Independent medical expert answers
on psychiatry and psychology

Treatment of Painful Sexual Intercourse

Written by: Wendy Moelker, psychologist in charge of Emergis, Goes, the Netherlands and Kerstin Granberg- Lundgren, HudSTDkliniken AC, NUS, Umeå.
First version: 22 Jul 2008. Latest version: 05 Apr 2009.

Abstract:

Depending on the cause, different experts can help.

Question:

How can painful sexual intercourse be treated?

Answer:

It is important not to make love when it hurts. Pain indicates the existence of a problem. Consult a gynaecologist or urologist for possible physical causes. And it is important to talk to the partner about the problem. Determine whether you are satisfied with the way you make love and about the relationship with your partner.

The treatment of a sexologist consists in searching for a possible cause of the problems and making the person aware of restraining, negative thoughts while making love and their consequences. The sexologist gives tips about how to deal with irritation of the vagina, e.g not washing the vagina with soap, wearing cotton underwear, hygienic toilet measures, etc. There are relaxation exercises and learning how to get control over the pelvic floor muscles. You will also get individual and couple related exercises to relearn again how to enjoy physical contact without fear of pain.

Women with vestibulitis should go to a clinic which specializes in the treatment of vulva problems. Such clinics sometimes have a gynaecologist, sometimes a skin doctor. It is very important to get to a clinic which has special competence on this specific problem. A combination of medical and psychological help is often needed.

Vestibulit is not always easy to treat. If a woman with vestibulit wants to try sexual intercourse, silicon-based lubricants are often better than water-based lubricants. Women with vagnismus need support in accepting the kind of sexuality which suits them. They need to know that it can be right to do without vaginal intercourse without having guilt feelings, and to experiment with other alternative ways of making love. Later on, they may be able to accept vaginal sex. For some women, help from a physiotherapist to learn to understand their bodies. Massage and acupuncture and similar treatments can sometimes also help.

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