ABSTRACT
Dyspareunia and vaginismus are disorders involving pain and sex. The pain wreaks havoc on the sex. It sets the stage for the development or reinforcement of comorbid sexual dysfunctions, negative sexual attitudes, avoidant and damaging behaviors, relationship discord, and declines in self-esteem and mood. These in turn augment the experience of pain. Despite significant overlap, pain may require certain interventions, while sexual problems may require others. An intersystem or integrative approach (Weeks, 2005) is thus the way to maximize effectiveness in the treatment of dyspareunia and vaginismus. In fact, a sex therapist alone is unlikely to properly assess or treat the painful intercourse without the collaboration of one or more other health professionals. A sex therapist, however, may be ideally suited to coordinate the effort if he or she has an understanding of the multidimensionality involved. The effort is a considerable one, as dyspareunia and vaginismus are difficult sexual problems to resolve.
