Desire: Finding your mojo when sex hurts


It is not uncommon to experience a lack of desire for intimacy when you are struggling with pelvic pain.  In fact, over 40 million women in the United States experience sexual dysfunction during their lifetime.1  We often hear from our patients that when they are experiencing painful intimacy, their desire remains decreased even after their muscular pain is resolved.  At Carolina Pelvic Health Center, Inc. we work with many practitioners in the medical field,  including sex therapists,  to meet all of your intimacy goals.

 Desire for intimacy may be influenced by many different factors, including but not limited to the following:





     Lifestyle and Beliefs

Hormone and/or medication effects


Anxiety/depression Unresolved tensions in current or past relationships Religious beliefs or expectations
Painful muscles


Self- Esteem  and body image Divorce or Separation Fatigue from caregiving and/or parenting  or illness
Chronic disease and general health


Stress levels elevated Caregiving for family member Lack of consistent exercise program
Recent surgery or medical procedure History of sexual/physical or emotional abuse Fear of sexual performance Decreased knowledge of sexual cycle and anatomy

As we learn more about the neurobiology of desire we now know that the brain is the central command center for controlling our desire. In an exciting book about sexual desire, “ Come As You Are: The surprising new science that will transform your sex life”, author Emily Nagoski, Ph.D. explains how the brain inhibitory and excitatory pathways can accelerate your desire or put the brakes on and extinguish your desires for intimacy.  This is an excellent adjunct to your treatment with physical therapy to help promote understanding of the role of your central nervous system in unleashing your desire for sexual activity.  

Despite the many factors that can contribute to painful sex, there are treatments that can help you experience intimacy comfortably and pleasurably! Pelvic physical therapists can help you learn more about what may be causing your pain and recommend treatment, home self care exercises and referral to other medical providers based on your symptoms and goals. There are many excellent resources in addition to Dr. Nagoski’s book that may be helpful in learning more:

“ Reviving Your Sex Life After Childbirth: Your Guide to Pain free and Pleasurable Sex After Baby.”
by Kathe Wallace, PT, BCB-PMD

“ Wanting Sex Again: How to Rediscover Your Desire and Heal a Sexless Marriage”
by Laurie J. Watson, LMFT, LPC, Certified Sex Therapist

“ Healing Painful Sex: A Woman’s Guide Comforting, Diagnosing, and Treating Sexual Pain”
by Deborah Coady, MD & Nancy Fish, MSW, MPH

“ Sex Without Pain: A Self-Treatment Guide To The Sex Life You Deserve”
by Heather Jeffcoat, DPT

Visit our website for additional resources, including videos and blogs that may enhance your return to pleasurable and pain free intimacy.  

If you are experiencing pain during intimacy or other problems during sex, give us a call @ 919.571.9912 to learn more about how we can help you reach your intimacy goals.  

  1. Berman JR, Berman L, Goldstein I: Female sexual dysfunction: Incidence, pathophysiology, evaluation, and treatment options. Urology 1999; 54:385-391.