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    Does Sex Hurt?.

    A little-known condition may be the cause of your pain.

    Looking for an Interim Treatment

    Meanwhile, doctors and their patients usually explore a number of options to find a treatment that might help.

    For Lucy, the answer was biofeedback, a technique that measures specific body responses, such as heart rate or muscle tension, and relays them back to the user in the form of sounds or lights so the user can become aware of these responses and learn to control them.

    Biofeedback was first used to treat vulvar vestibulitis in 1995 by Howard Glazer, PhD, a clinical associate professor of psychology in obstetrics and gynecology at Cornell University. Glazer says about 90% of his patients have significantly reduced pain through biofeedback, to the point they can have sexual intercourse comfortably -- like Lucy, who enjoys intercourse with her husband once again and now has two children. "In biofeedback you reduce the painful inflammation of the skin by stabilizing the pelvic muscles," says Glazer, whose studies have been published in the September, 1999 issue of the Journal of Reproductive Medicine and elsewhere.

    Nora has found relief with a series of injections of interferon, an antiviral and antitumor medication that has been shown to block the inflammatory response in some women. For example, a January 1993 study in the Journal of Reproductive Medicine found that 27 of 55 patients (49%) treated with the drug reported "substantial or partial improvement." Before she tried this treatment, Nora had consulted 12 doctors. Most said there was nothing wrong with her. ''I'm the most optimistic person in the world,'' she says, ''and I became borderline suicidal.''

    Surgery to remove the painful tissue helped improve or cure the condition in up to 89% of women, according to a study published in the June 1995 issue of the Journal of Women's Health. But only a third to a half of them enjoyed long-term relief, defined as more than four years. And surgery sometimes makes the condition worse.

    Physical therapy is another potential treatment avenue. A study in the May-June 2002 issue of the Journal of Sexual Marital Therapy shows that 71% of women who took part in physical therapy sessions saw moderate to great improvement in pain.

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