Sex Therapy · Behavioral
Sexual Pain — Pacing Plan
Un-learn the pain-fear cycle
For dyspareunia, vaginismus, vulvodynia, or post-surgical pain: a pacing plan that protects the nervous system from pain-fear conditioning while a medical workup and pelvic-floor PT run in parallel.
Rule out and refer first
This sheet supports psychotherapy alongside a medical evaluation. Persistent pelvic pain warrants pelvic-floor PT, GYN or urology consult, and often a specialist team. Do not use this in isolation.
Pain-fear cycle — where you are
What the pain feels like (sharp / burning / pressure / deep / entry / other)
What you've stopped doing to avoid it
What you fear will happen if the pain comes back
Graded plan — smallest tolerable step
Step
What's included / off-limits
Pain 0–10 during
Repeat until reliably 0–2
Communication script with partner — how you'll signal to pause
Pain is a stop sign, not a hurdle
Pushing through re-teaches the body that sex hurts. Every step should be sub-threshold. The goal is un-learning fear, not endurance.