Your Pain Probably Isn’t In Your Head and Shouldn’t Ruin Your Whole Sex Life


Yet again, I spoke to a woman who has vaginal pain that her physician couldn’t “see” or identify and the doctor told her to see a therapist because it was likely “in her head.” As a sexual health practitioner it just makes me so mad.


I see it every day, women who have been told that their pain is “in their head” because the doctor wasn’t able to identify the problem. I wish more health care providers would be comfortable saying, “I’m sorry. I just don’t know.”. If I had a nickel for every woman who spent years in therapy talking about her vaginal pain, with little results to show for it, I’d be rich. And time after time, I have seen those women successfully treated through physical/medical/behavioral interventions. I think most women have a gut feeling whether the problem is physical or psychological. We should trust them. And more often than not, pain is a physical problem.


And let’s talk about the “meantime”, while you are trying to work out your sex life. Our view of sex as having to revolve around penile/vaginal intercourse is perhaps the single most limiting and misleading element of our current sex education. There are many kinds of sex. There’s oral sex, manual sex, anal sex. There is sex using every potential part of your body. If you can’t have sex one way…there are so many other ways!! Why does someone who can’t have vaginal intercourse feel as though she should be embarrassed to discuss this? And why does she feel like her sex life is over??? I had a patient who had vaginismus (a condition in which you can’t get a penis into the vagina.) She was married for 3 years when I saw her. She had one of the best sex lives I’ve seen. She was having sex with her husband about 3 times a week, in various way. She had an orgasm (or more) most every time they had sex. She was having fun. 


Now — after we worked together, and she got the help she truly needed,  do I think she’s having more fun? Yes. Probably. (Although she’s quite clear that intercourse is not her favorite sexual activity.) More options is usually better. BUT do I think someone’s sex life should be over because they can’t have vaginal intercourse?! No way. And I think we’d do ourselves, our daughters and our partners a big service if we put vaginal intercourse into perspective. Would her husband be having a grand old time if he was having sex 2 times a week with a happy, excited, willing partner who was the queen of blow jobs (kind of how she describes herself),  who brought him to orgasm with her tongue, her lips, her breasts, her feet, her butt, her anus? 


Would her husband be having a grand old time if he was having sex 2 times a week with a happy, excited, willing partner who was having orgasms from his hand, a vibrator or his mouth. My guess is yes. Would he miss vaginal intercourse? Probably. Is that a price he would pay to be with a woman he loves? Would it be that be so very different from a guy who is heartbroken because his wife won’t go down on him and he loves oral sex? Perhaps not so very different.


So here’s advice if you (or your friend or your partner) has pain with intercourse. 

      • Get help. Real help. 
      • Face the reality that it’s probably not in your head


Try to build a fun, happy sex life anyhow. You can do it.



Written By

Dr. Bat Sheva Marcus

Sex Therapist & Relationship Expert  |  Author of Sex Points & Satisfaction Guaranteed: How to Have the Sex You've Always Wanted