When a woman loses desire for sexual intimacy, there is a lot of talk about why. Commonly cited is that she isn’t trying, her hormones have betrayed her, or worse, she is labeled, “frigid.”

Yet there is silence about one of the most common underlying reasons for loss of desire: pain.

It has been estimated that 16-18% of women in the US have experienced chronic lower genital tract discomfort for at least three consecutive months. That means a whopping 14 million women will experience such pain during their lifetime, making sexual intercourse uncomfortable at best and extraordinarily painful at worst.

Of course, real intimacy is about experiencing meaningful connection and deeply pleasurable touch with the person you love. It’s not supposed to hurt.

“Not even a little?” asked a new client, eyes wide.  It should not hurt even a smidge.

But when it does, real intimacy is at stake.

If vulvodunia is causing burning, a woman may put a stop to feeling anything during sexual intimacy in an effort “to get through it.” Yet meaningful sexual intimacy is about feeling deeply, and feeling more —  not less.

It goes without saying that this hidden issue underscores a loss of sexual desire for many women. And often worse than the physical pain is the emotional distress and fear that the relationship could be destroyed due to this issue.

Unfortunately for women with vulvodynia, routine medical exams commonly pronounce everything, “normal.” And an astonishing number of women have been (horrendously) advised by medical professionals, “Have a glass of wine and get on with it.”  Of course, such ill advice leaves women feeling crazy and, understandably, less inclined to discuss the problem again.

Adding insult to injury, the misguided implication that “it’s all in her head” encourages her partner to believe that she is trying to avoid intimacy altogether when, in fact, she is just trying to avoid pain.

University of Michigan physician and internationally known leader in this field, Dr. Hope Haefner, explains that vulvodynia is “often undiagnosed or misdiagnosed.”

More important, Dr. Haefner points out, a failure to diagnose properly results in a failure to treat.

That so many women are untreated or mistreated for this illness is a sin because the pain resulting from vulvodynia can be successfully managed with proper care.

Where do you start if you are suffering with this issue? Here are my recommendations.

• Consult a gynecologist who specializes in vulvodynia or “vulvar disease.”  Many women have seen more than 10 doctors before seeking out a vulvar pain specialist who (finally!) identified the issue successfully.
• Answer the following question, “On a scale from 1-10, how much pain do you feel?” Share this number with your partner.

Jane told me that she felt “just a little bit of discomfort.” But when I asked her to use the above scale, she responded, “Well, I suppose if child birth was a 10, what I feel is about a 9.” In other words, like the vast majority of women with this issue, she downplays the level of discomfort involved. But quantifying the experience helps paint an accurate picture.

A woman’s partner may be left feeling rejected or less connected without knowing why. And in the majority of cases, partners have been shocked (and deeply upset) to learn that significant pain has been involved. Yet partners are usually immensely supportive once they get the full story.

• Even with the best care, this issue will take months to resolve. Find a sex therapist in your area who can help you rebuild both your emotional and physical intimacy in a safe way.
• Visit the National Vulvodynia Association (www.nva.com) for additional information
• A commitment to focus on non-genital touch is critical when dealing with vulvodynia (until vulvodynia pain is resolved).  Stop doing anything that burns or hurts in favor of anything that doesn’t.  If a woman can count on being pain free, then she can relax. And if she can relax, she can focus on intimate touch, intense eye gazing, and caressing with her partner that feels truly delicious to both.

And that leads to intimacy in which she can be deeply present with her partner, fully open to experiencing a deep and loving connection.

Lori Hollander is a dual-certified couples and sex therapist at the Center for Intimacy in Ann Arbor. E-mail her at star@toledofreepress.com.

Tags: Lori Hollander, Real Intimacy, vulvodynia

This entry was posted on Tuesday, August 17th, 2010 at 8:09 am and is filed under Real Intimacy, Star.
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