Psychosexual Issues

Many people experience difficulties with sex at some point in their lives, both men and women. Psychosexual health is just as important to treat and in this section many problems - and resolutions - are covered. Please contact Conifer House for help and referrals for treatment.

1. Erectile Dysfunction - please see link

2. Dyspareunia
Is painful sexual intercourse, due to medical or psychological causes. The symptom is reported almost exclusively by women, although the problem can also occur in men. The causes are often reversible, even when long-standing, but self-perpetuating pain is a factor after the original cause has been removed. It's a common condition that affects up to one-third of women at some point in their lives.

A medical evaluation of dyspareunia focuses initially on physical causes, which must be ruled out before psychogenic or emotional causes are entertained. In the majority of instances of dyspareunia, there is an original physical cause. Extreme forms, in which the woman's pelvic floor musculature contracts involuntarily, is termed vaginismus.

The diagnosis of dyspareunia is made when the patient complains of recurrent or persistent genital pain before, during, or after sexual intercourse that is not caused exclusively by lack of lubrication or by vaginismus. Clinically, it is often difficult to separate dyspareunia from vaginismus, since vaginismus may occur secondary to a history of dyspareunia and even mild vaginismus is often accompanied by dyspareunia. It is important to establish whether the dyspareunia is acquired or lifelong and whether it is generalized (complete) or situational. Further inquiry should determine whether the pain is superficial or deep - whether it occurs primarily at the vaginal outlet or vaginal barrel or upon deep thrusting against the cervix. Even when the pain can be reproduced during a physical examination, the possible role of psychological factors in either causing or maintaining the pain must be acknowledged and dealt with in treatment.