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Stressed Woman

Women's Sexual Health Counseling in Dallas, Texas

Physical and mental health are connected in many ways. When our mental health suffers, physical problems can occur, and vice versa. Sexual intimacy may be the strongest example of this connection. Dyspareunia is pain that occurs before, during, or after sexual intercourse. There are many possible causes for dyspareunia, such as physical injury, hormonal factors, vaginal dryness, and emotional issues.


Pain with intercourse is extremely common. Three out of four women will experience it at some point in their lives. Emotional issues that contribute to dyspareunia can be related to how someone feels about having sex, such as being anxious, embarrassed, or fearful. Traumatic events like sexual assault or sexual abuse can also be major causes of dyspareunia. In all these cases, seeing a therapist is the best way to treat dyspareunia.


How Do Emotional Issues Cause Dyspareunia?


Certain emotions cause the muscles in the vagina to constrict or spasm, making sex uncomfortable or painful. The pain may begin when sex is anticipated, during sex, or even hours afterward. Pain can occur in the vagina or elsewhere in the pelvic region, lower back, bladder, or uterus. The area affected by pain can help determine whether there’s a physical explanation rather than an emotional one. It’s important to rule out physical problems that may be causing pain. Then, you should consult with your doctor to determine whether the problem is physical or emotional.


There are several ways emotions and mental health factors can result in painful sex. Generally, they’ll cause pain either through vaginal dryness or vaginismus, spasming the muscles in the vagina. Here are a few examples:


  • Fear or anxiety around having sex

  • Body image issues

  • Lack of emotional connection or attraction to your partner

  • Shyness or embarrassment

  • Previous sexual trauma, including sexual abuse or sexual assault


Sex involves not just physical intimacy but emotional intimacy as well. That’s why sexual trauma like abuse and rape is so damaging—it affects the core of who you are and how you view yourself. Having sex with someone, even if you love and feel emotionally connected to that person, means being vulnerable. It can reveal issues you may not have realized there.

How Therapy Can Help With Sexual Issues

At Therapy With Abby, I specialize in treating patients struggling with painful sex. I have standing relationships with doctors who treat these issues, and we work as a team to address the problem. When you begin therapy for dyspareunia with me, you may or may not have an idea of what’s causing it, but you should have been checked for physical causes by a doctor. I’ll complete an assessment and work with you and your doctor to identify why you are having pain with sex. We’ll build a targeted treatment plan to have a healthy sexual relationship with your partner.


If your issues are anxiety-related, we’ll confront the negative thoughts, feelings, and beliefs you have related to yourself and/or sex. We’ll discuss where they might have come from and how they influence your behavior. Increasing your self-confidence and your ability to be kind and affirmative with yourself is key to intimacy and vulnerability.


If you have suffered the trauma of a sexual nature, you should know that confronting this topic won’t be easy. Talking about sexual trauma is triggering and will likely be upsetting. At the start of therapy, we’ll discuss what you can expect from therapy and build coping skills to help you through painful thoughts or feelings that arise during the process.

I hope that after reading about how I address female sexual issues at Therapy With Abby, you feel hope for your own intimate relationship. I opened my counseling practice in Dallas, Texas, to help local women like you feel confident and connected. To ask a question, discuss further, or schedule a first session, contact me today.

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