What emotional, relationship, sexual and social issues did heterosexual couples raise when requesting sexual therapy (where a female partner was referred to a sexual difficulties clinic with a history of vulval pain) in a qualitative interview, prior to commencing couple psychotherapy?

The purpose of this study was a project which attempts to gain more understanding and insight into the syndrome and its effects on the individual and the couple relationship. This study hopes to describe in more detail what vulval pain and concurrent vaginal dryness means to the couple, and the effects on a couple of this chronic problem, in an area of the body which is currently taboo to many health professionals.

This further research analysis showed themes which had been experienced by most of the couples. These were the concept of emotional distress; failure and loss issues; specific damaging effect on the couple relationship; emotional isolation; and feeling uncared for by the medical profession who had ‘sent them’.

These themes, the other raised issues, their relevance to sexual therapy and to using appropeiate physical treatments, including increased and appropriate vaginal lubrication, will be discussed.

Psychotherapy was viewed as more likely to be helpful when the client views the professional as believing that the pain is real. The client may not initially consider therapy to be useful, particularly if the realistic goal of therapy may need to be to help the couple adjust to new sexual activities, where pain and dryness may be managed rather than cured.