Sex Therapist on Pelvic Pain and Trauma: When the Pain Itself Becomes the Trauma

What happens when pelvic pain improves, but your body still expects sex to hurt?I'm joined by Romi Terk Brudno, a sex therapist specializing in pelvic pain and painful sex.Drawing on her own experience of ulcerative colitis and painful sex, Romi explores avoidance, feeling "broken," and the gap between progress in pelvic floor PT and feeling safe during intimacy. We discuss trauma-like responses to pain, sexual motivation, and how diagnostic labels and research gaps can shape access to care.For anyone whose pain has improved but who still feels on guard, or who's wondered whether their experience deserves support.Sponsors: The Pelvic People, makers of the Ohnut and the Kiwi. 15% off with code TWTC15 at thepelvicpeople.com/twtc Origin, in-network pelvic floor PT. Get your first month of On Track free with code TWTC at theoriginway.com/twtcRomi Terk Brudno: Instagram: @thepelvicpress Website: romiterk.comConnect with Mathilde: Instagram: @theworldstightestcommunity Website: theworldstightestcommunity.com Newsletter: https://tinyurl.com/4h4snzzd Support the podcast: https://tinyurl.com/mtxnzhsd00:00:00 Introduction, Romi Terk Brudno 00:02:12 Pain, Trauma, Gaps in Care 00:03:53 Vulvodynia, Medical Dismissal 00:05:58 Romi's Story, Ulcerative Colitis 00:07:10 Pain Without Sexual Trauma 00:09:02 Avoidance, Bracing, Isolation 00:10:40 Supporting the Podcast 00:11:10 Gut Pain, Pelvic Floor Tension 00:12:57 Pain, Learned Threat 00:13:55 Anger, Missed Screening 00:14:41 Therapy, Persistent Bracing 00:16:03 PT Progress, Intimacy 00:17:39 Chronic Pain, Trauma Responses 00:18:47 PTSD Criteria, Core Beliefs 00:19:49 Pain Reprocessing, The Way Out 00:21:39 Sexual Pain, Identity 00:22:22 Sex, Pressure, Motivation 00:23:32 Pleasure, Connection 00:24:47 Sponsor: Origin 00:27:01 Sponsor: The Pelvic People 00:29:48 Diagnosis, Access to Care 00:31:58 Trauma-Informed Care 00:33:18 Trauma, Agency, Safety 00:34:20 Modern Life, Stress 00:35:50 Nervous System, Stress Relief 00:37:32 Research Gaps 00:39:21 Self-Worth, Deserving Care 00:40:02 Persistent Pain, Self-Blame 00:41:45 Social Support, Protective Factors 00:43:01 Pain Validation 00:44:15 Tool: Trusting Your Experience 00:45:14 Tool: Self-Compassion 00:45:50 Working With Romi 00:46:54 Staying Connected