Sex Pain and Sex Dysfunction

Sex pain and dysfunction

Sex Therapy
Woman with brunette hair in a white t-shirt sitting in a chair looking out the window
If you’ve been told that sex should be easy, hot, and happen “naturally”, you’re not alone.
Sex feels like it doesn’t work like it should, and it’s causing problems in your life.

Sometimes the act of sexual intercourse itself hurts badly, and you’re either trying to “push” through the pain, or you’re avoiding having sex altogether.

Or you have other sexual performance issues (like erectile dysfunction) that leave you increasingly anxious before or during sex. You don’t want to let you or your partner down, but you can’t help how you feel, and the anxiety keeps getting worse.

Changes in your health may have unexpected impacts on your sexuality. Or if you’ve had past sexual trauma, the idea of even having a sexual relationship at all can feel unnerving. This response affects your sexual desire and prevents you from accessing the pleasure you deserve.

There’s a good chance you’ve tried various solutions to “fix” it. And maybe some of those solutions have helped a little, but you’re still struggling with both emotional and physical discomfort.
Virtual SF Therapist for clients across all sexual & gender spectrums such as LBGTQIA+ & more.
Types of Sexual Dysfunction
Sexual dysfunction refers to specific sexual issues that impact people from experiencing pleasure or satisfaction. These issues can occur during any point of the sexual response cycle, from lack of sexual desire to orgasm disorders to pain disorders. Some of the key symptoms of sexual dysfunction include:

  • Experiencing genital or pelvic pain during sex (ex: vaginal dryness, dyspareunia, vaginismus, vulvodynia, pain with/during erections)
  • Problems with arousal, such as erectile dysfunction or inadequate vaginal lubrication
  • Premature ejaculation or delayed ejaculation
  • Difficulty achieving orgasm or having no orgasm at all
  • Performance anxiety before sex
  • Pain due to hormones, illness, or medical complications
Psychological factors, such as depression, anxiety, low self-esteem, poor body image, and relationship problems impact how easy it is to have sex. Certain medical conditions can cause or exacerbate sexual dysfunction. For example, diabetes, neurological disorders, and heart disease may impact sexual response. In addition, aging or other conditions that affect hormones will change your sensations and how you experience sex. Pelvic floor problems in any gender can cause pain during sex or other bodily functions.
How Your Sexual Life Impacts Your Emotional Well-Being

It’s no secret that problems in the bedroom can result in problems with your mental health. The following symptoms exist on a spectrum, and they often worsen with stress. But without proper treatment, they can significantly affect your self-esteem and relationships.

Shame: Shame is the emotion that tells you, Something is really wrong with me. I think I’m broken. When we feel high levels of shame, we tend to struggle with low self-esteem and isolate ourselves from others. Even if you’re in a loving relationship, you might notice yourself avoiding vulnerability or feeling immense embarrassment during sexual activity.

Low sexual desire or sexual interest: Sexual dysfunctions can naturally impact your desire to have sex. Even if you have a strong libido, you may realize that you find yourself avoiding sex or lacking sexual excitement altogether.

Fear: People experiencing sex problems often feel that things will be this way forever. This fear can be even more pronounced if you’ve always had sexual issues or if you have ever felt rejected by past partners or healthcare providers.

Loneliness: You may feel like you’re alone in your sexual behavior. It can seem like everyone else is having a great time with sex, which can be confusing. If sex has always been a problem, you might wonder how anyone could possibly find it enjoyable.

Anger: There may be a sense of anger that you’re struggling with this particular issue. If you’re a partner of someone with a sexual dysfunction, you may also feel frustrated by the situation, which can spiral into resentment. This anger often speaks to the helplessness associated with experiencing a sexual disorder or loving someone who’s struggling.

Ruminating about your past sex life: If the sexual problem occurs later in life (such as after having children or going through menopause), you may notice yourself continuously comparing your current situation to what you had in the past.

How Sex Therapy Can Help You

If you’ve ever opened up about your sexual difficulties, you’ve probably received a myriad of well-intentioned suggestions. Use more lube! Watch porn together! Buy this herbal remedy. Just relax!

But the truth is that sex is incredibly complex, and it evolves over time. Just like anything else. And while sexual issues can be challenging to live with, things can improve. This is why working with a sex therapy specialist can help you put the pieces together. My goal for therapy is to provide you with support and practical, effective guidance. My specialties include helping both individuals and couples to:

  • help in understanding “what is normal” and what you need to know about your condition.
  • lessen or eliminate performance anxiety before sex.
  • create a plan for how to have sex with less pain.
  • techniques and resources for how to assist arousal and orgasms.
  • linking potential causes to previous sexual experiences or traumas.
  • collaboration with your other medical or sexual health professionals, such as pelvic floor therapists or surrogate partners.

Sex therapy is similar to regular therapy. We will dive into your thoughts, experiences, feelings, and functioning. This work may feel vulnerable, but most clients find they wish they had this outlet earlier.

I embrace holistic work in my therapy, as sex is both a direct experience and a symbol of other important values, such as creativity, pleasure, joy, renewal, and play. While this type of therapy may be directly about your sexuality, remember that sex therapy is not a  surrogate partnership or sex work. We’ll just be talking, and you’ll never be required to discuss things or do anything you’re not ready for.

What If I Have Other Problems Besides Sex?
Yes, that is often the case. There are likely anxieties, old wounds, and troubles in other areas that we talk about and incorporate into your therapy. Let’s talk about where else you may feel stuck. If you already have an individual therapist or are thinking about switching therapists, I talk about this more in depth on my FAQ’s.
Sex Therapy in San Francisco, California
There’s no doubt that you’re ready for something different. But you don’t want to keep trying a bunch of random techniques or going to different doctors. You also don’t want to talk to a therapist who can’t actually help you with this specific issue.

I get it. It’s frustrating to be in pain. And it’s even more frustrating to not know where to turn.

As a certified sex therapist, I have spent considerable time understanding how to address sexual concerns in clients. My goal is to show you that a great sex life is possible and that you can feel more confident and empowered with yourself.

In my practice, I welcome all genders, sexual identities, and different relational and monogamy agreements. I am a sex work ally and have advanced competency in kink practices. Many of my couple therapy clients have one or both partners who are LGBTQIA+ identified. Matching my own background, I often work with people of mixed ethnic and cultural identities, first and second-generation immigrants, and BIPOC clients. Come as you are.
Sexual health looks different for everyone. If you want to be on a path to find out what it looks like for you, book a free consultation with me.

“Sex not as something we do, but a place that we go” – Esther Perel

Deva is a licensed psychotherapist (LMFT CA #103816 / ME #MF7207 / SC #TLC 825 MFT) and AASECT Certified Sex Therapist practicing in the downtown Financial District of San Francisco, CA. She has worked with clients aged 6 to 88 in different settings since 2011. These days, she helps individuals and couples get more in tune with their wants and needs. She has a special focus on sexuality and folks of mixed ethnic or racial backgrounds.

She slightly prefers pie over cake, but loves dogs and cats equally.

© Deva Segal, Marriage and Family Therapy and Consulting, Inc. SF Therapist. All rights reserved. 2018-2024