ABSTRACT
Vulvodynia and the associated sexual dysfunction destroy the lives of women who suffer from it. Sexual pain disorders are common and can be so debilitating that they can break relationships or affect a woman's ability to function at work and home. Some women may choose to present with a direct appeal to a healthcare professional for help with a sexual difficulty. However, the most important principle that a clinician must embrace is that sexual pain disorders are a complex interplay between physical and psychological factors. The physical examination is part of the psychotherapeutic consultation in psychosexual medicine. In psychosexual medicine, every patient is unique and the approach to identifying and elucidating the nuances of each patient's story will vary from case to case. Pain with sex may be a secondary presentation, only disclosed when patients have found a person that they trust.
