Tuesday, January 11, 2011

A Public Service Announcement

By Maria Boccia, PhD
Professor of Pastoral Counseling and Psychology
Director of Graduate Programs in Counseling Charlotte campus

It happened again this week. A young couple called me for help. They love each other but are struggling because the wife has lost all interest in sex. They come to me for help with this area of their marriage. It has happened several times this past year. A young couple, faithful Christians, wait until marriage to have sex, and then (usually right on their honeymoon) there are problems.[1] They are confused and embarrassed. They don’t know who to turn to. They keep trying, but over time, the wife loses interest in sex, starts avoiding her husband’s touch, gets to where she actively dislikes sex and wishes they would never have sex again.
They arrive in my office ambivalent: hopeful and fearful, in despair and yet willing to try this as their last resort. He loves her, but he can’t go on like this. We talk about their relationship, how they met, how they fell in love, and how sad they are that they have gotten to this point in their marriage. Often, the final push to seek help comes because they want to have children. No intercourse, no children, unless they take extraordinary measures. At the end of the first session, I give them some papers to fill out and ask them each to make an appointment to talk with me individually about things. They agree. They are hopeful that I can help.
The wife comes to her appointment wary. She feels bad because she can’t meet her husband’s need for sex. She knows that God designed sex for pleasure between husband and wife, but she would rather just never do it again. Except that she feels guilty because he wants it. What can I do to help? We review the forms she’s completed. We get to those questions: Does it hurt. Yes. Where? How much? What kind of pain? Turns out, it has always hurt. She has avoided gynecological exams because they hurt. She can’t use tampons because they hurt. I wonder how she thought sex would be different. I tell her, something is physically wrong. Sex is not supposed to hurt. Let’s get you to a doctor who understands this and can help you.
She goes to the doctor I recommend. She is diagnosed with vulvodynia, vulvar vestibulitis, or vaginismus. The doctor starts a course of treatment. I work with the couple to help support the medical interventions and treat the psychological and relationship damage that has been done.
Then one day they come in, shyly smiling. They had pain-free intercourse! It’s a miracle! We celebrate. We work to repair the damage that the painful intercourse has done over the months, years, or longer. She becomes interested in finding pleasure in sex. Then my work turns to sexual enhancement, and I help them find each other. It is very satisfying work. It feels great to help this young Christian couple find God’s blessings in their sexual relationship.
Let me summarize: sex should not hurt. If intercourse is painful, if that’s a new problem or an old problem, if it’s just intercourse (or tampons and pelvic exams), it should not hurt. Not every gynecologist is prepared to deal with this. Sexual medicine is not in the curriculum of every medical school. If you or someone you love is struggling with painful intercourse, get help. It does not have to be this way. The sexual medicine practice I work with has information about this on its website (www.bestsexualadvice.com). You can also find a listing of doctors who specialize in sexual medicine on the website of the International Society for the Study of Women’s Sexual Health (http://www.isswsh.org/resources/provider.aspx). Don’t wait and don’t ignore it. When sex is good, it is a small part of satisfaction with one’s marriage. But when sex is bad, it is a huge part of dissatisfaction with one’s marriage. God intended sex for pleasure. It should not hurt.

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