Dyspareunia, caused by vulvodynia, has, like other sexual problems, evolved from being conceptualized as a psychological problem through a period when it became viewed by the medical world as a physical problem. It is now seen as being a combination of psychological and physical factors. However, no research to our knowledge has explored in depth the level of sexual and relationship dif® culties of this population. This investigation involved 172 women (85 suffering with vulvodynia and 87 women in a control group with general dermatology conditions) to establish the prevalence of relationship and sexual dif® culties, using validated questionnaires, a newly devised symptom checklist and a structured interview. The results demonstrated increased levels of sexual and relationship dif® culties within the vulvodynia group that need further exploration.