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.
Looking to the Future
Many women experience occasional mild flare-ups even after a successful
treatment. But Lucy and Nora feel lucky: They are still free from chronic pain
and remain sexually active. Like others with the problem, they hope that the
discovery about the defective gene will spur the development of a new treatment
and make more doctors aware that vulvar vestibulitis is a disorder that
Elaine Marshall is a freelance writer living in Reno, Nev. She also reports
for Time magazine and teaches at the Reynolds School of Journalism at
the University of Nevada, Reno.