Do you know which conditions most commonly overlap with Temporomandibular Joint Disorder (TMD) and orofacial pain that affect sexual intimacy? How would you help a client who reveals they suffer from TMJ Disorder and an overlapping pain condition?

As sex coaches, we are not qualified to make medical diagnoses. However, it is becoming increasingly important to understand and acknowledge the overlapping pain conditions that primarily affect women and how those conditions may affect our clients’ sex lives. 

Many medical and therapy professionals continue to deny the correlations between these different pain conditions. Patients wind up feeling caught between the psychologist that blames their TMJ disorder on sexual abuse or marital stress, the primary care doctor that denies a misalignment issue, and an insurance system that contributes to a lack of comprehensive treatment. 

What is TMJ disorder?

A couple navigates the challenges of TMJ disorders

Photo by Kevin Turcios on Unsplash

TMJ disorder (TMD) is a complex set of conditions characterized by pain in the jaw and surrounding tissues leading to what’s known as orofacial pain. The chronic pain associated with TMD can affect a person’s ability to speak, eat, chew, swallow, make facial expressions, and even breathe. For many sufferers whose speech seems unaffected, it is an invisible condition that can lead to daily migraines, tinnitus, muscle spasms, and many other debilitating symptoms.

It has been found that 85% of patients with TMD also suffer from other painful conditions, such as:

  • chronic fatigue syndrome
  • chronic headache
  • endometriosis
  • fibromyalgia
  • interstitial cystitis
  • irritable bowel syndrome
  • low back pain
  • sleep disorders
  • vulvodynia

While each of these can individually affect sexual intimacy, a combination of these can be devastating to the sufferer’s sexual expression alone and with a partner.

How do TMJ disorders affect sexuality?

A quick search on TMD forums reveals many unanswered questions about how to deal with TMD and sexual intimacy. For many, TMD has deeply affected their intimate lives by changing how they experience being caressed, hugged, and having their face stroked. Additionally, patients report they cannot experience open mouth kissing or perform oral sex. 

This can be an embarrassing thing to discuss with one’s partner, which can lead to those with TMD suffering unnecessarily through certain sexual acts in order to avoid bringing up their condition. Unfortunately, they often experience much worse pain afterwards. Even the most understanding partner may find themselves afraid to approach the suffering partner sexually for fear of causing additional pain.

Besides kissing and oral sex, some people experience difficulty with the noise their jaw makes in their own ears; they may fear their partners can hear the popping of their jaw joint, as well. This worry can pull them out of a sensual headspace. Others report the potentially jarring impact of sex can even aggravate their TMD symptoms and so they are restricted to gentler expressions of intimacy, despite their desire for more intense sessions. 

Even at the point of orgasm—when many chronic pain sufferers of other conditions may finally find some relief—many TMD patients find that opening their mouth wide or clenching down during orgasm can cause painful muscle spasms in their face, jaw, neck, and shoulders.

What specific suggestions can we offer as sex coaches to the client suffering from TMD?

A woman with a TMJ disorders smiles about her health options

Photo by Vladimir Yelizarov on Unsplash

Many patients go through a series of ear nose and throat doctors, psychologists, therapists, massage therapists, neurologists, dentists, and orthodontists over the course of years before ever getting the appropriate referral to a TMJ disorder specialist.  When they finally are referred to the right medical professional, they often cannot broach the topic of sexual intimacy with their specialist. This is where sex coaching can come in. 

By including a body map and pain scale on your intake forms, you can create an opportunity for clients to mark areas where they may be experiencing chronic pain. This simple act can go a long way toward empowering the client who came to you for other concerns to reveal their difficulty with TMJ disorder. This can also help those who wouldn’t normally seek out a sex coach to see us as professionals who may be able to provide the sexual intimacy guidance that their medical providers are not trained to give.

Using a holistic view of human sexuality, such as the MEBES™ model, developed by our founder, Dr. Patti Britton, allows us to work with the TMD sufferer as a whole person. By doing so, we may be able to provide life changing support to these clients who are dealing with a lifelong condition that few other providers understand. 

Some potential solutions we may offer our clients include:

  • Open discussions on sexual positions more conducive to pain associated with TMD
  • Suggestions on how to disclose to new and current partners
  • Validating the client’s experience of overlapping pain conditions and letting them know they are not alone
  • Giving them permission to experiment sexually and have fun
  • Redefining and expanding an individual’s definitions of sex
  • Tools to assist in better communication and compromise with their partner

It is important to note that what few resources exist out there on TMD and sexual intimacy are primarily geared toward opposite-sex couples. As sex coaches, we can certainly offer guidance to same-sex and other queer couples that experience intimacy issues with TMD, as well.

Your clients with TMD might be feeling frustrated, hopeless, or at a loss, but that could end with you. Although sex coaches can’t address every concern a client has, the nature of our work allows us to craft solutions that many other professionals neglect to consider. With creativity and our desire to bring healing to those who need it most, we can find many ways to help our clients with TMD and other chronic pain to reclaim and enjoy sexuality.

To learn more about TMD, check out The TMJ Association and The Campaign to End Chronic Pain in Women


Continue the Conversation

Do you know someone living with a TMJ disorder? Perhaps you live with one yourself. What approaches would you take to help a client whose TMD negatively impacts their sex life? We’d love to here! Join us in our Facebook discussion group, Sex Matters, and let us know your thoughts today. We can’t wait to see you there!