Interview with Sex Therapist Dr. Rose Hartzell (Part 3)

interview with sex therapist Dr. Rose Hartzell - when sex hurts there is hope

Finally, the rest of the amazing feedback from Dr. Rose Hartzell, PhD, EdS, CHES, LMFT, Sex Therapist at San Diego Sexual Medicine. Here is part 3 of my interview with this remarkable woman.




10. The message of my blog is that when sex hurts there is hope. Do you think that is true, and if so, in what way?

Oh my gosh, yes, because I‘ve seen so many people who had pain and then did not have pain.  Or who have pain but ended up living the life they want, whatever that might be.  Having pain doesn’t have to mean the end of the world or even that you’ll never have a good sexual relationship.  I just had a couple the other day that the woman said “I can’t imagine ever having a normal healthy sex life,” but you can, I’ve seen it.

11.  Many sufferers of sexual pain go years without finding help for their suffering. As a community of patients and practitioners, how do you think we can reach those suffering from painful sex to find hope and help sooner?

I agree with everything you just said and sometimes I see people who for 20 years they’ve had pain and never saw hope. Continue reading

Interview with Sex Therapist Dr. Rose Hartzell (Part 2)

There was just so much great content from my interview with Dr. Rose Hartzell, PhD, EdS, CHES, LMFT, Sex Therapist at San Diego Sexual Medicine. I had to break it up so you could take it all in. Here is part 2!

6.  In your experience, what have you seen to be the most common difficulty or challenge that couples face when one partner suffers from painful sex?

My honest answer of what I have seen across the board as the most common difficulty is acceptance that other sexual activities are sex.  If a woman has pain, often it is the woman that has the hardest time with this.  Exploring ways to bring pleasure to each other can be a fun experience for couples and is not so emotionally charged.  Often women will say that if I can’t have intercourse, why even bother.  And sex becomes about performance or reaching a goal.  But, I hear a lot of the men say, “I will take anything, I would be happy with oral sex or I can masturbate, I just want to be close to my partner again.  I just want her to touch me.”  Not every man is the same, but in general that is what I have noticed.

7.  Does your answer to the previous question change depending on whether the partner suffering from pain is male or female, and if so, how? Continue reading

Interview with Sex Therapist Dr. Rose Hartzell (Part 1)

interview with sex therapist Dr. Rose Hartzell - when sex hurts there is hopeI recently had the honor of interviewing Dr. Rose Hartzell, PhD, EdS, CHES, LMFT. She is the resident Sex Therapist at San Diego Sexual Medicine, the premier center for sexual health, and is responsible for addressing the sexuality, relationship, and intimacy concerns of individuals and couples who attend the clinic, many of whom suffer from sexual pain.  Here are some of the insights she shared.


1.  What made you decide to become a sex therapist?

I took a roundabout way of getting there.  I started off as a sex researcher and then realized that, although doing research was interesting, I found that a lot of people would come to me with questions.  I decided that I really like helping people better.  Research is helping people, but helping people as a therapist is more one-on-one, or two-on-one.  So I went back to school and while I was working on my PhD I added a Masters and then an EdS in therapy.

On a more global level, I like talking to people about things that they can’t talk about with anyone else.  Sex is something that is really important to people, but often times they have difficulty talking about it.  And for some reason God granted me the gift of feeling comfortable talking about sex, so I like to help other people feel more comfortable talking about it and have more satisfying sex lives.

2.  You are part of the team at San Diego Sexual Medicine. What type of work do you do there? How does your role fit into the larger goal of the center?

Here at San Diego Sexual Medicine we take a bio-psycho-social approach or a holistic perspective.  The kind of people I see here is usually different than the average sex therapist would see because a lot of times the people that we see here are people that have a physical component. So I often see people who have some type of physical issue that has affected them psychosocially.  My role here is for both men and women, to help them to see how whatever happened to them (erectile dysfunction, low sexual desire or whatever it is) is impacting themselves and their relationships, and how to get what they want out of their sex lives.

I have been working in this office for four and a half years and I love my job.  I can’t think of anything cooler.

3.  How does sex therapy differ from other types of psychotherapy or counseling? Continue reading

The path to a right diagnosis (this is my story…part 4)

The pain continued, and in some ways seemed to get worse.  But in the end it wasn’t the pain itself that led me to start my search again.  By now the far reaching effects of sexual pain had imbedded themselves into my subconscious.  Sex always led to pain, and physical affection often led to sex.  Thus, I eventually started avoiding affection altogether.  My husband took about as much as he could handle and finally confronted me about it.  It was this reminder and realization that my marriage lay in the balance which gave me the momentum to begin my journey again.

With the psychological effects becoming clear, the next step on my path was to see a sex therapist.  She had some positive advice on how to start the process of unraveling the psychological aspects of prolonged pain association.  The relaxation techniques she taught me were very helpful, but it became clear that we couldn’t make any real progress without first addressing the medical cause of my pain.

She referred me to a gynecologist who specialized in sexual issues.  He was definitely more knowledgeable on the subject than the doctors I had seen in the past, but I did not relate well with him at all.  I remember coming home from my first appointment, crawling into bed, and just sobbing.  Having to tell my whole story all over again of everything I had already been through—all of the unsuccessful tests, treatments, surgery, and the reality that I was still no closer to a diagnosis—just left me in a state of depression.  Fortunately, that doctor referred me to another urologist, who diagnosed hypertonic pelvic floor muscle dysfunction* and referred me to a pelvic floor physical therapist.

That first appointment with my physical therapist was the turning point in my story.

*Here’s my definition of hypertonic pelvic floor muscle dysfunction: when your pelvic floor muscle (that’s the extremely important, often neglected, sling-like muscle that holds all of your internal organs in place and allows you to “hold it” between bathroom breaks) is chronically tightened and shortened.  The best description I have been given is that it is like if you were to take your hand and make a fist as tight as you can and then hold it like that—for days, months, years—without letting go.  Even when you do let go it is likely that your hand will not open back up to its normal state very easily, and it will be incredibly painful.  This is similar to what happens to someone’s pelvic floor muscle who has this disorder.