A Trauma-Informed Approach To Pelvic Pain And Sexual Wellness With Rose Schlaff, PT, DPT, WHC, IF

Welcome back to the Healing Pain Podcast with Rose Schlaff, PT, DPT, WHC, IF

According to statistics, there is a significant number of people who, at some point in their lives, will experience pelvic pain. Unfortunately, the lack of education about sexual wellness often keeps people from finding the right care they need. Talking about a trauma-informed approach to pelvic pain and sexual wellness, Dr. Joe Tatta interviews Rose Schlaff, PT, DPT, WHC, IF—a Doctor of Physical Therapy, Sexual Health Coach and Sexual Health Fellow (ISSWSH). Dr. Schlaff discusses the importance of bringing conversations around sexual health to the fore, especially in breaking down barriers that keep women and queer people from addressing their issues. Highlighting the benefits of a trauma-informed approach, she also exposes a gentler and easeful patient experience instead of the daunting misconception that tends to cloud people’s ideas about seeking help in this area. Dr. Schlaff then takes us deeper into the episode by tapping into topics such as the desire puzzle, the role of the nervous system, successful sex, and the impact of heteronormative portrayals of sex in the media on the LGBTQ community. It is high time for us not to shy away from these important conversations. Let today’s show remind you of the need to normalize sexual health simply because it is a vital part of our human life experience.

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A Trauma-Informed Approach To Pelvic Pain And Sexual Wellness With Rose Schlaff, PT, DPT, WHC, IF

In this episode, we have a truly exceptional guest joining us, Dr. Rose Schlaff. She is not just a doctor of physical therapy but a sexual health coach and fellow with the International Society for the Study of Women’s Sexual Health. After years of clinical experience as a pelvic health physical therapist, Rose began to craft her holistic approach to sexual wellness.

Driven by a passion for empowering individuals, particularly women and queer people, she created her transformation program called Be Well With Rose, which empowers people to harness the power of their pelvic floor, breath, and nervous system for healing. Rose’s approach is not just about physical therapy. It’s about holistic coaching and somatic techniques that help our clients feel more confident, connected, and carefree in all aspects of their relationships. Whether working with individuals, partners, or small groups, Rose provides guidance that transcends boundaries both in geography and in the bedroom. That’s not all.

Rose’s impact stands beyond her coaching practice. She’s also a guest lecturer for prestigious institutions like the University of Michigan and San Diego State University, where she shares a wealth of knowledge on human sexuality. You’ll also find her gracing the stages of conferences such as Sex Down South and the American Physical Therapy Association’s Combined Sections Meeting. If you’ve ever wondered how a trauma-informed approach can change your understanding of pelvic pain and sexual wellness, you’re in for a treat. Before we dive in, don’t forget to subscribe and leave us a review on your favorite platform. Without further ado, let’s begin, get started, and welcome Dr. Rose Schlaff.

Rose, thanks for joining me.

Joe, thanks for having me.

I’m excited to talk to you about pelvic pain. We’ve started to explore pelvic pain more and more but I know you have other unique interests and ways that you help people around their sexual wellness, which, as far as I’m concerned, everyone is interested in their sexual wellness at some point, optimizing that and learning more about it.

A place to start is let’s talk about pelvic pain a little more broadly. As a pelvic health physical therapist, you often see pelvic pain and people looking for help with their pelvic pain but there are also a lot of barriers that people come up against when they’re looking for pelvic care in general. What are those barriers that you’ve observed in your practice?

This is something that is more common than people realize. There are some stats that show that 3 out of 4 people will experience pain with penetration at some point in their lives. About 30% or so continue to have pain. The biggest barrier is the lack of education about sexual wellness for healthcare providers. People are going to doctors. They don’t know which doctor to go to. They think maybe a gynecologist or primary care might help them. When they get there, there’s this lack of understanding of how can we best diagnose this and what are the resources to get them to.

I can’t tell you how many people have told me, “I went to my doctor and they told me to relax. They gave me some lube. They told me that my only option was a Botox shot or some wine. Maybe try that.” It’s disappointing. It does harm, especially when we’re talking about populations that already may have medical trauma populations that are less likely to reach out for medical care. The queer population is trans, non-binary folks, and people of color. These are the times that this is extremely detrimental as well because of all the barriers that it even took to get to the doctor’s office and then, on top of that, not getting the care you need.

