The Psychologist's Perspective
Managing patients with gynaecological difficulties requires a great deal of sensitivity as well as an understanding of female sexuality, psychosocial and cultural issues. The genitals have many social, religious, emotional and moral connotations and, along with sexual behaviour, still carry many taboos. As such, working in this area requires discretion, a sound knowledge base, patience and superior interview skills. This eChapter aims address that need and clarify some of the nonmedical factors associated with chronic vulvar symptoms.
The author begins this eChapter by stressing the the contribution made by human behavior and emotions to the outcomes of many conditions, and an excellent diagrammatic representation of this claim is provided to illustrate the concept. Subsequently, the concept of damaging self care is explained, as are the psychological and behavioral motivations behind pathological behavior such as repeated unnecessary washing, the insertion of cleaning equipment into the vaginal cavity, and the excess or inappropriate use of cleaning fluids and liquids that ultimately result in conditions such as topical dermatitis.
The author then describes the range of sexual behaviors that can result in disease of the vulva and vagina, including the use of lubricants, untreated dyspareunia, and repeatedly submitting to sexual advances from partners when the recipient is not sexually aroused. The eChapter then describes in detail the psychological contribution to treatment of chronic vulvar disease, and suggests a range of strategies for effective patient management, including educational approaches and techniques based on cognitive and dynamic psychotherapy. The chapter ends with an exemplar of an instructional pamphlet that can be used in practice for patient education.
This eChapter forms part of the Ausmed publication The Vulva and Vaginal Manual, edited by Graeme Dennerstein, James Scurry, John Brenan, David Allen and Maria-Grazia Marin. A richly illustrated and comprehensive guide to the identification and treatment of over 275 vulvovaginal diseases The Vulva and Vaginal Manual is an invaluable resource especially suitable for:
- General Practitioners
- General nurses
- Practice nurses
- Nurse Practitioners
There are also 14 additional eChapters from The Vulva and Vaginal Manual available for members to download from the Ausmed website. Subscription also entitles members to access the full range of resources that compliment and build upon the material described within The Vulva and Vaginal Manual, including a richly populated catalogue of Audio Lectures, Fast Facts and Video Learning Activities on the topics of gynecology, obstetrics, oncology, women’s health and a wide range of other healthcare topics. Both members and non-subscribers alike may also purchase a hard copy of this book of from the Ausmed Education Online Bookstore, along with hard copies of the complimentary publication Gynecological Cancer Care: A Guide to Practice.
- An integrated approach: understanding the multifactorial nature of chronic vulvar disease
- The personal determinants of abnormal vulvar health, including hygiene, sexual behaviour, scratching, substance use, fear and unaroused sex
- Strategies for effective patient management
- Complex assessments: understanding the importance of culture
- Effective and sensitive patient education and counselling
- An exemplar pamphlet on genital self-care that can be given to patients.