Do you struggle with pain during sex? There is hope!

Pelvic Floor Dysfunction - Vaginismus - Vulvodynia -  PGAD
Estrogen Deficiency - Interstitial Cystitis - Chronic Prostatitis 


As a support group leader for almost twenty five years, I've spent hundreds of hours talking with husbands and wives struggling with painful  intimacy. Whether it's from a preexisting medical condition, a new illness or pelvic floor muscle dysfunction, you are certainly not alone. These books and CD's provide insight into the causes of painful intimacy and, more importantly, offer practical tips and suggestions that may help reduce your discomfort. I've also included some of the products that we've found to be comforting and soothing! 

Conditions That Can Cause Sexual Pain


Pelvic Floor Dysfunction / Vaginismus

When the pelvic floor muscles are tight they can cause several symptoms including: muscle spasms, tightness, difficulty sitting, difficulty starting the urine stream, pain with penetration, pain that worsens during the day.  If you have any of the symptoms above, it's time to have a pelvic floor assessment. Pelvic floor dysfunction responds beautifully to physical therapy. 

Skin Pain - Vulvodynia, Lichen Sclerosis

From vulvodynia to lichen sclerosis, millions of women can share their struggle with pain on the skin of their nether region. Symptoms may include: burning, itching, irritation, pain with touch, pain on the labia, clitoris, perineum, rectum and vulva. Some skin disorders may causing bleeding. Urine burn, pain from urine touching the skin, is common. Please share your symptoms with your ob-gyn. There are a wide variety of self-help tips and therapies available. Always, ALWAYS avoid using any harsh chemicals or douches on your skin "down there." 


There are two forms of vestibulodynia: primary and secondary. Symptoms can include: burning, stinging, itching, throbbing, numbness, swelling, tearing  or a cutting sensation, persistent urethral burning. Primary vestibulodynia may be present from birth and be the result of overabundance of nerves. Secondary vestibulodynia can occur later in life if there has been an injury to the vaginal area. If you have difficulty using a tampon, having a pelvic examination or have always strugglied with pain upon touch or intimacy, you may have vestibulodynia. Some patients feel better after stopping birth control pills. Allergies and/or sensitivity to chemicals may cause symptoms. Infections, particularly yeast infections, can also trigger discomfort. 

Nerve Pain

If your skin looks normal and/or there are no obvious signs for the burning, irritation and itching, you may have nerve pain. The pudendal nerve can cause pain of the vulva, anus, label or clitoris. Persistent Genital Arousal Disorder (PGAD) may also occur. In many cases, touch can cause pain, as well as clothing that has seams that can rub, sustained sitting and bike riding.  Compression of the pudendal nerve is common, often from injury, sitting for long periods of time and/or long-term pelvic floor dysfunction. Spinal cord compression can also trigger symptoms. 

Organ Pain (Bladder, Bowel, Reproductive Tract)

If you struggle with bladder pain during intimacy, urgency during and after sex, prolonged periods of urinary frequency and/or urgency, you may have interstitial cystitis. If you struggle with bloating, gas, rectal pain, you may have some bowel issues. If you struggle with severe pain during your period, stabbing pain during intercourse, you may have endometriosis. Uterine fibroids can trigger a sense of heaviness and fullness in the pelvis as well as irregular and heaving menstrual bleeding and deep pain with intimacy. Pelvic congestion syndrome can cause heaviness and discomfort especially as the day goes on, as well as deep discomfort during intimacy and/or during your period. Please track your symptoms carefully and then bring that information your doctor for a proper diagnostic evaluation. Bladder sensitivity may be from something as simply as drinking soda or coffee. 

Hormonal Causes

Genitourinary Syndrome of Menopause (GSM) has been the bane of millions of women as they age. With the reduction in estrogen, tissues become thinner, dryer and more vulnerable to injury or infection. Symptoms may include: burning and tearing at the vaginal opening, touch sensitivity, change is discharge, stinging of the urethra, burning as urine crosses the vulva, weakness of the pelvic floor muscles, a tight sensation and/or vaginal spasms.  This can also occur after pregnancy when estrogen levels drop until breastfeeding is over or as a result of hysterectomy, in response to cancer treatment or systemic autoimmune conditions. The use of a topical estrogen cream can be remarkably effective for some patients. 

Recommended Reading

When Sex Seems Impossible

By Peter T. Pacik MD FACS

Have fear and pain stopped you from having intercourse? Are you unable to use tampons, or feel like they won't fit? Do you physically withdraw or panic during gynecological exams? If you answered "yes" to any of these questions, you may be suffering from vaginismus, a condition that affects millions of women worldwide. This book offers important medical information and first-person stories, including a new treatment option that has helped over ninety percent of my patients with severe vaginismus overcome this condition to go on to have pain-free, intimate relationships.

When Sex Seems Impossible: Stories of Vaginismus and How You Can Achieve Intimacy provides medical information about this condition and how it can be overcome. Equally important, the book shares the personal experiences of several of my vaginismus patients. These women volunteered to tell their stories in an effort to let their sister sufferers know that they are not alone, and do not need to suffer in silence. I admire them more than I can say. 

160 Pages

Odyne Publishing

Available On Amazon


When Sex Hurts: A Woman's Guide To Banishing Sexual Pain

Andrew Goldstein MD, Caroline Pukall PhD

While dyspareunia (or, painful sex) is estimated to affect millions of women, it is a condition that causes embarrassment and silence—often going undiscussed or undiagnosed. And while more doctors are beginning to recognize sexual pain as a physiological, not a psychological, condition, most are still quick to prescribe antidepressants and numbing agents to mask the pain instead of treating its cause.

