Adding behavioral sex therapy to physical treatment brings a powerful weapon into the battle with PVD. Little attention has been given so far to the benefits of different types of psychotherapy in couples affected by PVD, but, as mentioned above, the positive impact of couples’ therapy in solving romantic discord is clear. It can go a long way toward curing one of the main side-effects of PVD – problems with intimacy. Talk therapy also works wonders on a woman’s individual distress and anxiety, which is otherwise bound to affect her physically and must be taken very seriously.
Over the years of treating PVD patients, I have determined that the most effective approach is a combination of pharmacological, physical and psychosexual treatment, with surgery regarded as an absolute last resort. Generally, the best approach is Cognitive Behavioral Therapy that is focused on sexual symptoms, as this directly addresses constantly recurring behavioral patterns or “ruts”. Most humans are prone to reacting to a particular emotional or physical stimulus in exactly the way they reacted before. In the case of anxiety and tensing up around sexual activity, it’s important to break this pattern, and Behavioral Sex Therapy is designed to quickly and effectively do just that.
Overall, women who suffer from PVD should take heart. While treatment is still in the early stages of development, there is good evidence that a combination of drugs, physical therapy and psychotherapy will alleviate and even completely resolve the problem.

When does therapy end?


Traditionally, therapy ends when the patient is healed and can resume a satisfactory sex life. When this happens, our goal is accomplished, but the bond between patient and doctor often continues. Something very heartening happened to me not too long ago. A patient who had finished PVD treatment a few months before called for a consultation. I worried she might have had a relapse. On the contrary! She was very well and happy. In answer to my question: “What can I do for you?” she smiled and said: “I don’t need anything, doctor, but you are the one who gave me my life back, and a I feel a bond with you, so I’d like to keep coming back from time to time.” She had gone eight years without sex, and could not picture herself ever having orgasms again. She had been on the point of finishing her relationship and yet, in a few months, she was normal again, married, and enjoying sex.

One patient was making very slow progress and, though she was making some headway, I thought she and her husband of five years didn’t seem very motivated. She also had the discouraging habit of calling off sessions at the last minute. After four or five sessions, she and her husband simply stopped coming to see me. I doubted they would complete treatment or even stay together as a couple. But one day, out of the blue, she called to announce happily that she was pregnant.

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