PVD, an example

1. Introduction and educational aims of this chapter
Women, faced with PVD or chronic dyspareunia, or in laymen’s terms chronic pain during intercourse, have a serious problem. It turns sexual encounters from pleasure into pain, it occurs mostly in women at the early years of their sexual career, and moreover is difficult to treat. These characteristics make PVD an excellent case for teaching the psychosomatic approach of sexual problems.    
After reading this chapter you:  
- are able to recognize PVD as a sexual problem;
- know that it is not just a trendy disease but despite its unknown pathological origin, it has clear pathological substrates like a chronic infection with a lot of mast cells and a proliferation of nerve vessels in the vestibulum;
- know that a multimodal treatment, including the pelvic floor, sexual response and coping skills, is necessary;
- know that one of the most important strategies is to end the vicious circle of pain-fear/proliferation/hypertonia of pelvic floor/low blood flow-pain;  
- are familiar with a bio-medical as well as a psycho social explanation of PVD;
- are familiar with the most recent insights in diagnostics and therapeutics in PVD.
Moreover you have insight in and or know where in this book to find relevant information on:
- the reason why sexuality and procreation exist;
- the mostly used perspectives on human sexuality
- the sexual response and the anatomy of sex
- the epidemiology of sexual dysfunctions in women;
- the bio-psycho-social determinants of sexual dysfunctions;    
- the process of sex therapy in general;
- the process and content of the sexual anamnesis (history-taking);
- the process and content of sex therapy;
- the role of communication, collaboration and professionalism in sex therapy.