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Women who suffer from the chronic-pain condition vulvodynia often feel isolated from their partners.

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But a better medical understanding is helping. In her 18 years as a sex therapist in Orange County, California, Stephanie Buehler has come to recognize a certain tense, fraught dynamic in couples when a female partner has vulvodynia. The chronic-pain condition affects female genitalia, sometimes manifesting itself in generalized pain throughout the vulva and sometimes in localized pain that can be provoked through vaginal penetration. Either way, vulvodynia can make sex extremely painful. Sometimes a partner, especially a male partner, feels rejected, believing the female partner is exaggerating the pain she feels during sex as a way to brush him off.

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But not many chronic-pain conditions affect relationships in quite as direct and obvious a way as vulvodynia does. When Buehler meets one of these couples, she first works with them on integrating some forms of affection back into their lives—kissing hello and goodbye at the start and end of the workday, sitting together on the couch, holding hands as they walk to their car. Buehler also puts women in touch with pelvic-floor physical therapists or physicians who can treat the parts of the vulva that experience burning or stabbing sensations through massage, biofeedback therapy, injection of Botox, or surgery.

Female pain during sex has a long history of being misclassified, misunderstood, and blamed on the women themselves. As Maya Dusenbery writes in Doing Harma book about sexism in medicine, vulvar pain was first described in medical texts in the late 19th and early 20th centuries as a sort of recurring but mysterious phenomenon, a pain with no known cause.

Vulvar pain, which often shows up in tandem with vaginismus a condition involving spasms of the pelvic-floor muscles that can make it painful or impossible to have intercoursewas frequently believed to be a physical manifestation of unhappiness in a relationship, and thus methods for treatment included things like hypnosis, couples therapy, and numbing ointments—the last of which often made sex possible, though not necessarily enjoyable.

But even in the s and s, after feminist activism had more firmly embedded female sexual pleasure into the conversation about sexual health, vulvar pain—now beginning to be called vulvodynia—was still widely considered to be linked to psychiatric or psychological problems. As a result, many women who suffered from pain provoked by sex and other genital touching were told that they were simply frigid or uptight, or that they just needed to relax.

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But the media is starting to. Phyllis Mate co-founded the National Vulvodynia Association inand today she serves as the president of its board. The new attention to vulvodynia also revealed just how common the condition is. Research conducted in the mids suggested that some 8 percent of women were currently experiencing vulvodynia symptoms; a study found that an additional 17 percent of women reported having symptoms in the past.

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A study found that more than half of women who reported experiencing chronic vulvodynia symptoms had sought care, but received no diagnosis. In JulyAllison Behringer told the story of her own experience with vulvodynia on the first episode of Bodiesthe documentary podcast on medical mysteries that she hosts. The relationship intensified, but so did the pain, and as Behringer searched for a remedy, her partner became more and more frustrated by her inability to have penetrative sex with him.

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But soon afterward, the relationship dissolved. Behringer and her ex had started to fight about a lot of things, even after the sex got better.

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Despite the strides researchers have made in recent years toward understanding vulvodynia, living with it can still be a profoundly isolating experience. It can be like having all the frustrating everyday complications of any other chronic condition plus the added hardship of being shut off from one important and primal way to feel close to a partner. Of course, other kinds of sexual expression are in many cases still possible, but penetration is often considered an important or primary objective of heterosexual sex.

Recent research has found, however, that how partners respond can greatly affect the relationship quality of couples affected by vulvodynia. It was my struggle to be believed and be taken seriously. Swenson eventually underwent surgery for her vulvodynia. After a two-month recovery and an all-clear from her doctor, she and her husband had penetrative sex for the first time.

But while the outlook for these couples a generation ago would likely have been bleak, today help, and hope, are possible. To view the original article, please visit The Atlantic. Search for:.

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