新片上架：Beyond Silence 跨文化骨盆健康對談：談女性性交疼痛

Beyond Silence 跨文化骨盆健康對話 EP3:

性交為什麼會疼痛？不只是身體的問題 ft. PT Joy Jang

性交，原本應該是親密、連結與愉悅的經驗。

但為什麼對有些女性來說，卻伴隨著疼痛，甚至慢慢變成害怕、逃避與挫折？

這一集，我再次邀請美國骨盆健康治療師 Joy，一起談一個很多人不容易開口，卻非常重要的主題——女性性交疼痛（pain during sex）。

性交疼痛的原因，可能來自外陰與陰道口組織的敏感、乾澀、骨盆底肌過度緊繃、子宮內膜異位症或其他婦科問題；但疼痛往往不只是單純的「身體問題」。

當一次疼痛經驗讓人開始擔心「下次會不會又痛」，恐懼可能讓身體更加緊繃，而緊繃又讓疼痛更容易發生，逐漸形成 pain–fear–tension cycle（疼痛－恐懼－緊繃循環）。

在這集對談中，我們也分享幾個令我印象深刻的臨床故事。

有一對新婚夫妻，表面上因性交疼痛而來求助，但深入了解後才發現，兩人對於「性」、「生育」與婚姻有著截然不同的期待。

另一位女性，原本以為自己在治療時感受到的是疼痛，後來才察覺，身體真正記住的其實是多年前看生產影片時留下的強烈恐懼。

有時候，大腦未必清楚記得一段經驗，但身體仍可能保留它所產生的反應。

也因此，骨盆復健處理性交疼痛時，我們關心的不只是：

「哪一塊肌肉太緊？」

「哪個組織在痛？」

還包括：

這個疼痛如何影響她的生活、親密關係與性滿意度？

她對自己的身體是否仍然感到安全？

她是否因為害怕疼痛，而逐漸失去對親密與愉悅的信心？

我很喜歡 Joy 在這集談到的一個觀念：

復健的目的，不只是讓疼痛消失，而是幫助一個人重新建立對自己身體的安全感與信任，重新連結自己的身體。

性交疼痛不是只能忍耐的事，也不一定只有單一原因。

找到真正的原因，也找到適合自己的專業協助，才有機會一步一步重新回到舒服、自在，甚至愉悅的親密經驗。

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Beyond Silence: Cross-Cultural Conversations on Pelvic Health EP3

Why Does Sex Hurt? It’s Not Just Physical

ft. Joy Jang

Sex is often expected to be an experience of intimacy, connection, and pleasure.

But for some women, it comes with pain—and over time, that pain can lead to fear, avoidance, and frustration.

In this episode, I’m joined again by U.S.-based pelvic health therapist Joy to talk about an important topic that many people still find difficult to discuss: pain during sex.

Painful sex can be related to vulvar or vaginal tissue sensitivity, dryness, excessive pelvic floor muscle tension, endometriosis, or other gynecologic conditions. But the pain is often not purely physical.

After one painful experience, a woman may begin to worry, “Will it hurt again next time?” That fear can cause the body to tense up, and the increased tension can make pain more likely—creating what we call the pain–fear–tension cycle.

In this conversation, we also share several memorable clinical stories.

One newly married couple sought help for painful intercourse, but as the conversation unfolded, it became clear that they had very different expectations about sex, parenthood, and marriage.

Another woman initially believed that what she was experiencing in treatment was simply pain. Later, she realized that her body may have been reacting to a strong fear response formed years earlier after watching a childbirth video.

Sometimes, the brain may not clearly remember an experience, but the body may still carry the response it created.

That is why pelvic rehabilitation for painful sex is not only about asking:

“Which muscle is too tight?”

“Which tissue is painful?”

We also need to ask:

How is the pain affecting her daily life, intimacy, and sexual satisfaction?

Does she still feel safe in her own body?

Has fear of pain gradually affected her confidence in intimacy and pleasure?

One idea Joy shared in this episode really stayed with me:

The goal of rehabilitation is not only to reduce pain, but also to help a person rebuild a sense of safety and trust in their own body—and reconnect with it.

Painful sex is not something women simply have to tolerate, and there is not always a single cause.

Understanding the source of the pain and finding the right professional support can be the first steps toward returning to intimacy that feels comfortable, safe, and even pleasurable.