Female Sexual Pain Conditions
What are ‘Female Sexual Pain Conditions’?
Female sexual pain conditions are sometimes called Dyspareunia, Vestibulodynia, and Vulvodynia in the classical medical tradition. There are other more specific conditions, but in this context, we are involved when a person with a vulva and vagina suffers pain (or the fear of pain) just before, during or after sexual activity and this condition is causing them distress.
What must be established first
There are many reasons why a woman may experience pain during sexual activity and it’s important to understand any medical reasons before further psychosexual work can take place. So if you have not spoken to your GP about the problem yet, you will be encouraged to do so. Your doctor will be skilled and experienced in the medical aspects and should put you at ease to talk about it. Once your GP has established if there are any underlying medical issues and is treating them, we can get to work.
Understanding the Context
When does the problem occur and how long has it been happening? Are other related problems happening? How do you feel about your partner(s) if relevant? Do you feel pain in solo sex or other circumstances? What is your attitude towards masturbation? How well do you understand your (and your partner’s) anatomy? Do you use porn and what is your masturbation style? Do you smoke, drink, use recreational drugs or have lifestyle behaviours that can impact arousal response? Has anything affected you in the past? Have previous sexual experiences been painful and shaped your views or expectations? What is your feeling about having sex?
Understanding your perspective
It’s understandable why pain (or the fear of pain) would cause you distress. In this context we are only able to address the psychological and procedural/educational aspects of this condition. What are your underlying beliefs that inform the distress. If some ‘shoulds’ emerge there may be opportunities for challenge, re-framing and psycho-education. Good availability of clear information about the female sexual anatomy and arousal model is now widely available. It’s possible that you might have some culturally conditioned disengagement with your entitlement to informed awareness of your anatomy and pleasure processes. What part may self image and anxiety be playing? Do you need additional vaginal lubrication and what is your (or your partner’s) attitude towards that? We might check your menopausal status and attitude to menopause hormone therapy?
If appropriate there are a number of exercises that can help you gain confidence, understanding of your unique arousal style and mastery of your habitual thought processes.