I’m so happy you’re talking about pelvic pain more so that people can understand that a gynecological exam doesn’t have to be painful. Not only that but it doesn’t have to be scary and traumatic. It can be much more easeful and from a sexual perspective, pleasurable, fun, and enjoyable even if you have a history of pain and you’re still on your pain journey. I hope that readers get a lot out of this and are able to recognize, “This is when I need to go to physical therapy, reach out, and get some support here.”

HPP Rose Schlaff | Pelvic Pain
Pelvic Pain: Sex gynecological exams don’t have to be painful, scary, and traumatic; they can be much more easeful and, from a sexual perspective, pleasurable, fun, and enjoyable.


It’s interesting because in some of the circles that we move in and out of, we’re talking about chronic pain more generally and different parts of the body that suffer when you have chronic pain. People are becoming more aware of it. We are being effective and raising awareness around it. Even with that, the biggest power that I hear from people is, “Where do I have this problem? I shouldn’t have pain when I have sex. I shouldn’t have pain down there with urination and other functions. How do I start to have this conversation with my primary care doctor or gynecologist when they’ve never asked me about my pelvic or sexual health before?” What recommendations do you have for your patients?

I like to write things down before I go into a medical office. Even as a medical professional myself, these are intimidating settings. Things are moving quickly, especially in insurance-based situations. Most of us are relying on insurance to get our primary medical care. Say, “It can feel like a whirlwind and there’s no time to even get it in words in edgewise. I like to have it written down as my primary concern.”

“Off the top, there’s something that I’d like to talk to you about. I’m having some discomfort with gynecological exams and intimacy. There are some resources in pelvic floor physical therapy or otherwise. Could you give me a referral?” A lot of medical providers won’t offer pelvic floor physical therapy, even if you say, “I’m having pain.” 1) “This is what’s going on,” and 2) “Please give me a referral to the place that I want to go,” can be very helpful.

A big part of what we do is helping people advocate for themselves in some way. For some people who have had pelvic pain for so long, because you mentioned medical, I’m going to slow down on medical trauma for a minute. In the world of chronic pain, there’s so much talk about early childhood events, which are extremely important. However, we don’t talk about medical trauma that happens every single day with our patients and people with chronic pain because they’re seeing multiple physicians, therapists, and providers.

Some of them are very well versed in a modern approach to pain and others are functioning on a very old frame with regard to pain. 1) Should a pelvic exam hurt someone? Is it normal to experience pain during a pelvic exam? 2) People are scared. They have had trauma before. Do I have to have my pelvic or parts of me examined if I’m struggling with chronic pain?

The first answer is no. I also want to model some language that you can use with your provider who might be pressuring you to have a pelvic exam, perhaps for a pap smear. There are real medical reasons to get pelvic exams. If it is indicated and you do feel like, “I’ve waited a long time to get a pap. I’ve never had a successful pap. The last time I had a pap was painful. I don’t want to go to pelvic floor physical therapy because they put their fingers where. I don’t want to have another pelvic exam.”

The language that I like to use here is telling your provider, “I have a history of pain. My body will be guarded during this exam. Something that will help me is if you tell me exactly what you’re going to do before you do it. If you ask my permission before each step.” Instead of, “We’re going to stick the speculum in now,” say, “Are you okay with me putting the speculum in? I’m about to do that. Is that okay?” “Yes,” then you proceed.

Additionally, I’ll also have patients or clients even say, “If I tell you to pause, I need you to pause and let me take deep breaths here before we continue.” Having this emergency plan ready before we even get into the pelvic exam or expose our bodies to that can be helpful. I wanted to make sure that people had that language or modeling so they could take that with them if they needed a pelvic exam.

Why don’t you give us those two questions again? When people read things more than once, it helps them realize, “This is important. I can use this during my healthcare.”

Keep it on a note on your phone. It’s high stress, especially if you had pain in the past and you’ve experienced discrimination, medical trauma, and all of these things. It makes perfect sense that you’re feeling anxious in these environments. There’s nothing wrong with you. Let’s give you some tools so that you feel better supported in this situation.

