The pain is always there. Sometimes it's a dull ache. Sometimes it's sharp enough to stop you mid-sentence. It's in your pelvis, that deep, central part of your body where you're supposed to feel pleasure, not suffering.
You've seen doctors. You've had tests. You might have a diagnosis. You might not. Either way, the pain persists. Six months, a year, years, it becomes part of who you are.
And at some point, you realise: this pain has taken your sexuality hostage.
In the UK, chronic pelvic pain affects approximately one in four women, a rate comparable to asthma and back pain. Yet unlike those conditions, pelvic pain sits in the very centre of your sexual anatomy. Every structure involved in pleasure, the clitoris, vulva, vagina, uterus, bladder, becomes a potential source of pain instead.
Let's talk about what it's like to live with chronic pelvic pain, and how embodiment practices can help you navigate intimacy when your pelvis has become a place of suffering.
The Pain That Colonises Your Life
It's there when you wake up. It's there when you're trying to work, when you're sitting in traffic, when you're attempting to have a conversation. It flares when you try to have sex. It aches when you walk. Sometimes it's manageable, a dull background hum you've learned to ignore. Other times it's sharp enough to stop you breathing.
You've learned to calculate everything around it. Can I make it through this meeting? Should I take painkillers now or save them for later? Is today a day I can attempt intimacy, or will I pay for it tomorrow?
The pain dictates your wardrobe, nothing tight around your waist or pelvis. It dictates your social life, you cancel plans when flares hit. It dictates your relationship, your partner reaches for you and your first thought isn't desire, it's will this hurt?
You've seen doctors. Multiple doctors. You might have a diagnosis, endometriosis, interstitial cystitis, adhesions from surgery, pelvic inflammatory disease, nerve damage. Or you might not. You might have had every test come back "normal" whilst your body screams otherwise.
Either way, six months turns into a year turns into years. The pain stops being something happening to you and becomes something you are. You're not just a person anymore. You're a person with chronic pelvic pain. And that changes everything.
When Your Body Becomes the Enemy
Chronic pelvic pain does something particularly cruel: it takes the very centre of pleasure and turns it into a source of suffering.
The structures meant for intimacy and connection, your genitals, your pelvis, your inner body, become sites of betrayal. Touch that should feel good doesn't. Arousal that should build toward pleasure gets hijacked by pain instead.
And over time, your relationship with your body fundamentally changes. You stop trusting it. You stop inhabiting it. You live from the neck up, disconnected from everything below your waist, because being present in your pelvis means being present in pain.
Your body becomes something to manage rather than something to enjoy. Something to medicate, to stretch, to carefully position, to negotiate with. Please, just let me get through today. Please, just this once, don't hurt.
But it does hurt. Again and again, it hurts.
The Fear-Pain-Tension Spiral
Here's what happens when pain persists for months and years:
Your nervous system learns. Pelvis = danger. Intimacy = pain. Sexual touch = threat.
The next time your partner initiates, the next time you consider masturbation, the next time you contemplate whether today might be a "good day" to try, your body mobilises its defences before you're even consciously aware.
Your pelvic floor muscles tighten. Your breath becomes shallow and held. Your entire pelvis braces for impact. This happens automatically, beneath conscious control, your nervous system trying to protect you.
But this protective response makes everything worse. Tight muscles restrict blood flow. Shallow breathing increases overall body tension. The bracing itself creates pain. And then when you do attempt intimacy, the tightness makes penetration more painful, which reinforces the fear, which creates more tension, which creates more pain.
You're stuck in a loop: Pain → Fear → Muscle tension → More pain → Greater fear.
And somewhere in that loop, something else happens. You start avoiding. Not just sex, though yes, sex becomes something you make excuses about, something you feel guilty about avoiding. But you also avoid thinking about your pelvis at all. You avoid being present in that part of your body. You disconnect.
Because if you're not present in your pelvis, you can't feel the pain as acutely. But you also can't feel anything else. No pleasure. No arousal. No aliveness. Just... absence.
The Medical Trauma
If you've been living with chronic pelvic pain for years, you've probably also been accumulating medical trauma.
The GP who suggested you were stressed and needed to relax. The consultant who said your scans were normal as if that invalidated your pain. The specialist who implied you were exaggerating. The procedure that was supposed to help but made things worse.
You've had people imply, or state outright, that the pain is "in your head." As if pain being processed by your brain somehow makes it less real. As if your suffering is a choice or a failure of will.
