What Medicine Taught Me About Sex

Like most people, I’m fascinated by sex. Unlike, most people, I spend my days helping people who have problems with pee, poop, and sex (collectively known as “pelvic health”). I knew early on that this was my calling and that sexual dysfunction was my specific passion. It’s also been the one that I’ve struggled with the most.

Why?

Because I realized that my medical training wasn’t enough.

Let me backtrack. While I’m branded as a vagina coach, I work with clients of all genders. In order to do that, I have earned a Doctorate in Physical Therapy, completed residency training, and became one of fewer than 400 board certified Women’s Health Clinical Specialists in the United States. Did I mention I’m also incredibly humble?

You’d think with a background like that I’m an expert in sex. I used to think so too. In my earliest years of preaching the pelvic health gospel, I was focused on spreading the message “Sex doesn’t need to be painful!!” [For you BDSM lovers, this does not apply ;-)]. It’s a message which still needs to be shared today, because like most problems that happen “down there” painful sex is common, not normal.

The primary focus of my training was on the various types of sexual dysfunction, causes and treatment options. Maybe you’ve seen “Tightly Wound”? It’s a film about one woman’s life with vaginismus, a condition which makes penetration painful and in many cases impossible. Beyond that, there are many conditions which can contribute to sexual dysfunction. Any problems with pee or poop can contribute as there are intricate nerve, muscle, and organ connections in the pelvis. Conditions which affect your overall health, like heart problems, can also be a factor. As can surgeries in the abdomen, low back, pelvis, and/or hips. And let’s not forget that sex is an experience which involves the whole person, so mental health plays a role in our sexual function too! Depression and anxiety can be the result of or primary contributors to sexual problems.

With this training, I was able to help many people understand what was happening in their bodies and to overcome it. However, my training didn’t help my clients move past neutral to get to awesome sex. I realized that eliminating symptoms (i.e. pain or erectile dysfunction) wasn’t enough. My clients didn’t just want to be free of their problem, they wanted to be thriving sexually!

So if you are someone struggling with any problems related to sex, please understand that medical models are focused on eliminating the symptoms of your problem, not on optimizing your sexual experience. Just like the absence of disease doesn’t mean you’re thriving, the absence of sexual problems doesn’t mean you’re having amazing sex.

The sooner you understand this, the faster you will be able to find the providers (medical or alternative) who take a holistic view of sexual function. When I realized that my medical knowledge was a spring board and not the pool, I dove into the sex education pool. And I am so glad that I did. In this journey, I have learned so much!

Key breakthroughs:

  • Penis in vagina sex (AKA intercourse) is the best way to reproduce, not the best way for everyone to experience sexual pleasure

  • There are no norms for sex; no set body parts which have to be involved, number of encounters or partners

  • Shame (i.e. the belief that you are bad/unworthy) is the #1 reason people struggle to experience pleasure

  • There are different types of sexual desire (spontaneous, responsive, and contextual). Each of them is healthy.

  • Sexual satisfaction is a barometer for person’s vitality. When we are in survival mode, our sexuality suffers

  • Each of us has internalized beliefs about sex from our individual upbring, family, culture, religion, and experiences. Some beliefs help us, some are roadblocks to sexual greatness. It’s up to us to identify the beliefs getting in our way and to seek help as needed to change these

  • Vulnerability is a pre-req for great sex and orgasms

The more I learn, the more questions I have. The more I realize that we’ve been fed a boatload of BS about what great sex is, which is actually holding us back from experiencing what we want. So here’s the manifesto I’ve got going so far:

We are all worthy of sexual greatness, simply because we are human and alive. We are designed to experience all the mental, physical, and spiritual pleasure that sex has to offer. We all have the right to explore that within ourselves and to willingly share it with as many people as we each desire. We achieve sexual greatness by coming to every sexual encounter with authenticity, intention, presence, and an open heart. Sex is an experience, not a specific set of body parts coming into contact. We experience sex through our physical bodies, which are always giving us signals. Unintended pain is a signal that something needs to change; it is not a failure or betrayal.  

Each of us is responsible for understanding how we show up sexually. With partners, we understand that each of our needs is equally important and we respectfully communicate these needs. Great sex is a process of collaboration, in which everyone wins. Orgasms are incredible releases of sexual energy, not scorecards of performance. It is up to each of us to determine our sexual desires and recognize these preferences are subject to change throughout our lives. In the pursuit of sexual greatness, we must be willing to release the beliefs which do not serve us and seek help when we encounter a roadblock. By embodying these beliefs, we empower others to pursue sexual greatness in their own way.

It’s a work in progress, so take what resonates with you. If you are a provider in this specialty then I challenge you to look beyond medical models. It will be a game changer for your practice. If you are a person struggling with sex, then I encourage you to find professionals who listen to you and collaborate with you through your journey. Remember the manifesto - you are worthy of sexual greatness.

And regardless of your background, if you’ve made it this far then kudos. You are genuinely interested in the pursuit of sexual greatness and what an exciting journey that is!


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