Take out your notes and write, “I’ve had pain or discomfort in the past. What would help me this time is if you explained everything clearly that you’re going to do before you do it. 1) I need you to explain everything before you do it. 2) I need you to ask me for permission before each step of the process, not just before you touch my body or insert. In each step, I need you to ask my permission. 3) If I am experiencing discomfort or I need to pause, I’m going to say the word pause.”

If you’re somebody who gets nonverbal when you’re in a traumatic situation, you can use a hand tap, the pre-discussed motion, “I’m going to hold up my hand and stop. I need you to talk to me throughout. If I stop answering, I need you to pause because that means I’m dissociating.” It’s unfortunate that the burden is on the patient. It should not be that way. The burden should be on the medical system to give trauma-informed training to our providers but we are failing.

I’m glad you said the medical system. We’re talking about pelvic health but by everything you said, it works well with people who have pain and/or trauma in any part of the healthcare system. I went to the dentist. Dental procedures sometimes involve a little bit of discomfort. I have known my dentist for a long time and he knows a lot of the work that I do.

We have a good line of communication but I was thinking back, “It wasn’t always that way necessarily.” It’s a much easier experience when the lines of communication are there and there’s some space to create a pause or explain things so people know what’s happening, what you’re doing, and what you’re discovering in someone’s body or on their body. All those are wonderful.

Here’s the second part that I want to make clear to everyone. If you read this and you’re like, “I do want to find an in-person physical therapist. I do think that I want some support outside of a gynecologist or primary care, even if my primary or gynecologist isn’t sending me.” For example, for me, I don’t work in person anymore. If you are seeing someone, I want you to know that it’s not important at the first session. It’s helpful at some point but I’ve had many people heal from pelvic pain without any internal pelvic floor work.

Whether that’s when you’re working with an in-person provider or somebody through telemedicine or coaching, it’s important to know that that’s possible. There’s a lot of coercion that happens in the medical system. That is well-intentioned. We want people to heal and give them what they need but sometimes that’s more detrimental for the nervous system.

We know that the pelvic floor, like your upper traps, is one of the most protective muscles in your body. When we’re shown threatening movie stimuli, those are the two muscle groups that contract first to protect us. We know that the pelvic floor is a part of a general defense mechanism. If we are terrified of internal work, it’s going to create this dangerous pattern that’s hard to get out of. The thing is we have to reestablish safety in the nervous system. It’s more important than even treating the tissues locally, I believe.

We have to reestablish safety in the nervous system, and it's more important than even treating the tissues locally. Click To Tweet

When we establish safety, then we can move on to other types of experiences that are part of our pelvic health-like desire, which is one thing you like to talk about. Why is this topic of desire important to bring into the general umbrella of pelvic health?

Desire is so important because it plays into safety and fun. When we want to do something, it feels different than when we don’t want to do it. We’ve all had those days where we’re excited to go to the gym. We get there. It feels good to move our bodies versus the days where we’re dragging and we’re like, “It’s good for me to go to the gym. I’ll be happy when I get there.” The amount of emotional resistance that you have to overcome to get to the gym that day is exhausting, even if it’s a positive experience in the end. This is what I hear from clients all the time.

Pretty much every time they have sex, it’s that second gym experience like, “I’ll feel good. This is good for my relationship but I’m exhausted. I’m pushing through. This is a chore on my to-do list to check off.” When we think about what that sending or signal to the nervous system, it’s not creating that reward system of, “This is fun and easy. Let’s do this again.” It’s creating a lot of external resistance.

Even emotional threats can have that same threat response that triggers the pelvic floor, other processes, and our physiology, fight and flight, even on a small scale. All of our blood is flowing to our heart and our lungs because we’re in a stressful situation. Our brain is like, “We’re running from a tiger. Why would we use our valuable blood down at the genitals? That doesn’t make any sense at all.” Why would we bring a baby into this situation and make you horny? This is not the time. We need to survive.

It’s important to talk about getting to a place where sex is fun and desirable, not just pain-free. When we medicalize sexual wellness, that’s where we get to. We say, “Sex has been painful.” “You’re 0 out of 10 pain. You’re discharged.” There’s a lot of other stuff going on interrelationally, emotionally, and nervous system-wise that we need to address to truly be well.

Our goal, ultimately, if we’re able to, is to help someone be 100% pain-free. We want that for our patients and ourselves. Sometimes, it can be difficult because there are certain conditions that are chronic. People have different physiologies and nervous systems. Things change. There are lots of factors. Sometimes lifestyle, genetic, or structural factors. The question with all of that in mind is, is it possible potentially to be someone who lives with some chronic pain but also has a very fluid, sensual, and desire-felt sex life at the same time?

