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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:

  • Gynecologists
  • Dermatologists
  • General Practitioners
  • Obstetricians
  • Midwives
  • 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.


Contents include

  • 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.
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Author / Editor Biographies

MBBS and FACD.
John Brenan is a dermatologist practicing in Melbourne. He is a past President of the Australian College of Dermatology, consultant dermatologist to the Mercy Hospital for Women and the original dermatologist for the Dermogynaecology Clinic.
MBChB, MMed, PhD, FCOG (SA), FRANZCOG and CGO.
David Allen is a certified gynaecological oncologist practicing at the Mercy Hospital for Women and the Peter MacCallum Cancer Centre, East Melbourne. He is an Associate Professor in the Department of Surgery at the University of Melbourne.
MBBS and FRCPA.
James Scurry is one of Australia's leading gynaecological pathologists. He is a pathologist in Newcastle, New South Wales.
RFD, MBBS, FRCOG (UK) and FRANZCOG
Dr Dennerstein is an Obstetrician and Gynaecologist with medical expertise in the health of the vulva and vagina. He is the former Head of the Dermo-gynaecology Clinic at The Mercy Hospital for Women and co-author of the book entitled: The Vulva and Vagina Manual. He has lectured extensively on this topic, both internationally and nationally. Graeme has extensive experience in family planning and reproductive health. In 1971 he established the Family Planning and Infertility Clinic at the Western General Hospital in Melbourne, serving as its director until 1986. From 1980 to 1989 he was the ...
MAPS
Grazia Marin is a psychologist in private practice in Melbourne and past committee member and Education Officer of the Victorian Psychosexual Society. She is also a member of the International Society for the Study of Vulvovaginal Diseases and is serving on its Patient Education and Sexual Difficulties committees.

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