Women's Sexual Health > Sexual Pain

Image Vaginal pain is a fact of life for far too many women. Vulvodynia occurs more frequently than most people realize. Approximately 16 percent of women between the ages of 18-64 have experienced chronic vulvar pain for at least three months or more, according to a survey by Brigham and Women's Hospital in Boston, Massachusetts. Vulvar pain is not a psychosomatic disorder. Vulvodynia is a pain disorder, and its cause is not yet well understood; Sufferers can experience intermittent or constant hurt for months, or even for years.

Many women living with vulvodynia experience feelings of despair and isolation. Guided Meditations to Support Women with Vulvodynia is a remarkably sophisticated, highly effective  and emotionally moving new CD, written and spoken by Dr. Carmen Pepicelli, with magical music by Paul McIntire and Peter Pillitteri M.D. I was asked to give feedback on this project while it was still in development, and it is gratifying to have the opportunity to review Dr. Pepicelli's CD. Dr. Pepicelli's goal has been to create a resource which would provide hope to women living with vulvodynia, to support ongoing treatment and to diminish suffering; she has succeeded most admirably in her goal.

Dr. Pepicelli writes: In vulvodynia, as in other chronic pain disorders, complex changes occur in the affected tissue as well as the brain and spinal cord, which result in normally quiet nerves becoming sensitive and irritable to such an extent that pain can occur even in the absence of a harmful stimulus. Once this pattern is established, the changes in the nervous system, the original cause, the expectation of pain and the resulting tensing of muscles can create a powerful pain loop which may be difficult to interrupt or change, even after the initial cause has been found and eliminated.

Guided Meditations to Support Women with Vulvodynia contains powerful imagery and music which can be used as a major tool in pain control: for instance, listening to it can increase physical relaxation, modifying tension, and lowering pain; Its guided imagery can help create an image of a time in the future when the pain is not there, creating relief in the form of a thought; It can alter the meaning of the pain: transforming the anxiety or threat that potentiates it.

Guided Meditations to Support Women with Vulvodynia will be a great help to sexual healing. Because the music, language, imagery, and Dr. Pepicelli's voice is relaxing and positive, the woman listening to this CD should be able to distract herself from vaginal and referred pain and to expand relaxation, which will allow her to expand the other kinds of sensual pain she can experience.

The pain experience is a complicated one, encompassing physical and psychological factors. Dr. Bruce Eimer talks about the elements of pain as: (1)Bodily sensation;(2)The experience of threat or interference with functionality;(3)An emotional feeling of unpleasantness or other negative feeling, based on the interference.

If it is bad enough, the experience of chronic vaginal pain can encompass and contaminate all aspects of life. For example, sufferers may have:

  • Preoccupation with pain and an inability to enjoy other aspects of life.
  • Sadness, depression, anxiety, guilt, feelings of anger and resentment toward others.
  • Negative self talk, pessimism about the future.
  • Fear of any sexual pleasure whatsoever, and anxiety and anger in their intimate relationships.
  • Social withdrawal or fears of abandonment.

The language and imagery on Guided Meditations to Support Women with Vulvodynia address the physical, the social, and the psychological components of vaginal pain. In my clinical experience, women with vulvodynia can feel a sense of stigma, a sense of not really being a woman like other women, and a social isolation growing from the fact that the affliction which so colors their life is way, way too private to share with most other people. Groups for women with vulvodynia are wonderful, but not everyone has access to one.

It's hard to be vulnerable and need support. In fact, sometimes it is difficult to get empathy and assistance from one's intimates. I've seen women whose closest family members grow "tired" of giving them support for their vulvar pain, as if their daughter or their sister is using "imaginary pain" as an excuse to get sympathy. Sometimes partners get frustrated at the limitations on sexual intimacy during times of pain flare-ups. Clearly, women with vulvar pain need to have resources which they can use independently, whenever they need them, to help them cope. Guided Meditations to Support Women with Vulvodynia is just such a resource.

One of the great things about this CD is that it is multi-dimensional. First, there is a spoken piece which is encouraging and educational. Listening to it, it is clear that Dr. Pepicelli understands the experience of chronic vaginal pain. She explains how guided imagery is useful for pain control. And the language is permissive enough for every woman listening to the CD to feel that she can do something helpful for herself in conquering her vaginal pain. Next there is a very powerful 23 minute long guided imagery meditation section, hypnotic enough so that it cannot be used when driving a car. It aims to lessen suffering by increasing a sense of control, hope and motivation, while decreasing shame, isolation and the side effects of treatments. It does this by inviting the listener to relax deeply while imagining normal functioning of the tissues. The carefully crafted language and imagery in this section is masterful and magical.

Lastly, there is a sweet, affirming lullaby. In it, friends and loved ones, practitioners and, (if the listener wants) spiritual guides, are called up. Using this tape over time, women suffering from pain disorders can begin to feel less vulnerable, more in control, more whole, and more hopeful.