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Timing Matters! – The Female Sexual Response Cycle & Sexual Pain

This session focuses on pre-menopausal women, most commonly in their 20s and 30s. Participants will explore how insufficient arousal impacts tissue compliance and pain, strategies for transitioning from treatment to sexual participation, and the importance of individual variability in identifying the “best” time in the sexual cycle for intercourse.

About the Speaker

Darla Cathcart, PT, DPT, CLT, Pelvic & Women's Health Board-Certified Specialist
Many patients with pelvic pain make meaningful progress in treatment—yet continue to struggle when translating that progress into real-life sexual experiences. One often overlooked factor is timing: engaging in sexual activity before the body has reached sufficient arousal can contribute to pain,
avoidance, and ongoing frustration.
This presentation explores the role of arousal, desire, and nervous system regulation in sexual pain, with a focus on premenopausal patients. Drawing from neuroscience, the Dual Control Model, and Basson’s Female Sexual Response Cycle, attendees will gain a deeper understanding of how arousal functions as both a reward and protective system. The presentation also introduces practical frameworks, including Arousal Architecture®, to help patients better understand their unique arousal patterns and create conditions that support safer, more pleasurable sexual experiences.
Learning Objectives
  1. Understand the role of arousal in tissue readiness and its impact on sexual pain
  2. Differentiate between desire and arousal within the sexual response process
  3. Recognize the influence of the nervous system on the experience of sexual pain
  4. Apply timing and arousal-based frameworks to clinical practice
About the Speaker

Kayna Cassard, MA, LMFT, is a Sex Therapist, Painful Sex Specialist, and Certified Trauma Therapist, and author of Arousal, Answered: An Expert’s Guide to Authentic Pleasure and Liberating Sex. She specializes in helping people overcome anxious or painful sex. Kayna’s personal experience with pelvic pain drove her to integrate clinical psychology, somatic psychotherapy, and neuroscience with the vital needs of patients facing similar emotionally and physically painful challenges. Kayna has lectured extensively at institutions like UCLA, AASECT, and the International Pelvic Pain Society (IPPS) and featured on NPR and CNN. She founded "Sex, Answered," an unconventional intervention center offering trauma-informed care, sex therapy intensives, retreats, and online educational programs.