Most important is listening to the partners' concerns and answering their questions. Existing lesions or defects should be corrected, if possible. For example, a tight hymenal ring may be stretched in the physician's office. Treating uncomplicated injuries is simple. Temporarily avoiding intercourse is important.
Sitz baths can relieve vulvar distress.
Liberal use of a water-soluble lubricant just before coitus can usually prevent pain and spasm. In some cases, posterior intromission that avoids pressure on a sensitive urethra reduces pain. For treatment of vaginismus, see below. For treatment of vulvovaginitis, see Ch. If the vulva is swollen and painful, a wet dressing of dilute aluminum acetate solution may be applied locally.