexual. Leah enjoyed cuddling, massages that could turn into something more, and long passionate kisses. When I asked Leah why they don’t do that, Leah said “because it leads to intercourse.”  When I turned to Josh, he seemed surprised. As it turned out, Josh was more than willing to be intimate with Leah in other ways without having to end in intercourse. Leah had been feeling so guilty about “denying” Josh, that she ignored how much she was denying herself. Once intercourse was off the table, Josh and Leah become a lot more intimate and passionate. They attempted intercourse again only after Leah really felt aroused and ready for it, and by then, she really began to enjoy herself.


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