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To be added.

The most important thing about treatment is to make sure you know what the cause is. There are a number of reasons for pain in the lower body and the vagina, and if the cause is not found, you could have the wrong treatment.

First Step

As a start, see your doctor. If you have had a baby recently, see your gynaecologist. There can be tiny folds or cracks or bits of a scar which can give bad pain.
Visit a Well Woman Clinic if you have not had a check up for a while. Go to the Genito Urinary Clinic if you think it would be wise to have a total check for any infection They are very expert, completely confidential, and will treat anything that is going on. If you have vulval pain that seems not to be any of these, it could be one of the vuvlval pain syndromes, like Vulvodynia.

 Visit http://www.vulvalpainsociety.org for more information.

If all is well Medically...

1. The most likely reason is that you are not turned on enough when you have sex. See Arousal Difficulties for more about this.
2. Another reason is that the relationship you have is not working for some reason and you are angry but not showing it.
3. The pain may be "in your head". People think this means you are making it up, but it is a real pain. It is very likely to get better with Sex Therapy and a therapist will take you through this at a pace which is right for you. Any hidden bad feelings that you have, can be talked about and got better in the therapy.

Greg is a 24 year old with a lifelong fear of sexual penetration. Ever since he became aware of his own sexuality he has known that he has not wanted to have intercourse. He says that he is heterosexual and that all his fantasies are about women. He can masturbate to these and has had a series of girlfriends - with whom he has been sexually active. He can achieve penetration, but is aware of a general anxiety that sweeps over him. He says that he prefers his girlfriend to masturbate him with her hand, or that they masturbate themselves in from of each other.

He and his partner Joanna want to get married and start a family. Greg wants to deal with his problem. Joanna thinks that Greg is frightened of being intimate with her, and possibly not wanting to make a commitment to marriage. Greg denies thus, and they have both argued a lot about this before coming to see a therapist.

If you have noticed a change in your level of sexual desire, it may be a normal effect of stress or tiredness, chronic pain and illness, or simply that you are getting older. Loss of a close relative or loved on is a very natural reason to lose sexual desire.

Loss of desire in these cases, except for during bereavement, can be improved by increasing the time you spend thinking about sex, inventing some new fantasies, trying new things with your partner,and masturbating more often, but not so often that your ability to be sexual in other ways is impaired. During bereavement, you just have to wait until your mourning is over.

If you are in a relationship, it is really important to talk things over with your partner. There may be hidden anger or resentment which are the commonest reasons for reduced desire with a partner. If your partner is angry with you, you may pick it up at an unconscious level, and be affected by it. If you are angry with your partner, the same thing can happen. Partners often blame themselves, thinking they are no longer attractive to you, or that you don't love them any more.

If talking to each other is too difficult, a therapist could help you get the ball rolling.

The first part of overcoming Premature Ejaculation is thinking about the situation and how it is affecting you. Think what makes it better or worse, and any self help you have tried. It can be useful to talk over your previous sexual history with a therapist. Family traditions and ideas about sex may also be important.

One thing to remember is that usually there is nothing wrong with the penis.

Once the underlying causes of the difficulty have been addressed your therapist may prescribe sex therapy exercises, with special training work for ejaculation. These will be slightly different according to whether you have a partner willing to join in the therapy or not. The two main techniques for therapy are the Squeeze Technique and the Stop Start Technique.

There are various drugs which can help with this problem, and using them alongside the practical techniques can be really effective. Sometimes the medication on its own can be enough.

If the pain has a medical cause, the the treatment may be a combination of medical and psychological approaches. We are not describing all the medical treatments on this web site, but if you want to mail us we will answer your questions. Click on "contact us" on the side bar.

The first step in treatment is to try to discover the reasons for the pain, so a sexual, relationship, and life history will be discussed.
Sometimes body tension causes pain, and Relaxation Training can help.
Deeper reasons may be helped by Self Hypnosis, which may also be effective as pain control.
Most men experiencing painful sex will be helped by Sex Therapy and a therapist will be able to guide you through it at a pace suited to you and tailored to your own particular needs.

First we want to understand the causes of the tightening up of the vagina, so a full discussion is important before embarking on any treatment. Also talking together allows the woman and the therapist to get used to each other, and builds a trust between them, which is necessary in this type of work.

Some of the common causes for this troublesome condition are:
· Lack of knowledge, wrong beliefs, strict upbringing,
· Past infection, trauma, or injury in the genital area,
· Difficult relationship with your partner,
· Concerns about intimacy or commitment,
· Difficult childbirth or genital surgery,
· Sexual trauma.
All these can be discussed and helped before doing any physical work.

Sometimes there are deeper reasons, and therapy, counselling or hypnotherapy would help with these. There may have been Sexual Abuse which would need extra time and care to recover from.

In treatment, the vagina has to be taught to become less tense, by accepting touch on the outside at first, then gradually a cotton bud, finger or small trainer on the inside. Larger Vaginal Trainers can then be introduced. When the vagina can accept all sizes of trainers, it is usually able to relax sufficiently to have intercourse, and Sex Therapy helps with this.

The psychological causes of erection difficulties are most often related to fear of failure, performance pressure and anxiety. There may be relationship stresses which make the problem worse. You really need to see a therapist for psychological treatment.

The first stage is to understand all the things which are causing the problem. There is often more than one cause. As far as possible, it is better to be seen with your partner if you have one, as it is much easier to overcome the psychological causes with the help of a partner. This is especially so where the problem only happens in the relationship.

Once the causes are understood, the next steps will be agreed with the therapist. Sometimes there are Sexual Abuse issues to be managed. Relationship stresses may need to be resolved. Any unrealistic expectations will have to be changed.

In the end, the most effective treatment will probably be sex therapy, but at first you may not be ready for it. Your therapist will guide you through it, and deal with any obstacles along the way.
A userful book is The New Male Sexuality, by Bernie Zilebergeld

 Full information about the mechanical choices open to you can be read on the web site of the manufacturer at Owen Mumford.

Once you have seen the information, you may want to speak to a therapist to help you decide on what is right for you.
Or you may have made your decision, and want to contact a therapist to help you decide how to make it part of your lovemaking. All of us are able and willing to discuss these choices with you.

• KY Jelly- Available in a range of sizes, this is the best known and most often used lubricant. However it can feel cold, and become sticky. It is available on most chemist shops at about £2 53 per 82g Tube. Try it, and if you don't like it, try something else.
• Aquagel- Very like KY, but some people say it is less cold. £1.27 per 82g Tube. Available from FPA SexWare Catalogue
• Sylk- Is more liquid, and like the natural vaginal fluid. It is not n oil, but a polymer. It costs about £9.95 per 40ml, from FPA SexWare Catalogue
• Senselle- Very like Sylk, and available from Boots and other chemist shops at about £2.25 per10ml, £5.75 per 40ml. High street chemists and FPA SexWare Catalogue have it.
• Replens- Is a pessary containing hormones and is meant for menopausal women who may have dryness of the vagina because of the lessening of oestrogen that happens in the menopause. Insert one every three days or so. £3.85 per pack of 3, £6.95 per pack of 6. Available from FPA SexWare Catalogue, and most chemists.
• Vaseline- Is a tried and trusted method, if rather old fashioned. There are nicer products. Never use it with condoms or diaphragms as it may damage the latex.
• Other oils- Vegetable oils are OK in some cases, but be careful that what you use will not cause an allergy, or damage condoms or diaphragms.