Women who suffer pain during sex.

First things first.....

I have not yet met a woman who doesn't suffer shame, guilt and often a sense of hopelessness and confusion when affected by this this issue.

For many women, these feelings have been kept private, often exacerbating the difficulty in dealing with the problem. Years of silence and self-blame just compounds the guilt over knowing there is an issue with sex, yet feeling unable to start looking at it.

But...there's often a good reason why you might feel this way if you are one of a number of women who know they suffer pain during sex....

We live in a culture surrounded by images of, apparently, happy fulfilled women having endless, orgasmic sex.
'Everyone else can do it, but me...'
If you found sex difficult, painful or distressing, you may have discovered this during your teens or twenties, often not in relationships that could cope with broaching this kind of conversation. You may also have found it impossible to put into words your fears, concerns and experiences to others; for women of all ages, accessing appropriate help can feel daunting.

It can also be true that for women who have enjoyed a full and satisfying sex life, pain during sex can also occur for any number of other reasons causing much distress. Pain might be caused by;
trauma during or after birth,
irritating and debilitating skin conditions such as psoriasis and lichen sclerosus,
transition through menopause,
relationship tensions and poor sexual technique and other related issues.

A word on Vaginismus, Dyspareunia and Vulvodynia.

Often sexual pain will fall into one or more of these categories. Essentially they all refer to different types of pain;

Vulvodynia usually describes pain that has a burning sensation to it. This pain is usually located at one or more sites around the vulva, but may also occur inside the vagina.
Vaginismus is a diagnosis often give to women who describe tightness and/or varying amounts of pain at the thought of, or at the start of anything going into their vaginas. Some women can cope with a finger, but not a penis. Often these women have avoided using tampons and have not managed smear tests well, if at all.
Dyspareunia is a more generalised description often given to women who report recurring or persistent genital pain associated with sexual intercourse.

Please note: It is important to know that although some of this terminology may appear alarming, unhelpful or not describe the way you feel during sex, I would encourage you to see a sexual health nurse or informed GP to gain clarity and additional information where possible. There may be medical routes, or treatments with sexual health physiotherapists, suitable for your situation to alleviate pain.What can be done and how could psychosexual therapy help me?

Often the first thing that needs to happen is for us to talk; for you to tell me your story and for me to and listen well. This might be the first time you've taken the courage to come forward in an attempt to address this problem.

I will ask details about exactly what you are experiencing, or have experienced, so that we can start to find any patterns or reasons that may enable us to understand your situation more clearly.
We will discuss any medical interventions to date and what possibilities may have been overlooked or could potentially be explored.
We will then move on to look at how your thinking is affecting what's happening. We will look at re-framing certain ideas and developing new thinking patterns that give you a sense of control.
We will look at practical exercises based on your understanding of anatomy, develop relaxation techniques, and build self-confidence in your capacity to explore your sexuality and sexual response positively.

What if you are single or in a relationship but would like to come alone or with your partner?

I can work with any combination of the above; what matters is your comfort. Bringing your partner, if appropriate, is often the most productive way to work as both of you will be able to share learning and develop new skills together. Certain exercises are designed with partners in mind although many other 'homework' exercises can be done by yourself at home.

Coming as a single woman means that we can positively work on many aspects of this problem, but if you don't have the opportunity to put your learning into practice, we have some limitations. However, in these circumstances many women stop therapy when feeling more confident and knowledgeable, sometimes returning in the future with a partner to discuss any unresolved issues.
What's import for you is just starting the process.

There may not be a quick answer, or a magic key, but I would like you to take heart from the women who have worked with me over the years. Many report a fuller understanding of themselves sexually, have expanded ideas of what lovemaking is about and often have diminished pain as they positively practice different ways of being sexual. Some experience times of less pain, even pain-free sexual episodes, but, crucially, they can manage times of pain more confidently.

Useful Information can be found at:
http://londonvpsg.googlepages.com/home