Healing Painful Sex

A Woman's Guide to Confronting, Diagnosing, and Treating Sexual Pain


Healing Painful Sex
 is the only book on the market that provides a comprehensive deep insight into the medical and psychological treatment of women suffering from sexual pain conditions. Both Deborah Coady, MD’s medical expertise and Nancy Fish’s MSW, MPH, personal experience with sexual pain and her extensive professional experience as a psychotherapist provide readers with an all-inclusive understanding of the medical causes of these complex conditions as well as multi-dimensional medical and psychological treatments. The book includes numerous patient vignettes based on women suffering from sexual pain and interviews with healthcare professionals treating women with sexual pain. 

The book is organized into three parts. The first section explains how common sexual pain is and offers the promise of the book: physical and psychological recovery from sexual pain. Dr. Coady and Nancy Fish speak honestly and directly to the reader’s experience, helping her to become comfortable with the topic and aware that this a problem that can be talked about, in preparation for absorbing and acting on the medical and psychological information in the chapters to come. We help women make sense of their medical experience up to now, helping them evaluate what has happened to enable them to move forward with optimism and assertiveness. A medical checklist helps to make sure their doctors are exploring all the latest diagnostic strategies to find out what is causing their pain and how it should be treated. We help our readers go into their medical office visits armed with all the personal and medical information the doctor needs to know about them.

The second part of the book focuses on all the possible medical diagnoses, and is organized around patients' stories, possible treatments, and an integrated medical/psychological approach to overcoming sexual pain. The third section helps women redefine their sexuality, focusing on their entire being, and provides guidance for re-entering an active and fully responsive sexual life both during treatment and after recovery. As sexual healing takes place, the destructive after-effects can be repaired, and we offer concrete guidance on how to move into the future. 

In summary, Deborah Coady’s extensive clinical experience and knowledge provides practical information to readers that no other doctor in this country has offered. Nancy Fish provides an understanding of the overwhelming challenges women face because she has faced and overcome many of the difficulties of sexual pain.
Male Genital Pain

Although this book is primarily about female sexual pain, we would be remiss if we didn’t mention that male genital pain is also an extremely serious and prevalent problem. The statistics about how many men suffer from genital/sexual pain is unknown, but we do know that their physical and emotional pain is as serious as it is for women. And the misdiagnoses and mistreatment men receive from medical professionals is as common. Most men with genital pain see a urologist as the primary medical contact. Most often when men report genital pain, they receive a misdiagnosis of chronic prostatitis or infection because very few urologists understand the roots of this type of pain. They may undergo many unnecessary tests and procedures and most likely do not receive relief from their pain. As in the case with women, they go from doctor to doctor in a frustrating attempt to find a proper diagnosis and treatment for their often debilitating conditions.

Many men might suffer from medical conditions such Pelvic Floor Dysfunction, a labral hip tear, or pudendal neuralgia.

Recently, Deb received an email from an educated man who works in the medical publishing field. He related his intense physical and emotional pain.  According to Jim, “I will tell you that this experience has been very hard on my life, my wife and my kids – mostly because of the terrible genital pain that went undiagnosed for 3 years and treated with drugs that have terrible side-effects.  How anyone can function on Lyrica, Elavil, Nortriptyline, Neurontin or even Flomax for that matter is unbelievable.  I would say this as it relates to pain in the male genitals – having the feeling like broken glass or steel wool is in your genitals is a terribly heartbreaking and earth shattering experience, most men never think about their genitals as women do because of their cycle or pregnancy.   I was in very dark places for a while trying to figure out how such a terrible thing could have happened to my “manhood” when I’m in perfect health, monogamous, with two kids and living a very clean lifestyle.   I guess the years of martial arts, running and working out contributed to the labral tear in my hip and all the compounding symptoms.” 

Nancy has been treating a man who is also quite educated and works in the medical field. About a year ago he began to experience severe rectal and genital pain and has seen numerous doctors without getting any relief. One doctor did finally diagnose him with Pelvic Floor Dysfunction and referred him to physical therapy. He has made considerable progress with physical therapy.

When Jay first sat down in Nancy’s office he apologized for the way he sat on her couch. “I have to sit so close to the edge like this or else I am in horrible pain. Sitting has been an awful problem for me,” said Jay.

He became extremely frustrated with the medical system and its failure to adequately diagnose and treat his condition. He also experienced shame and embarrassment about suffering from such an intimate condition. He does have a good support system and wife, but his pain level has severely affected his marriage and level of functioning.

“There are days when I can’t stop thinking about the pain and am so afraid it will never get better. And I am constantly asking my wife why this is happening and if there is anything else I can do,” commented Jay. “I also have a hard time accepting that Pelvic Floor Dysfunction is what is really causing my pain. I feel that there must be another medical explanation for my pain. And the fact that I don’t know if I will ever totally recover, scares me to death,” added Jay.

Jay’s wife, Carol, also expressed great frustration and anger about their situation. “I feel like this had taken over our life and I get so frustrated and angry with Jay because this has become the focus of our life,” said Carol. “I also feel guilty about feeling angry and feel so helpless much of the time,” added Carol.

Men should also have a great deal of hope that their genital/sexual can improve and be treated successfully. Physical therapy is an excellent treatment option for men. Other options include surgery if a labral hip tear is diagnosed. Also, there are some very competent pain management specialists that can treat their conditions with various medical interventions including pudendal nerve blocks and epidurals.

The physical and emotional anguish that men experience is very similar to what women feel but their prognoses are equally also as hopeful.