It is so possible. There are three key pieces here that we need to address. Most of us don’t get the information that we need about sexual wellness growing up. I certainly didn’t. I grew up in an open family but we don’t have the information. I want readers to know that what we see on TV and what our understanding of desire is like you look at your partner and they look hot so you’re like, “I’m in the mood. Let’s go,” is very rare for most of the people I talk to.

“I look at someone. I’m sexually aroused. We’re ready for intercourse.”

Especially in a long-term relationship and you are somebody who has experienced pain. On top of this, what is very common and pretty normal is more of what’s called responsive desire. When I talk about responsive desire, imagine you’ve eaten lunch. You’re not hungry. Your friend invites you over to hang out. They’re cooking food. They offer you some. You’re like, “I just ate. I’m good.” You’re not in the mood. You smell their food cooking. It smells delicious. The friend is super chill. They’re not pressuring you. Once you smell that food, you’re like, “I am going to want some of that food. It smells delicious.”

Your sensory system leads and then your desire follows. It’s an important piece of the puzzle. There are two main barriers to experiencing that responsive desire of, I call it, smelling the cookies in my coaching. “What helps you smell the cookies?” That’s one piece of it. Erotic novels, connecting to your partner, eye contact, and chore play where your partner does all the chores for you. You don’t have to do anything. The towels are taken care of. There are all different kinds of things that help you smell the cookies.

The two pieces that are key here that block us from smelling the cookies are one is pressure. This can come externally but more often than not, it’s an internalized pressure from a lot of the patriarchal BS that we are exposed to, intergenerational trauma, religious trauma, lived experiences, media and unrealistic expectations of beauty standards, racism, and sexism. All these isms that we live within the world filter through our subconscious and then we have this thought, “If I was a good wife, I would have sex with my partner three times a week, once a week, or once a month,” whatever the number is. We have these shoulds that pressure us to act.

“It should look this way. It should always perform this way. It always feels this way.”

“Why can’t I stop doing my grocery list in my head while we’re having sex? Why aren’t I in the mood when I see my partner? Are we not in love anymore? Am I broken? Do other people feel this way?” All of that creates that internalized pressure.

“If I can’t get an erection this one time, is there something wrong with me?”

“If I last too long or it’s too short, what’s the perfect amount of time?” We can’t win. None of us. We are all impacted by these beliefs. It’s worse, especially in our sex lives. There’s no normalization or talking at the dinner table. It’s like if you had a hurt shoulder, your family would be like, “How’s that shoulder going? Are you back to playing tennis?”

They know this is something that’s impacting your life. You can’t openly talk in social situations about, “I’m having a lot of pain and it’s stopping me from having enjoyable sex with my partner. It’s creating an impact on our relationship.” You’re not going to talk about that at the dinner table. You feel very isolated and alone. That’s one piece that blocks us.

The second piece that blocks us is a nervous system that isn’t able to switch. You talk about the nervous system a lot on this show. All of the readers are aware of this but we have pushed that active part of our nervous system to get things done throughout the day, check things off our to-do list, and be productive. It’s hard at the end of the day to shift out of that, “Go, go, go,” sympathetic drive into that more parasympathetic, relaxed, and restful place that is oftentimes needed to be fully present in our body and even tap into our desire in the first place.

I want people to have that information. That’s something I wish we all learned early on. Most of the people I talk to don’t know about responsive desire. It’s such a key piece to the desire puzzle. This applies to things outside the bedroom. We talked about the gym. What helps you smell the cookies for the gym? Is it putting your gym shoes right there? Is it a gym playlist that you love? Your pressure piece for the gym is that you feel judged at the gym because everybody is super fit and looks a certain way. All these things can play into other areas of our life but they’re super important in our sexual wellness and overcoming pain in our sex lives.

There are two things that people can focus on and take away from this episode. Responsive desire and you’re nervous system state. The two are interconnected in some way. In the nervous system state, we have to learn about what the nervous system is. We teach people about things like hyperarousal. We help them learn to modulate their nervous system. Is it easier to help people with the first part, create an environment where they feel safe and more likely to experience arousal and desire?

