Pelvic pain center addresses mind and body

By Kimberly Vandegeest-Wallace, PhD, psychologist

vandegeest-wallace-kimberly-BWP000T6Just like chronic pain in any part of the body, treating pelvic pain can be intensely frustrating and difficult for providers – often leaving them without a clear diagnosis or treatment plan.

Sexual dysfunctions can present complex challenges due to their many potential causes. From diverse physical conditions – including vaginitis or scarring from previous childbirth – to hormonal issues to social and psychological concerns, the underlying source of pain can be difficult to discover.

Qualified specialists at The University of Kansas Physicians' Center for Pelvic Pain and Sexual Health provide comprehensive, multidisciplinary care for couples suffering from pelvic pain during intercourse. In addition to addressing the physical causes, we support women and their partners by addressing the psychological, mental and social drivers that may be contributing to the occurrence of pelvic pain.

The benefits of talk therapy

Physicians at The University of Kansas Health System are unique in their ability to assess and treat physical causations of pelvic pain as well as provide emotional healing through talk therapy. Talk therapy is an effective option when mental or emotional components are influencing the sexual experience.

The role of emotions and embarrassment

Many women have grown up believing that sexuality is shameful or have been told "it's all in your head" or "you just need to relax." Pelvic pain is not psychosomatic; it is very real. Physicians don't always have immediate answers, but even so, empathy goes a great distance in helping these patients begin a journey toward physical, mental and emotional sexual health.

Associated embarrassment or hesitance to discuss sensitive issues openly and honestly presents a challenge to physicians. Seeking the support of a specialist – one experienced and comfortable with compassionately, professionally and thoroughly exploring personal, intimate scenarios with patients – can be advantageous.

Our physicians, physical therapists and psychologists combine skills to help determine the causes of each patient's issues. We can then develop tailored treatment plans to overcome symptoms and help patients attain a safe and satisfying sexual relationship.

Specialized care for sensitive issues

We frequently counsel couples to "repair the system" that is resulting in painful intercourse. Emotions are inextricably rooted in sexual activity and can play a role in the occurrence of pain. Anxiety, depression, fear of intimacy, relationship problems, stress and history of sexual abuse can all be contributing factors. Initial pain can lead to concerns of additional pain, which in turn can drive avoidance of activities associated with pain.

Often, dishonesty in patient-physician communication is motivated by fear or embarrassment, which can make resolving issues more difficult. Sex therapists at The University of Kansas Health System help patients discover their authentic sexual voices. We create an environment and partnership in which patients feel confident to honestly share their experiences. We guide them in learning to communicate what they want, and as important, what they don't want.

A comprehensive approach for better care

Patients who visit our clinic benefit from receiving medical, surgical and counseling services from a single collaborative clinical team. Given the highly case-specific nature of the field of focus, the wide-ranging diagnostic and treatment options available mean faster resolution for patients. Another advantage is the experience of our specialists. We see a large number of patients, and the treatment of each one has the potential of helping the patients who follow.

Because each case is unique, treatment plans must be diverse. Consider:

  • One patient reported five years of painful intercourse and was told by six different OB/GYNs that nothing was wrong. A single visit to our clinic yielded a need for estrogen cream, and the patient's problems resolved in two weeks.
  • Another young woman sought help from the clinic for painful sex. Clinicians soon discovered she had eczema inside her vagina. A combination of medication and therapy with her fiancé helped build a mutually intimate and satisfying relationship.
  • A woman with an assault in her history reacted with fear when her current partner tried to hold her hand. The couple sought counseling to help her redefine intimate contact as a positive experience. Therapy involved a focus on open, honest communication through guided hand massage – a safe, secure, lights-on, fully clothed scenario – for the couple to practice sharing thoughts on the contact they enjoyed or did not care for. They found it an intimate experience on which they could base further growth in their relationship.

While these patients have unique situations and backgrounds, what they share was a need for support in repairing systems. There are many ways to approach this, and our staff work with patients and couples individually to diagnose and treat uniquely. It's important to assess the big picture – of lives and of relationships – to heal the symptoms, and ultimately, provide a better quality of life.

Dr. Vandegeest-Wallace is a clinical psychologist specializing in sex therapy at The University of Kansas Health System. She also serves as assistant professor for The University of Kansas Physicians' Center for Pelvic Pain and Sexual Health.

Consult with a physician online. Or call 913-588-5862 or 877-588-5862.