Director of the Centers for Vulvovaginal Disorders Dr. Andrew Goldstein and leading researcher Dr. Caroline Pukall tackle the stereotypes, myths, and realities of dyspareunia, addressing its more than twenty different causes and offering the most up-to-date research. This book provides the long-awaited answers to so many women’s questions.

Frank, authoritative, and accessible, When Sex Hurts helps women understand why they hurt and what can be done about it.

272 pages

Da Capo Lifelong Books 

Available Through


Secret Suffering: How Women's Sexual and Pelvic Pain Affects Their Relationships

By  Susan Bilheimer & Robert J. Echenberg, MD

When one of every five women between ages 18 and 50 in the United States have sex, it hurts, often badly. Until now, very few patients ever talked about their experience until a new IC hero, Susan Bilheimer, arrived on the scene. A chronic pelvic pain patient, Susan has been a driving force in creating this book and, partnered with Dr. Robert Echenberg, now offers hope and encouragement to the millions of women struggling with this condition.

Secret Suffering: Understanding Women's Sexual Pain and How That Affects Relationships has it all. Patient stories, a husbands point of view, a same sex couples experience with pelvic pain, the dilemma confronting single women with chronic pain, faith and the poignant story of two men who experience sexual pain. They talk about the difficulties working with the medical community but the great hope promised by a new, far more accepting medical paradigm of chronic pelvic and sexual pain. The appendix offers 64 tips to relieve sexual and pelvic pain!

224 pages 

Available Through Amazon


Healing Painful Sex

Millions of women suffer from sexual and pelvic pain in America today, yet it is frequently misdiagnosed—or not diagnosed at all. In Healing Painful Sex, Deborah Coady, MD and Nancy Fish use their combined professional expertise as a doctor and therapist who specialize in sexual pain to provide readers with an understanding of its many causes and how to treat them, from both a physical and psychological standpoint. 

Organized into three parts—naming the problem, getting a diagnosis, and overcoming pain—Healing Painful Sex includes medical checklists, illustrations, vignettes based on interviews with women and their healthcare professionals, treatment options, and guidance for moving forward after healing. Coady and Fish speak honestly and directly to sexual pain sufferers' experiences, helping them address the problem of chronic pain, understand and prevent misdiagnoses, define medical terms and conditions, and regain sexual joy. 

Comprehensive, multi-dimensional, and deeply insightful, Healing Painful Sex offers women the tools to successfully take on the many challenges of sexual pain and move toward a healthy, happy future.

382 Pages

Available Through Amazon

Healing Painful Sex

Healing Painful Sex

Healing The Pain Down There

We're thrilled to announce a fabulous comprehensive new resource for women struggling with pelvic pain! This 4 DVD series was produced by a team of multi-disciplinary professionals (ob-gyn, pt, etc.) and an incredibly motivated patient who wanted to make a difference. Their point is simple. When you have pain "down there", it's very difficult to determine where the pain is coming from. This guide will not only help patients learn this, but also offers clear insight and self-help strategies for pelvic pain and pelvic floor dysfunction. Each kit also comes with a welcome guide that includes a vaginal health guide, vaginal canal map, tips for managing constipations and tips for approaching and mantaining sexual health.

One of the great tragedies that young women with pelvic pain face is the clear lack of knowledge among medical care providers about the many potential sources of pain. Not all pelvic pain originates from the reproductive tract. Some patients experience bladder pain while others struggle with the legacy of a pelvic floor muscle injury and dysfunction. Vulvodynia, lichen sclerosis, endometriosis, irritable bowel syndrome, pudendal neuralgias add diagnostic and treatment complexity. 

This groundbreaking DVD not only educates the patient but gives them the essential tools they need to find relief. Patients can’t afford to be passive. They must learn about their condition. They must work with knowledgeable care providers. They must be willing to follow every pathway as they seek to identify and treat the source of their pain. 

The Interstitial Cystitis Network proudly supports the work of Dr. Robert Echenberg and colleagues who are at the forefront of pelvic pain clinical care. They offer hope and encouragement to patients who, for years, have been ignored and/or minimized. If you have struggled with chronic pelvic pain and have not responded to therapy, we encourage you to watch this DVD. It will undoubtedly help! - Jill Osborne, ICN Founder 

4 DVD's

Available from the IC Network


Pelvic Floor Dysfunction Resources

Healing Pelvic & Abdominal Pain


Ending Male Pelvic Pain


Ending Male Pelvic Pain

By Isa Herrera MSPT, CCC

Ending Female Pelvic Pain

Ending Female Pain

Ending Female Pelvic Pain
By Isa Herrera MSPT, CSCS

Heal Pelvic Pain

Heal Pelvic Pain
Amy Stein DPT

Heal Pelvic Pain

By Amy Stein DPT

Guided Imagery To Enhance Healing For Pelvic Pain in Women


Guided Imagery To Enhance Healing For Men with Pelvic Pain


Products That May Help



Releveum - Made by Desert Harvest, this is an aloe gel with lidocaine, ideal for skin irritation 

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Desert Harvest Aloe Glide


A soothing aloe gel for irritated skin. 

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Made by Medicine Mama's Apothecary, V-Magic is an all organic intimate skin cream ideal for dryness and for patients who are uncomfortable with using estrogen. 

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Basis For Sensitive Skin


Basis Sensitive Skin Bar - Not sure what soap to turn to, the two favorite for vulvodynia patients are Basis and Dove Unscented. 

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Luvena Personal Moisturizer


The first lubricant that is both paraben and chlorhexidine free with natural enzymes. 

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ProSirona is a natural product specifically designed to reduce pelvic pain, particularly the pain of endometriosis and fibromyalgia.

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