Psychological Concerns & Sexual Health
Like other pain conditions, patients experience frustration, fear and anxiety that can lead to depression and decreased coping. Patients should be screened and treated for depression. Some patients are on anti-depressants and these may in fact be aggravating their sexual problems.
The chronic association of sex with pain can result in decreased sexual self-esteem, avoidance of sexual situations, decreased sexual frequency, inhibited sexual response and diminishing sexual intimacy within the relationship. Women may develop fear and anxiety associated with sex.
Couples are often unprepared to cope with the diminished sexual intimacy, and their emotional and physical intimacy may be also adversely affected. Couples need to be advised to avoid painful sexual activity. Abstinence will not cause the pain to go away but it will stop the association of sex and pain. Couples need to continue to engage in pleasurable sexual activity. Many couples will benefit from sexual counseling to help them enhance their sexual intimacy. Counseling has been found to be an effective intervention in reducing sexual pain.
Studies report that patients with vestibulodynia do not have an increased history of emotional, physical and sexual abuse compared to the general population. Patients with abuse in their history however may have more difficulty coping with this condition and may also benefit from counselling.