For people in pelvic floor physical therapy
When sex hurts — or you’re afraid it will
Pelvic floor physical therapy treats your body. Sex therapy can work alongside it, on the fear, stress, and relationship strain that often come with sexual pain.
This is the printed handout, word for word. Print or download it at the end of the page.
Does any of this sound familiar?
- “Sex hurts — or I avoid it because I expect it to.”
- “My body tenses up before anything even happens.”
- “I’ve pulled back from touch and affection, not just sex.”
- “I feel guilty, or like I’m letting a partner down.”
- “Leaking, surgery, birth, or other body changes have shaken my confidence.”
- “Something in my past makes touch feel less safe.”
- “Hormones or surgery changed my body. I want to find what feels good now.”
- “I’m not sure what sex could look like for me now.”
Pain and fear can feed each other
When sex has hurt, it makes sense to expect it to hurt again. That expectation can bring tension, watchfulness, and avoidance, which can make pain more likely and closeness harder. Over time the cycle can affect desire, confidence, and relationships.
How sex therapy can help, alongside your physical therapy
Pain
Make sense of it
Notice what makes pain better or worse, and learn to separate pain from the fear of pain. Progress is usually gradual.
Safety
Go at your pace
You decide what happens and when. Nothing is expected that you haven’t agreed to, and each step builds slowly.
Pleasure
Widen what counts
Pleasure and closeness don’t depend on penetration. Explore what feels good in your body as it is now, including after gender-affirming hormones or surgery. Structured touch and body-awareness practices, done at home, can be part of this if they fit you.
Intimacy
Include a partner, or don’t
A partner can join some sessions if you’d like. Talking together about pain, needs, and boundaries can ease pressure on both of you. You can also do this work on your own.
What sex therapy is
Sex therapy is talk therapy about sexuality, intimacy, and relationships. There is no touch, no exam, and nothing physical happens in sessions.
Your physical therapy still matters
Sex therapy doesn’t replace pelvic floor PT or medical care. With your permission, I coordinate with your physical therapist so both parts of your care work together. New, sudden, or worsening pain should be checked by a medical provider.
Getting started
Request a free 15-minute consult at JosephMaronLPC.com or call 215-804-9315.
Telehealth for adults in Pennsylvania. Private pay; superbills provided for out-of-network reimbursement.
I’m Joseph Maron, MS, LPC, a sex therapist. I work with adults on sexuality, relationships, identity, and ADHD.
Joe Maron Therapy · PA License PC017785 · Doctoral student in human sexuality, Widener University · Certificate in Affirmative Therapy for Transgender Communities · ADHD-CCSP · LGBTQ+ affirming care
Print this handout
For your clinician: the matching provider sheet.