Vulvovaginal pain problems are major health concerns in women of childbearing age.Controlled studies have shown that vulvovaginal pain can adversely affect women and their partners' general psychological well-being, relationship adjustment and overall quality of life. These women have significantly lower levels of sexual desire, arousal, and satisfaction, as well as a lower intercourse frequency than normal controls. They also report more anxiety and depression, in addition to more distress about their body image and genital self-image. Empirical studies indicate that specific psychological and relationship factors may increase vulvovaginal pain intensity and its psychosexual sequelae. Randomized clinical trials have shown that psychosexual interventions, namely cognitive-behavioral therapy (CBT), are efficacious in reducing vulvovaginal pain and improving associated psychosexual outcomes. Women reporting significant psychological, sexual and/or relationship distress should be referred for psychosexual treatment. A multimodal approach to care integrating psychosexual and medical management is thought to be optimal.Keywords: vulvovaginal pain, vulvodynia, provoked vestibulodynia, psychological adjustment, sexual function, cognitive-behavioral therapy 3 Vulvovaginal pain problems are major health concerns in women of all ages. As conditions which are often misdiagnosed, mismanaged, trivialized or ignored, they entail a great personal cost to patients and a significant financial cost to society [1]. A case in point is vulvodynia: a population-based study suggests that the lifetime cumulative incidence of vulvodynia is 16% [2, 3] and its incidence is thought to be increasing in young women [4,5]. In fact, many women suffering from vulvovaginal pain are under the age of 30, with community estimates showing that one in five women aged 18-29 report chronic dyspareunia [6]. In addition to disrupting all aspects of sexual function, controlled studies have shown that vulvovaginal pain can adversely affect women and their partners' general psychological well-being, relationship adjustment and overall quality of life [7, 8]. Because of their deleterious impact on sexuality and romantic relationships, vulvovaginal pain problems may indeed carry a heavier psychosocial burden in comparison to other pain problems common in women, with many patients reporting feelings of shame, inadequacy and low self-esteem [9]. Further, up to 45% of women with vulvodynia report a comorbid-pain condition, and having a comorbidity is associated with increased feelings of isolation and invalidation [10]. In terms of helpseeking behaviors, epidemiological results indicate that only 60% of women who report chronic vulvovaginal pain seek treatment, and 40% of these never receive a formal diagnosis [5]. A recent study involving a community sample showed that women saw an average of five physicians before diagnosis [10]. The quality of health care received by this patient population is thus less than optimal. It has been suggested that a multi...