Sexual Pain? How A Psychologist Can Help A Woman with Vulvodynia


Sexual Pain? How A Psychologist Can Help A Woman with Vulvodynia
Vulvodynia–literally, pain in the vulva area–can be distressing for both a woman and her partner.

Last week I was part of a panel of experts on vulvodynia who spoke about the treatment of this confounding syndrome at Mission Hospital.  Vulvodynia–literally, pain in the vulva area–can be distressing for both a woman and her partner.  Basically, vulvodynia is best described as searing pain on the outer part of a woman's genitals.  It can occur right at the entrance of the vagina, in the area surrounding the entrance, or onto the clitoris.  Vulvodynia can make intercourse extremely difficult; women describe the friction as feeling like sandpaper being rubbed over the affected area.

Who gets vulvodynia?  Women of almost any age can be afflicted with this syndrome.  At one time, women who had this problem were pretty much told "it's all in your head," and in fact women in other parts of the country who may not have access to women's sexual medicine experts are often left without a diagnosis after a visit to the gynecologist.


The experts on the panel, including myself, all agreed on one thing:  It takes a village to properly treat vulvodynia.  A woman's treatment team must consist of a medical doctor who knows how to diagnosis and treat vulvodynia.  Treatment is very individualized; what works for one woman beautifully may not work at all for another.  Medical treatments include numbing creams, antidepressants (help with perception of pain), hormone balancing, and sometimes, surgery.  Women also benefit from visiting a physical therapist who specializes in pelvic floor work.  The PT can help relax tense muscles in the pelvic floor, which helps relieve pain.

A psychologist who has training in sex therapy is the best choice for helping a woman who has sexual pain of any kind.  Again, it isn't that the pain is in a woman's head.  It is that there are things that can make the perception of pain worse.  When a woman is anxious, sad, or stressed (sometimes about the condition itself) it can make pain feel worse.

It goes without saying that vulvodynia affects not just the woman, but her partner.  Most heterosexual couples enjoy having the closeness and intimacy of sexual intercourse, but when a woman has vulvodynia it makes intercourse impossible or nearly so.  Some couples are able to be sexual in other ways, but some avoid sex altogether.  Needless to say, a woman's drive may also diminish.  She may feel ashamed or guilty because she is unable to function sexually for herself, for her partner, and as a normal woman in her own eyes.

It was once thought that women with vulvodynia were survivors of sexual trauma, but this is not always the case.  Some women have vulvodynia because of nerve injury, abnormal response to infection, repeated infections like yeast infections, allergies to chemicals such as the scent used on feminine hygiene products or soaps, and muscle spasms.  But since 25% of females are estimated to have been sexually abused, it is no wonder that there can be overlap.  Having been sexually abused can also contribute to heightened perception of physical pain.

This article was originally published at . Reprinted with permission.
Article contributed by
Advanced Member

Dr. Stephanie Buehler


Are you curious about how a more fulfilling sex life?  In addition to  in-person sex therapy at The Buehler Institute in Newport Beach, CA, Dr. Buehler has written books for both general and professional readers.  The Buehler Institute is also approved by the APA, California BBS, and AASECT as a provider of continuing education.  Visit The Buehler Institute site or to find out more.

Location: Newport Beach, CA
Credentials: CST, Other, PsyD
Other Articles/News by Dr. Stephanie Buehler:

Drawing The Line Between Curiosity And Abuse Between Siblings


  Much heated debate has spurred in response to recent media drama over revelations in Lena Dunham's new book. A passage describes her engaging in sexual activity with her much younger sister when they were both children. The big question on everyone's mind is whether or not Dunham's actions constitutes "abuse." There seems to be ... Read more

Sex Therapy Q&A: Breast Cancer Survivors And Sexuality


Q: I'm lucky because my breast cancer treatment went well and I am in remission, but I have zero interest in sex with my partner. Will this ever get better or will I be stuck in neutral the rest of my life? Help! A: It is very common for women survivors of breast cancer to struggle with low sexual desire and other problems, including vaginal dryness and ... Read more

Sex Therapy Q&A: Moving Through Childhood Sexual Abuse


Q: I was sexually abused as a child. Will I ever learn to enjoy sex? I am a married man and I just can't get excited about it at all, even though I love my wife. First, I am sorry that you ever had such things happen to you. No child should ever be hassled with unwanted touch. Not only can sexual abuse cause sexual problems later in life, but it can ... Read more

See More

My Videos
Must-see Videos
Most Popular