Pain with intercourse or attempted intercourse is a medical condition which requires diagnosis by a medical doctor, preferably a gynecologist specializing in vulvar pain conditions. One of the most common conditions causing pain is PVD (provoked vestibulodynia) also known as vulvodynia, or vestibulitis.

Once diagnosed, the physician will likely prescribe appropriate treatments including physical therapy. However, medical treatment alone, may not be enough to address the distress of a couple attempting to enjoy a satisfying intimate life.

In heterosexual couples, the woman experiencing pain often feels guilty and “at fault” for wanting to avoid any intimacy due to the fear that any touch will lead to intercourse, and often the mail partner feels resentful and rejected. A recent study in the Journal of Sexual Medicine highlights the importance of couples therapy in the multidisciplinary treatment of sexual pain. 

Paquet and colleagues demonstrate that many couples experiencing sexual pain, perceive injustice about having to deal with sexual pain , and in fact, in my clinical practice, couples frequently express that they feel they are the only ones dealing with while their friends and contemporaries are likely enjoying a wonderful sex life. This injustice is associated with more sexual distress, and the authors suggest targeting these feelings in couples therapy.