Anytime you work on safety, you are impacting the nervous system, which would you know. It is a matter of how nerdy you want to get with it. I have some of my clients doing, “I exercise to impact my nervous system.” We go down that route but I have some of my clients whose safety is key to tapping into responsive desire. The way that we understand safety is by using our body and pleasure as a compass. We will do this activity where we tap into it, “What are the things that feel 100% great?”

HPP Rose Schlaff | Pelvic Pain
Pelvic Pain: Safety is really key to tapping into responsive desire. The way that we understand safety is by using your body and using pleasure as a compass.


These are the green activities where if somebody wanted to give me a shoulder massage, pretty much anytime somebody that I knew, I would be like, “One hundred percent, yes.” You probably don’t have to ask my permission. If you want to, great. I’m probably going to be fine with that. To a stranger, maybe not but to somebody I knew and trusted, those are the green and 100% safe items, whereas a red item is something that is 100% no.

For a lot of people with pelvic pain, penetration is a red item. A lot of people have been pushing through because there’s been no example of the fact that you have permission to stop and take penetration off the table for a little bit of time or forever. That’s so freeing for people because there is such a societal expectation that successful sex equals, 1) Penetration, which is very heteronormative, and 2) It ends in orgasm for both people. There’s so much pressure surrounding that.

Hopefully, you orgasm at the same time as we see it in the movies because if not, you’re probably broke. It’s so unrealistic. We are allowing people to redefine, “What does successful sex look like to you? What are the things that your body feels are 100% percent green? Can we have a period where we just do those things?” I don’t know if you ever do this in chronic pain people but sometimes we can paint non-painful sensations. I often paint with pleasure with my clients.

It’s like, “If your knee is pleasurable to touch but when we get halfway up your thigh, it’s starting to feel like a yellow zone.” Yellow is not 100% red but we’re getting close to a red zone, “I’m a little hesitant. I’m starting to feel my body tense up. I’m starting to be nervous about where this is going to go.” Can we use that green little by little inch and paint with the green into the yellow zone to make those yellows more green?

You mentioned the idea of heteronormative sex. We probably should define that for people so they understand it. You mentioned the LGBT community at the beginning of the episode, which I appreciate. We’re heading into LGBT Pride Month here in the United States of America in various cities. My experience, because I am gay, is in general, the LGBT community will explore sex in other ways than the one way that we always see on TV. To be quite honest, there’s a little bit of fun that can happen with that and desire. It’s healthy. It’s a normal part of our human sexuality. How does a heteronormative view potentially get in the way of desire for other groups of people?

As a core person myself, I’m super excited that we’re spending time on this topic. It’s so important. Heteronormativity is what we have seen oftentimes in the media. Media representation is getting better. When I was growing up, it was very straight-white-skinny. Everybody looked one way.

Funk and had sex one way. It typically means the man on top and the woman on bottom in a traditional missionary position.

Everybody orgasms at the same time. It’s miraculous. That’s not how it works for you. Everybody else is having simultaneous orgasms everywhere in the world. If you are reading this and you cannot pick up on sarcasm, please know that I’m joking. If there’s a focus on penetration, there’s a disconnection from the process of intimacy, pleasure, and exploration. What I love about the LGBTQ community is we already are outside of the mold. We have to be creative with every part like, “How are our relationships and families going to look?”Everything has to be creative because it’s not what we’ve seen modeled for us a lot of the time.

That’s why I refer to this goal-oriented sex as heteronormative. There are many heterosexual couples that have sex that doesn’t look like that and are exploring these things. It’s that goal-oriented sex where we’ve checked the box and hit home base. You had penetration. That’s the end of everything. The goal of the end goal is orgasm. I encourage people to let go of those two definitions that are rooted in heteronormativity. Let go of the fact that we have to immediately be doing penetrative activities and explore more of what feels good.

Let go of the fact that we have to immediately be doing penetrative activities and explore more of just what feels good. Click To Tweet

I define successful sex as I’m connecting with myself or my partner and I’m feeling good in my body. That’s the only thing I need for success. I have every coach and client answer the question, “What does successful sex look like to you?” This is a way that we can begin to shed those heteronormative patriarchal definitions that aren’t even ours to begin with. It’s the only example we’ve seen in most porn and media.

