As little as a decade ago, most women who experienced painful sex were told to "just relax," a comment that made most women think that painful intercourse was all in their head–and that looking for medical answers was futile.
Thanks to researchers in the area of sexual pain (also known as "vulvodynia"), medical doctors and psychologists are learning that sexual pain has genuine causes and possible treatments. And actually, while the term umbrella term "vulvodynia" means "pain of an unknown source in the vulvar region," there are multiple reasons a woman might have sexual pain, including nerve damage, repeated infections, weakness in the pelvic floor muscles, and even genetics.
The role of the sex therapist is similar to that of a health psychologist or medical family therapist. As with other illnesses such as diabetes or chronic pain conditions like rheumatoid arthritis, psychological factors can affect a person's experience of discomfort. Sexual pain can cause depression and anxiety, which can make the pain feel worse. Difficulty coping with the pain, such as defining one's entire being by the pain or using pain for secondary gain, such as getting attention or avoiding sex, can also maintain sensitivity to pain signals. A sex therapist can help a woman learn techniques to manage sexual pain, as well as educate a woman's partner. New ways of being sexual together may also need to be discussed and explored.
Sexual pain can make a woman feel worthless or ruin a marriage. When sex hurts, it is important for a woman to stop having intercourse and take steps to feel better–mentally and physically. (Notice I did not say "Stop having sex," I said, "Stop having intercourse." You can still have a pleasant sexual experience without intercourse.)
Sometimes women call a sex therapist first, and the sex therapist refers to a medical doctor who is trained to diagnose sexual pain disorders. Sometimes women call their physician first, who may refer them to a sex therapist as part of the treatment team. Physical therapists who have specialized training may also be contacted for help.
Pain may be eliminated or it may need to be managed, but what is certain is that women no longer have to be turned away by physicians and psychologists because "it's all in your head."
If you are in the area of Orange County, CA, to make an appointment for psychological help with sexual pain, please contact The Buehler Institute. If you are outside the area, please visit www.nva.org or www.isswsh.org for information and referrals to an appropriate practitioner.