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Pain during sex

Mar 02, 2011

How a male partner responds to a woman’s chronic vulvovaginal pain could make her pain increase, but could also improve her sexual satisfaction, recent research suggests.

The study was conducted by researchers at the University of Montreal and the University of Montreal Hospital Research Centre. The Journal of Sexual Medicine published the findings in its October 28, 2010 online edition.

Researchers surveyed 191 heterosexual couples in which the woman had provoked vestibulodynia (PVD).

PVD is marked by discomfort in the vestibule – the area that surrounds the vaginal opening, where the vulva and vagina meet. In addition to the vaginal opening, the vestibule includes the urethra, through which urine exits the body. It also houses the Bartholin’s gland, responsible for vaginal lubrication, and other smaller glands that emit vaginal discharge.

Women with PVD feel discomfort, burning, and/or stinging in this area, sometimes at the slightest touch. Intercourse, pelvic exams, and inserting tampons are usually painful. Each woman with PVD has a different pain threshold. For some, intercourse is still possible, but for others, it’s not.

Doctors aren’t certain what causes PVD. On examination, they sometimes see some redness or inflammation in the area, but sometimes there is nothing visible. It is believed that for women with PVD, nerve fibers in the vestibule are oversensitive or overgrown.

The effects of PVD can be serious. Many women with PVD avoid sex, feel decreased desire and arousal, and experience more stress and relationship problems.

There are some treatments available for PVD. Women can apply a anesthetic cream or gel to the area and temporarily numb the sensitive nerves. This can be especially helpful for intercourse. Other treatments include vaginal dilators, which can help relax the pelvic floor muscles. Some women find pelvic floor physical therapy helpful and others go for sex therapy. Surgery is sometimes recommended, but this is rare.

The Montreal study considered the couples’ relationships. Researchers found that in couples with PVD issues, women may feel more pain if their partner is especially supportive or sympathetic. This may happen because the extra attention from her partner may make her feel more anxious about the problem. She might also be more focused on pain during intercourse.

However, researchers also found that a woman with PVD may feel more sexually satisfied when her partner shows concern.

“This study furthers our understanding of the importance of how couples communicate about PVD in predicting pain and sexual satisfaction in women,” comments Sophie Bergeron, a psychology professor at the University of Montreal in a press release issued by the university. “Results of our study can help in the development of targeted psychological interventions to assist couples in coping with PVD.”