The presence of a female assistant during the exam is critical. Figure 1 displays mean pain levels for each of these situations. Displays mean pain levels for each situation. Many couples draw on sexual interaction as their primary, if not sole, means of experiencing or expressing love and closeness. Disruption of this process can create havoc for women with CPP, independent of their pain intensity.
Sexual problems can also produce significant issues related to identity and femininity.
Some of our patients describe decreased feelings of femininity due to their inability to have sex and because their partners withdraw from them both emotionally and sexually. Even very supportive partners may back away from sex out of fear of causing their partner pain. Furthermore, pregnancy and infertility issues associated with treatment approaches are often overlooked in working with CPP patients. Some of our younger patients have had to choose between having a family or pursuing pain relief. Women with CPP, like other pain patients, often experience decreasing social support.