You've learned not to trust that medical professionals will believe you. You've learned to downplay your symptoms because saying how bad it really is makes you sound "dramatic." You've learned that "I'm in pain" is often met with a shrug and "that's just how it is for some women."
So you stop seeking help. Or you seek help but don't fully trust it. You become your own researcher, your own advocate, exhausting yourself trying to understand what your own body is doing and why no one seems to take it seriously.
What Chronic Pelvic Pain Does to Your Sexuality
Research shows that women with chronic pelvic pain report more sexual problems than women with any other type of chronic pain. But the statistics don't capture what it actually feels like.
It feels like grief. Grief for the sexual self you were before pain. Grief for spontaneity, the ability to simply want someone and act on it without calculation. Grief for your body as a source of pleasure rather than a problem to solve.
It feels like disconnection. You're there physically during sex, but you're not present. You're monitoring the pain levels, bracing for the sharp stab you know is coming, counting down until it's over. Your partner is touching you, but you're somewhere else entirely.
It feels like guilt. Your partner reaches for you and you tense. They suggest sex and you make excuses. Again. They stop initiating and you feel relief mixed with shame. The gap between you widens. Neither of you knows how to bridge it anymore.
It feels like fear. Not just fear of pain, though that's there. Fear that this is permanent. Fear that your sexuality is gone. Fear that no amount of treatment will bring it back. Fear that your partner will leave. Fear that even if they stay, the intimacy you once had is lost forever.
And underneath all of it: rage. Rage at your body for betraying you. Rage at a medical system that often can't or won't help. Rage at having to choose between pain-free existence and sexual connection. Rage at the unfairness of it all.
The specific ways it manifests:
Penetration becomes impossible or excruciating, not just because of the original pain source, but because your pelvic floor has learned to guard, tightening involuntarily the moment penetration is attempted.
Desire disappears, not because you don't want intimacy, but because your nervous system has filed sex under "danger" and shut down arousal as a protective mechanism.
Arousal becomes difficult even when you want it, blood flow to your genitals is affected, lubrication decreases, your body simply won't cooperate.
Orgasm changes or vanishes entirely, the muscle contractions hurt, or the buildup of tension triggers pain, or you've become so disconnected from your pelvis that orgasm is no longer accessible.
And through it all, the exhaustion. Managing chronic pain is exhausting. Navigating intimacy with chronic pain is exhausting. The constant vigilance, the calculations, the disappointment, it's all so deeply, relentlessly exhausting.
The Weight You Carry
There's research that quantifies this: 31% of women with chronic pelvic pain experience high symptom-related anxiety, compared to just 7% of women with period pain. But numbers don't capture the actual weight of it.
The weight of being told your pain isn't real whilst living in a body that screams otherwise.
The weight of seeing test results come back normal and feeling simultaneously relieved (it's not cancer, it's not something terrible) and devastated (so why does it hurt this much? why won't anyone believe me?).
The weight of becoming "the one with chronic pain", that person who can't commit to plans, who has to leave early, who needs accommodations, who's always apologising for their body's limitations.
The weight of watching your partner's patience wear thin. You see it in their eyes, the frustration, the resignation, the way they've stopped hoping that tonight might be different. You see them pulling away emotionally because staying close hurts too much when physical intimacy has become a minefield.
The weight of medical trauma accumulating. Each dismissive doctor, each failed treatment, each invasive procedure that made things worse, they stack up. You become wary of hope. You stop trusting that help is possible. You stop seeking it.
The weight of isolation. You can't talk about this at work. You can't explain it to friends who don't understand chronic pain. You can't adequately convey what it's like to have pain located in the most private, unspeakable part of your body. So you suffer alone, your experience invisible even to the people closest to you.
And perhaps heaviest of all: the weight of not knowing if this is forever. Years pass. You try treatment after treatment. Some help a little, some make things worse, none provide the relief you desperately need. And you start to wonder, is this just my life now? Is this all I get?
The grief of that realisation is enormous.
What Happens to Grief in the Body
Here's what most people don't understand about grief, rage, fear, and all the other emotions that come with chronic pelvic pain: they don't just live in your mind. They live in your body. And when you can't or won't feel them fully, they become part of the pain itself.
Your pelvis holds more than just your reproductive organs. It holds memories. It holds trauma. It holds the emotions you've pushed down because they were too big, too frightening, too socially unacceptable to express.
