The medical specialists are rightfully concerned with identifying and treating the pathology within their field of specialty. Like most people, they are not that particularly knowledgeable or comfortable discussing issues of sexuality. Although this may sound strange for doctors who specialize in treating vulvovaginal pain, many of my patients tell me that when they ask their gynecologist about details of sexual activity, the doctor becomes visibly uncomfortable. Now on the other side of the coin, we have the sex therapists. Before starting my work in pelvic floor muscle rehabilitation in the treatment of vulvovaginal pain, I had many years of training and experience as a sex therapist.
Sex therapists are from the ranks of mental health professionals.
No matter how much they try or know better, they are trained to look for unresolved or unconscious sexual conflicts or repressed memories of child or adult sexual abuse. Many of my patients tell me how frustrating it is to go as couples to sex therapy. Even though the therapists acknowledge that these are medical conditions, they can't help but delve into your psyche looking for psychological reasons why you have unexplained pain in your vulva or vagina. So once again the sufferer is left in the middle, with doctors inspecting the anatomy and therapists inspecting the psyche, but nobody helping you to get back to having sex. I confess that when I first started working with vulvovaginal pain patients using pelvic floor muscle rehabilitation techniques, I specifically stayed away from dealing with the sexual aspects of these problems, because I too had been clinically trained to assume there must be some psychological underpinnings to these vulvovaginal pain conditions.