We start to think about, “What’s my favorite part of the sex that we’re having? What are the parts that I’m interested in that we’ve never done before? What might that look like? What are the parts that make me feel pressured?” A lot of time, orgasm is very pressure-filled for people. Sometimes, I’ll have people take orgasm off the table. I’m like, “Your homework is to connect physically with no penetration and orgasm.” If it happens, there’s no slap on the wrist. It’s like, “Added bonus,” but it’s not the goal.

We talked a lot about things that people can do. We’re starting to move into the moment where people should stop doing. One that we spoke about is the idea of letting go of a heteronormative approach to intimacy and sex. What things should we stop doing or do significantly less of it?

There’s a lot of pressure on what I call gourmet sex.

I want to get out like some whipped cream and cherries but I’m interested in what gourmet sex is.

It is perfectionism in the bedroom, like perfectionism in all parts of our life in any healing journey and all areas of personal development. It stops us from action. If we say to ourselves, “Every time that we have sex, I have to be perfectly in the mood before we even think about it or before he even looks at me. Every time we have sex, we have to hit these goal markers. We have to have 45 minutes of foreplay. We have to stare at each other in the eyes for 30 minutes.”

I’m not saying that those are bad things. I do think that setting aside significant chunks of time to have that time and space to connect is important but there’s a balance. It’s also nice to have some fast food moments. It is funny that I have this metaphor because I eat so clean. It’s another way to take the pressure off. How can we take any pressure off of ourselves of how this has to look?

Maybe that’s like, “I feel disconnected from you. I want to connect with you. I’m exhausted. It’s the end of the day. I don’t have the energy for sex. Could we spend five minutes and hold each other? Could we take two minutes and I’ll give you a massage and then we’ll swap? For two minutes, you’ll give me a massage? Could we put our phones down, make eye contact, put our hands on each other’s chests, and breathe for one minute?”

There are these little intimate snacks or fast food moments of getting something intimate or connected that isn’t sex. That isn’t the gourmet version. I’m not knocking the gourmet version. I’m saying it doesn’t have to be that all the time. If you eat your favorite food every single day, you get sick of your favorite food. Variety is nice.

I love this because it makes you think about the entire process and the experience and what that’s like instead of the end goal that people think about. It also makes me think that this process doesn’t have to be the same all the time. The experience doesn’t necessarily happen to be the same all the time. Pleasure exists on a continuum. There are lots of different colors and hues within a pleasurable experience, including a sexual experience, potentially if you have some type of pelvic pain condition.

This is especially important if you are somebody who has pain or a cycle. We are different from somebody with a menstrual cycle. Emotionally and physically, we are in different places at different points of our cycle. If we are somebody who has chronic pain, we may have high symptoms days and low symptoms days. The things that are going to work for us on one day may not work for us or even sound good on another day. It normalizes the flow of being a human.

Any human was never the same in any given day. It doesn’t mean we’re “not our best selves,” but it’s finding that pleasure, joy, and deep intimacy at whatever season, level, and emotional state you’re in. You can still stay connected to your body and partner. You can take any pressure off of what it should look like. You get to decide what it looks like and you can build that by following the pleasure.

I want to give a quick nod to professionals because we’ve been talking more globally about pelvic pain, pelvic health, and sexuality. You do some work with practitioners and interact with a lot of clinicians. What’s the one thing that you feel is missing that you try to impart to new professionals who are coming into this area, like this one tidbit that you find to be most impactful to their practice, which then affects their patients and clients?

Like many new grads, myself included, when I was in that place, a lot of the time, we were trying to prove how good we were as physical therapists by “fixing” our patients. Sometimes, depending on what setting you’re working in, especially if it’s an insurance-based setting, there’s a real sense of time urgency. We are like, “Let me fix you quickly. Let’s go. Do this dilator. Do that dilator. On to the next one. You’re not doing your homework. What’s wrong with you?” You’re “non-compliant.”

From what I understand about the nervous system and healing in general at this place, I want providers to understand that baby steps can be so much more impactful than throwing the kitchen sink, going fast, and giving all the resources. I want to give this example of when I was in the clinic, any time I would do a pelvic exam with somebody who had pain, I would ask them, “I’ve seen with past patients who have had pain that doing visualization and a grounding practice before doing internal work can be helpful because it grounds your nervous system and relaxes your body. If that’s something that would feel helpful for you, is that something that you want to explore?”