The rage at your body for betraying you? That creates tension. The grief over your lost sexuality? That creates holding patterns in your pelvic floor. The fear that this is permanent? That keeps your nervous system locked in threat mode.
You can talk about these emotions in therapy. You can intellectually understand them. But if you never actually feel them, if you never let them move through your body, they stay stuck. And stuck emotions become chronic tension, which becomes chronic pain.
This is where embodiment work becomes essential in a way that's different from medical treatment.
Medical treatment addresses the physiological source of pain. Embodiment work addresses what your body has done to protect you from that pain, the ways you've held, braced, disconnected, and shut down. And part of that work is learning to actually feel what you've been avoiding feeling.
Not thinking about it. Not analysing it. Actually feeling it, in your body, and allowing it to move.
Grief Needs Witnessing, Not Fixing
When you've lost your sexuality to chronic pain, there's real grief. You're mourning something tangible, your sexual self, your spontaneity, your ability to experience pleasure without fear.
Most people try to think their way through grief. They try to be rational about it, to find the silver lining, to "stay positive." But grief doesn't respond to rational argument. It responds to being witnessed, held, and allowed to move through you.
In embodiment work, we don't try to fix your grief or talk you out of it. We create space for it to be present. We notice where it lives in your body, perhaps as heaviness in your chest, tightness in your throat, an ache in your pelvis. We allow it to be there without trying to change it.
And often, when grief is finally witnessed rather than pushed down, something shifts. The tension that's been holding it in place can begin to release. The pelvic floor that's been guarding against feeling can begin to soften. The breath that's been shallow and held can deepen.
This isn't about "releasing emotions" in some dramatic cathartic way, though that sometimes happens. More often, it's quiet. It's simply being present with what is, in your body, without needing to fix it or make it go away.
Your body holds the grief. Your body also knows how to process it, when you finally give it permission to do so.
What Embodiment Offers
Medical treatment for chronic pelvic pain is essential. Finding and treating underlying causes, managing pain with medication, working with specialists, all of this matters.
But medical treatment alone is often insufficient to restore sexuality. Because sexuality isn't just about whether your body hurts. It's about:
- Whether you feel safe in your body
- Whether you can be present with sensation
- Whether your nervous system allows arousal
- Whether your pelvic floor can soften
- Whether you can connect with pleasure rather than only bracing for pain
This is where embodiment practices become essential.
Nervous System Regulation
When you've lived with chronic pain for months or years, your nervous system shifts into a constant state of vigilance. You're perpetually in "threat mode", scanning for danger, braced for pain, unable to fully relax.
This nervous system state is incompatible with arousal and pleasure. Sexual response requires your parasympathetic nervous system (rest and digest) to be online. But chronic pain keeps you stuck in sympathetic activation (fight or flight).
What this looks like in practice:
Begin with practices that signal safety to your nervous system:
- Deep, slow breathing that reaches your belly
- Gentle movement that doesn't trigger pain
- Time in nature or other soothing environments
- Touch that feels good (self-massage of hands, scalp, feet)
- Activities that bring genuine joy or calm
These aren't "nice-to-haves." They're essential retraining for a nervous system that's forgotten what safety feels like.
Pelvic Floor Awareness
Chronic pelvic pain almost always involves pelvic floor dysfunction. Your pelvic floor muscles, the hammock supporting your pelvic organs, become chronically tight, guarding against pain.
This chronic tension creates its own problems. Tight muscles restrict blood flow, compress nerves, and make penetration painful even when the original source of pain has been treated.
What this looks like in practice:
Work with a pelvic floor physiotherapist who understands pain. Not all pelvic floor work is the same, you need someone who knows the difference between strengthening tight muscles (which makes things worse) and releasing chronic tension (which actually helps).
At home, practice pelvic floor awareness:
Lie comfortably with knees bent. Bring attention to your pelvic floor without trying to do anything. Just notice. Is there tension? Holding? Tightness?
Practise gentle releases. Imagine your pelvic floor softening with each exhale. Don't force it. Just invite. Just allow.
This takes time. Chronically guarded muscles don't release quickly. But over weeks and months, you're teaching your body: You're allowed to soften. You're safe enough to let go.
Reconnecting with Sensation (Slowly)
When your pelvis has been a source of pain for so long, you learn to disconnect from sensation there. It's protective. Why would you want to be present in a part of your body that hurts?
