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Pelvic Pain and Painful Sex Therapy
When sex hurts, tampons won't go in, or the thought of a pelvic exam makes your whole body brace, you are not broken. And you are not imagining it.
I'm Dr. Holly Wood, an AASECT Certified Sex Therapist helping women across California with vaginismus, vulvodynia, vestibulodynia, and painful sex. Together we untangle the fear, tension, and pain that have been running the show, working alongside your medical team so you get care for your whole body, not just one piece of it.
Virtual Therapy Across California
AASECT Certified Sex Therapist
Board Certified Clinical Sexologist
Trauma Informed & Afirming Care
Individuals & Couples
This is about more than just painful sex
Pelvic pain affects so much more than just sex.
Pelvic pain shows up in the bedroom, and it also shows up in the exam room, the bathroom, and the quiet moments when you wonder what's wrong with you. If any of these feel familiar, you're in the right place.
When sex hurts
Burning, stinging, rawness, or a deep ache during or after sex. Maybe it feels like hitting a wall. Maybe it used to be fine, and now it isn't.
When penetration feels impossible
Tampons, fingers, toys, or a speculum won't go in, or your body clamps down on its own. You've been told to "just relax," and it hasn't helped.
When OB-GYN visits feel unbearable
You've put off your pap smear for years. You tense, cry, or dissociate during pelvic exams. IUD insertions, postpartum checks, and fertility care feel terrifying, or you've left appointments feeling dismissed or hurt.
When pain shapes your relationship
You avoid a kiss in case it leads somewhere. You feel guilty, your partner feels rejected, and neither of you knows how to talk about it anymore.
Putting a Name to What You're Feeling
Genital and pelvic pain often goes years without a name. One large population study found that fewer than 2% of women whose symptoms met the criteria for vulvodynia had ever been diagnosed (Reed et al., 2012). Here is plain language for what you may be experiencing. A diagnosis comes from your medical provider. My role is to help with everything the pain has touched. These are some of the pelvic pain disorders I treat:
Dyspareunia (Painful Sex)
Dyspareunia is the clinical term for pain that happens again and again before, during, or after sex. It can be felt at the entrance or deeper inside, and it has many possible causes. Think of it as the umbrella the conditions below sit under.
Vaginismus
Vaginismus is an involuntary tightening of the pelvic floor muscles when penetration is attempted, whether with a partner, a tampon, or a speculum. It is not a choice, and it is not "all in your head." It's your body trying to protect you. Today it falls under a broader diagnosis called genito-pelvic pain/penetration disorder.
Vulvodynia
Vulvodynia is vulvar pain lasting at least three months without a clear identifiable cause. It can be constant or come and go, spread across the vulva or show up in one spot. These definitions come from a 2015 consensus written jointly by ISSWSH, the International Society for the Study of Vulvovaginal Disease, and the International Pelvic Pain Society (Bornstein et al., 2016).
Vestibulodynia
Vestibulodynia is vulvodynia located in the vestibule, the tissue around the vaginal opening. In its provoked form, pain is triggered by touch or pressure: sex, tampons, exams, even tight jeans or cycling. Provoked vestibulodynia is the most common form of painful sex in premenopausal women (Bergeron et al., 2016).
How therapy helps
Why a Sex Therapist for Pelvic Pain?
Pain is physical, and it is also learned. Once sex or an exam has hurt, your brain starts expecting it to hurt again. Your pelvic floor guards, arousal and lubrication drop, and the next attempt hurts more. Over time the fear becomes part of the pain.
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That cycle is exactly what therapy works on. In randomized clinical trials, cognitive-behavioral therapy improved more dimensions of provoked vestibulodynia than a topical steroid (Bergeron et al., 2016), and a couples version outperformed a topical numbing cream (Bergeron et al., 2021). Every body is different, but the research is clear: the mind-body side of pelvic pain is real, and it is treatable.
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What we may work on together
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Calming the fear and anticipation that tighten your body before touch even begins
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Understanding your anatomy, your pain, and your arousal without shame
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Processing medical or sexual trauma with EMDR, so your body stops bracing for danger
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Gradual, at-your-own-pace steps back toward touch and pleasure, with sex redefined beyond penetration
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Support with dilator work or home exercises your pelvic floor PT prescribes
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Rebuilding closeness and communication with your partner using the Gottman Method and Emotionally Focused Therapy
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Preparing for gynecological care so you can walk into appointments feeling informed and in control
your relationship deserves care too
Your Pain Is Real. So Is the Path Forward.
You don't have to keep pushing through, avoiding, or explaining your pain to people who don't get it. Let's talk about what's been happening and what you want instead. Your first step is a free consult call.
If you're in crisis or thinking about harming yourself, call or text 988 to reach the Suicide and Crisis Lifeline, or call 911.