Provoked Vestibulodynia (PVD) and Vaginismusn
PVD involves chronic and distressing genital pain. Sensations can include sharp pain, burning, irritation and rawness around the vulvar vestibule. Vaginismus or pelvic muscle tension can also occur and it makes vaginal penetration very difficult or impossible. PVD symptoms can be provoked by light touch, tampon insertion, sexual penetration, and gynecological examinations. PVD affects up to 20% of reproductive age women in Canada.
PVD is a physical condition related to sensitized nerve endings, nerve proliferation and chronic inflammation. Psychological stress can also act as a ‘volume control’ for pain. Anxiety, fear of pain and other stressors can make nerve endings more sensitive and can exacerbate pelvic tension.
Intercourse, for women with PVD or Vaginismus is either painful or impossible. Women with PVD or Vaginismus often experience diminished sexual desire, as well as feelings of inadequacy, helplessness and shame. They may be hesitant to start a relationship and they often experience frustration and tension if they have a partner.
Effective treatment for Provoked Vestibulodynia (PVD) and Vaginismusnt
PVD and Vaginismus can cause a lot of suffering. Treatment options used to be limited but in recent years a very useful treatment program has been developed. The program is a specialized version of Mindfulness-Based Cognitive Therapy (MBCT). MBCT has been shown to be effective for chronic pain management, for reducing sexual distress and anxiety, and for enhancing sexual desire. Women with PVD who have completed an MBCT course feel better about themselves and more in control and less helpless when they think about or engage in sexual activities. The course does not ‘cure’ the pain but participants learn to be less reactive to pain sensations so they can experience sexual arousal and intimacy. They judge themselves less and they are better able to negotiate sexual preferences as an equal sexual partner. They also feel more confident about when, or if, to reintroduce intercourse, or other penetration into their sex lives.