But this disconnection means you also lose access to pleasure. Because pleasure requires presence. It requires being able to notice sensation without immediately categorising it as "pain" or "threat."
What this looks like in practice:
This work must be trauma-informed, slow, and entirely under your control.
Begin with non-genital touch. Your arms, your belly, your thighs. Use different kinds of touch and notice what feels pleasant, neutral, or uncomfortable. You're relearning that touch can be safe.
Over time, weeks or months, you might bring exploratory touch closer to your pelvis. External only. No goals. No expectations. Just noticing: Can I be present with this sensation? Does it feel pleasant? Neutral? Do I need to stop?
You're teaching your nervous system that touch doesn't automatically mean pain. That you have agency. That you can explore on your terms.
Pleasure Beyond Penetration
For many women with chronic pelvic pain, penetrative sex remains painful or impossible even after treatment. And that can feel devastating, like your sexuality is gone.
But penetration isn't the sum total of sexuality. When penetration is off the table, you have an opportunity to discover:
- The extraordinary pleasure available through clitoral stimulation
- What full-body sensual touch feels like
- How breath and energy can create intense sensation
- The intimacy possible through eye contact, skin-to-skin contact, being held
- That pleasure can exist without performance or goal-orientation
This isn't consolation. This is expansion. Many women report that chronic pain, though initially devastating, ultimately broadened their sexuality beyond what they'd previously imagined.
Working with Anxiety and Depression
The research is clear: anxiety and depression don't just accompany chronic pelvic pain, they actively contribute to sexual dysfunction.
If you're living with depression or anxiety, addressing your mental health is part of addressing your sexuality. This might mean:
- Therapy (particularly CBT or trauma-focused approaches)
- Medication if appropriate
- Mind-body practices like mindfulness or yoga
- Peer support groups for chronic pain
And if you have a history of sexual abuse or trauma, which is common in women with chronic pelvic pain, working with a trauma-informed therapist is essential. The pain in your pelvis might be partly held trauma expressing itself somatically.
Partner Communication
Chronic pain affects relationships. Partners feel rejected. You feel guilty. Intimacy becomes a minefield of unspoken tension.
What helps:
- Name what's happening: "My body is in pain. It's not about you. I still desire connection with you."
- Redefine intimacy: What forms of connection feel good? Being held? Massage? Eye gazing? Talking?
- Communicate in the moment: "This position isn't working." "Can we slow down?" "That feels good."
- Plan for good days: If your pain fluctuates, take advantage of lower-pain days
- Get support together: Couples therapy or sex therapy can help navigate this
Your partner can't fix your pain. But they can witness it. They can adapt with you. They can help you discover new forms of intimacy.
Medical Treatment Alongside Embodiment
Embodiment practices work best alongside medical treatment, not instead of it.
If you haven't already, see your GP and ask for referral to specialists as appropriate. Medical treatment might include:
- Diagnostic laparoscopy to identify causes
- Treatment for specific conditions (endometriosis, IC, etc.)
- Pain management strategies
- Pelvic floor physiotherapy
- Nerve blocks or other interventional treatments
- Medication (hormonal, pain relief, nerve pain medications)
- Multidisciplinary pain clinics
Medical treatment addresses the underlying pathology. Embodiment work addresses how your nervous system, pelvic floor, and psyche have adapted to protect you from pain. Both matter.
What's Possible
If you're in the thick of chronic pelvic pain, it's hard to imagine that things could ever be different. That sex could ever feel good. That your body could ever be a source of pleasure rather than suffering.
But even with ongoing pain, change is possible. Not a return to your pre-pain self, that's not realistic. But a new relationship with your body that includes:
- Reduced pain intensity and frequency
- Improved ability to manage flares
- Reconnection with your pelvic floor and genitals
- Discovery of forms of pleasure that work with your body now
- Restored intimacy with partners (or self)
- Reduced anxiety and increased sense of safety
This work takes time. It's measured in months and years, not days and weeks. But every woman who has walked this path reports the same thing: it's worth it.
Your pelvic pain might never completely disappear. But it doesn't have to destroy your sexuality.
Take the First Step
Every journey begins with a conversation. Book a complimentary 60-minute discovery call where we’ll discuss where you are, what you’re seeking, and find the best approach for your unique journey.
No pressure, no obligation, just an opportunity to explore what’s possible.
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