Healing Painful Sex: A Woman's Guide to Confronting, Diagnosing, and Treating Sexual Pain

by Deborah Coady, Nancy Fish

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 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. 

Genres: Nonfiction, Sexuality

400 pages, Paperback

First published November 1, 2011

Reviews

[K · Rating 4 out of 5]

I think this book could serve as a very helpful introduction to sexual and pelvic pain to someone who is seeking or has just received a diagnosis, or for a partner trying to understand their loved one's diagnosis. I have been dealing with some of the issues described in it for over a decade and still found new information and helpful descriptions that I hadn't heard before. I wish someone had given it to me much, much earlier.

It covers a lot of ground in a field where there are many complicated, interconnected issues, few "root causes," and no easy answers. There is still an incredible dearth of research in this area and many doctors remain woefully uneducated about sexual pain and pelvic health. I would not call it comprehensive, but it is a helpful starting point and can give patients language and a sense of empowerment. It was published in 2011, so some of the information is obviously a little out of date.

This book has several major blind spots. It is highly focused on cishet women. I only remember one short section that addressed patients with woman-identifying partners, and I don't believe there is any discussion of considerations for trans or non-binary patients. As another reviewer noted, there are also gaps socioeconomic status (the price barrier to getting treatment for painful sex and pelvic pain is significant).

[Elizabeth · Rating 3 out of 5]

Healing Painful Sex: A Woman's Guide to Confronting, Diagnosing, and Treating Sexual Pain (Paperback)
by Deborah Coady

There is so much about this book that is worthwhile that it pains me to say that it doesn't address much of what to do sexually that could help. I t does give a brief but useful description of tantric practice. It does gives some ways to think about sex that are helpful.

Things that could help: off the top of my thoughts...learn what really turns you on

learn about your hot fantasies, learn about touching your body in ways that are very desirable

try touching with various sensations like silk, in the bath tub, with various oils or creams

try reading or writing your erotic fantasies

Remember that the body experiences everything in a different way when we are aroused. Front loading arousal can be very useful in planning to have sex. Consider learning new ways to have orgasms and in new parts of the body.

[Felicia · Rating 4 out of 5]

Excellent book on topic that desperately needs more research and understanding! I only gave this 4 stars instead of 5 because I wished that they included more chapters on the emotional/psychological healing component. As a psychologist and psychotherapist I would recommend this to other therapists and clients alike.

[Beth · Rating 3 out of 5]

This book has a frustrating blind spot regarding class. The authors mention up front that they don't accept insurance, and though they offer an explanation for this decision, it does ensure that their patients are all professional class and wealthy women living in New York City. Some of their advice takes for granted that readers have similar economic resources. They assume, for instance, that taking a 3-6 month hiatus from work is an option. I would be interested to see a version of this book updated with advice that is helpful to working class and poor women.

[SHIP (formerly The CSPH)]

Healing Painful Sex: A Woman’s Guide to Confronting, Diagnosing and Treating Sexual Pain is a comprehensive guide in which two women join forces to help other people suffering from sexual pain understand their individual conditions, take control of their healthcare and find treatment, and manage their personal and professional relationships. Nancy Fish and Deborah Coady both make careers out of helping others; Fish, a social worker with a master’s in public health, went through many doctors for her chronic sexual pain before arriving at Dr. Coady, a gynecologist with a practice devoted to treating sexual pain. “Painful sex” is an umbrella term that encompasses all types of sexual pain experienced by those with vaginas, from Clitorodyna, to pelvic floor or vestibular pain, to complications from IBS and hormonal changes. Sexual contact—or, in some cases, any type of contact—is excruciatingly painful for people with any of the conditions described in the book, leading to unfulfilling sex lives and possibly upsetting personal relationships.

The authors address the current medical system in the United States, which they say is not educated about sexual pain and ill-equipped for its treatment in general: doctors often have time for only 15-minute appointments with each patient, which is not enough time for adequate examination or questioning. Women suffering from sexual pain are often told that their problems are psychological, that they just need to relax and deal with it, and that their pain can’t possibly be as debilitating as they claim. This isn’t an anti-doctor or home remedy/holistic medicine book, though: Dr. Coady and Fish acknowledge the limits of Western medicine while teaching their readers how to navigate within these limits to achieve freedom from pain. It might take many visits to many doctors, it might take the cooperation of several specialists and physical therapists, and won’t be quick, but individuals who suffer from sexual pain can reclaim their bodies and their sexualities; they can heal.

However, the authors make it clear that this isn’t a diagnostic book, as diagnosing and treating sexual pain isn’t easy. The pain sufferer (often addressed as “you”) is brought first to a place where the sufferer can articulate the types of pain they are feeling, and then the book describes a litany of different types of sexual pain in subsequent chapters. In these chapters, the types of pain and typical reasons for the genesis of the pain are listed and discussed with the purpose of educating the sufferer and providing them with articulate information to bring to a healthcare provider.

Perhaps the most useful and original part of this book is how the authors arm pain sufferers for their meetings with doctors. Urging the patients to be their own best advocates, the authors provide pain sufferer with scripts and suggestions for having a conversation with a doctor to determine whether or not the doctor will be able to treat their condition. Dr. Coady knows, as a practicing gynecologist, that many doctors are overtaxed as is and don’t have the time or funds to help sufferers of chronic pain, and that, crucially, this isn’t their fault. Pain sufferers are coached to be choosy about their doctors but not to see them as adversaries or obstacles to healing. Ultimately, the chosen doctor or doctors should believe that sexual pain is not psychological, should understand that many visits and perhaps more than one doctor will be needed, and be willing to either do research into specific types of sexual pain or accept the patient’s own research (from scientific journals, and other legitimate non-internet sources, of course).

There can be no telling how long pain will last in many cases, or how long it will take to heal. Fish and Dr. Coady make sure to talk about the psychological toll that sexual pain can have not only on pain sufferers, but also on sex partners and family members of those suffering. Those without partners are not left out of the “relationships” conversation, as the authors give advice for those who have begun to heal and are interested in dating. Additionally, the authors discuss navigating the workplace with a condition that most sufferers don’t wish to make openly known. Suicidal thoughts are common in sufferers of sexual pain, and Dr. Coady and Fish address this often, stressing that if any pain sufferer finds that their thoughts are turning into suicidal plans that they need to go immediately to an emergency room.

Healing Painful Sex is a must-read guide for any female-bodied individual suffering from sexual pain who has been unable to get adequate care, as well as anyone in a sexuality profession that could encounter someone asking them for advice about sexual pain. It’s truly comprehensive in scope and compassionate in tone, while offering practical advice for how sufferers can learn to work with medical providers to get better. Deborah Coady and Nancy Fish aren’t offering any sort of cure-all or product, they simply want sufferers of sexual pain to know that treatment is available, and how to advocate for that treatment in a cooperative and effective manner.

More information about the book and the authors’ contact information can be found at http://healingpainfulsex.com/.