Reconnecting through Intimacy

Presenting a Biopsychosocial Intervention for Women with Sexual Dysfunctions and their Partners


About Amy and James

Paris, 2009

These are Amy and James on their first vacation together in 2009. They had a very happy relationship, however Amy had experienced traumatic sexual experiences with her first boyfriend, which lead her to experience chronic pain during sexual activity.

"I miss feeling connected to my partner, and am afraid he will leave me so I try to engage in sexual activity despite the pain"

Amy

Beginning of the new Relationship

In order to be able to be intimate with her partner, Amy tried to disregard her pain and engage in sexual activity with him. To not hurt James, Amy avoided telling him about her painful experiences. Amy grew up in a conservative household and was ashamed to talk about her pain with her family or friends.

50 % of women experiencing pain during sexual intercourse are hesitant to inform their partners

And women frequently report to want to engage in sexual activity despite pain

However, the pain increased and Amy could no longer experience sexual intercourse with her partner

Amy experienced decreased self-esteem and confidence and started to avoid intimacy with her partner, which put a strain on their relationship

Amy searched help from her doctor

But as GPs and Gynecologists are frequently not trained in diagnosing sexual dysfunction and still experience shame around the topic, Amy was frequently dismissed, not taken seriously, and not diagnosed.

As Amy is reacting avoidant to James, their disconnection increases and they fight a lot

Amy is afraid to loose James if she will not be able to engage in sexual activity with him

Amy and James join an Intervention for Women experiencing pain during sexual activity and their partner's

About 10 - 28 % of Women in the general population experience pain during sexual activity


Background on Vulvar Pain

Sexual pain is prevalent all over the world, with prevalence rates between 10 and 60 %

Factors associated with the development and maintenance of vulvar pain

Causes of Vulvar Pain According to the Biopsychosocial Model

Overlapping chronic pain conditions

  • Chronic fatigue syndrome
  • Endometriosis
  • Fibromyalgia
  • Irritable Bowel Syndrome
  • Interstitial Cystitis

Psychosocial Effects of Vulvar Pain

  • Negative consequences of social narratives around womanhood, sexuality and femininity, emphasizing penetrative sex, the role of women to provide sex for men, and portrayals of sex as easy and normal
  • Experiencing the health-care community as dismissive and at times uninformed
  • Feeling shame and guilt associated with psychological distress, low mood, anxiety, low self-esteem and social isolation
  • Positivity about the availability of changing narratives elucidating a way forward such as empowerment, self-efficacy, and group and individual multidisciplinary approaches

For an appointment at the Mayo Clinic Women's Health Clinic, please call 1-507-538-3270 or visit www.mayoclinic.org, and specify the Women's Health Clinic. Vulvodynia is a term that simply means pain of the vulva. Vulvodynia is a silent epidemic affecting 1 in 4 adolescent girls and women. While no one treatment for vulvar pain or genital pain is right for every woman with vulvodynia, several treatment options are available.

Amy looking for help after being dismissed by her doctor


The Intervention

Intervention for women affected by vulvar pain and their partners according to the biopsychosocial model

The Biopsychosocial Model


Biological

Medication, vaginal dilators, food intake, hygiene, clothing

Social

Communication in couple, re-writing sexual script (away from pressure on penetrative intercourse), learning what is desired and how to communicate it, partner-responsiveness to pain

Psychological

Psychoeducation on condition, work on own attachment style, address trauma, own communication skills

Goal

Develop ways to communicate with each other and find ways to rebuild intimacy and connection


Amy and James now

Amy and James enjoying different kinds of intimacy and feeling connected after completing the intervention

Credits

illustration

storyset.com by freepik

Paris, 2009

Factors associated with the development and maintenance of vulvar pain

Amy looking for help after being dismissed by her doctor

The Biopsychosocial Model

Amy and James enjoying different kinds of intimacy and feeling connected after completing the intervention