HPP Rose Schlaff | Pelvic Pain
Pelvic Pain: Doing a visualization and a grounding practice before doing internal work can be really helpful because it grounds your nervous system and it relaxes your body.


If they said yes, then we would do it. It doesn’t have to be long but it would be grounding. You’re safe. You’re exactly where you need to be. Thank your body for protecting you and keeping you safe. Pain is a signal to do something different. Anytime there’s pain in the body, it’s a sign that it wants something different. You can thank your body for bringing you here and letting you know that something different needed to happen. Let it know that this is exactly where you need to be.

Take that moment of eyes closed and breathing. Sometimes I would do a progressive muscle relaxation with them. Sometimes not. It’s so easy to dissociate when you are somebody who has chronic pain of any kind. Coming back to your body as a place of safety is the best first step that you could take with anybody on their journey. We’re not doing the healing. We are just privileged enough to walk with somebody on their journey. If you can walk with them on the journey back to that safe place in their body, you are doing more for them in the long-term than any dilator work or anything else.

Just a tip, vibration is always a great option for pain interruption and adding pleasure. Any type of homework you’re giving somebody with pelvic pain, out of a vibrator, unless they are somebody who feels threatened by vibration. It is something that I found very beneficial to disrupt pain signals and for pleasure. We have to medicalize it in certain ways for patient’s safety and comfort but when they’re at home, take the medical out of this. Have fun with it.

It has been great speaking with you about pelvic pain and sexual wellness. I know everyone will enjoy this episode. They have a lot of good information to take away and probably had some fun with this as well. I appreciate you being here. Let everyone know how they can learn more about you and follow your work.

Thank you so much for having me. It was so much fun. You can find me on Instagram, @BeWellWithRose. If you’re reading this and taking something away, I love hearing that from people. Please shoot me a direct message. Let me know what you are taking away from this episode. You can also find me at www.BeWellWithRose.com. I offer free twenty-minute phone calls for any clients who are feeling like, “I’ve maybe potentially had pain in the past or currently have pain.”

In the type of work I’m doing, I tend to collaborate with in-person physical therapists. We work together and co-treat. I bring in more of the coaching, nervous system, and how to make sex fun and easy again while you’re getting that hands-on work from a pelvic floor physical therapist. If you’re a pelvic floor physical therapist reading this and you’re like, “I would love to collaborate,” I’m looking for pelvic PTs all over the country because I have clients all over the country. Please introduce yourself. I want to find good people. There are also some free resources if you go to the link in my bio on Instagram as well. Thank you so much for having me.

It is so easy to follow, BeWellWithRose.com or you can go to @BeWellWithRose on your favorite social media handle. At the end of every episode, I ask you to share this with your friends, family, and co-workers on Facebook, LinkedIn, Twitter, and Instagram, wherever anyone is talking about treating chronic pain or pelvic pain, or if they’re interested in sexual wellness. I’ll see you next time. Thanks for being here.


Important Links


About Dr. Rose Schlaf

HPP Rose Schlaff | Pelvic PainDr. Rose Schlaff (she/her) is a Doctor of Physical Therapy, Sexual Health Coach and Sexual Health Fellow (ISSWSH). After years of clinical experience as a Pelvic Physical Therapist working directly with world-renowned sexual medicine physician, Dr. Irwin Goldstein, Dr. Rose created her own holistic sexual wellness program www.bewellwithrose.com that helps women, and queer leaders harness the power of their pelvic floor, breath and nervous system to experience more fun, ease and a deeper connection in and out of the bedroom.

Dr. Rose works with individuals, partners, and small groups of clients virtually all over the world and loves combing her years of pelvic and sexual health experience with holistic coaching and somatic techniques to help her clients feel more confident, connected, and carefree in all areas of their relationship(s).

In addition to her coaching practice, she is a guest lecturer for the University of Michigan’s Human Sexuality Certificate program and San Diego State University’s Marriage and Family Therapy Sexuality and Intimacy course, UC Irvine’s Human Sexuality course has spoken at conferences including Sex Down South and APTA’s CSM and been published in the Journal of Women’s Health Physical Therapy.

To learn more, go to https://www.bewellwithrose.com, check out Dr. Rose on Instagram @bewellwithrose or get in touch with Dr. Rose at [email protected].


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