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Sex Shouldn’t Hurt

One of the main complaints that bring couples to my office for sex counseling is lack of sex. There are many reasons couples don’t enjoy sex anymore. Marital conflict, depression, and stress all affect libido. One of the reasons rarely talked about but perhaps one of the main reasons is “painful sex.” When a woman talks about painful sex the first thing a health care worker will think of is prescribing lubricants. This may alleviate the pain, and may cure the problem, but there are many things that cause painful sex besides dryness. The main hurdle to overcome is encouraging the couple to address the issue and talk to their health care professional about the problem. So many times, women believe painful sex is part of sex and they either avoid sex entirely, or endure the pain. This is unfortunate as sex is so healthy for women and men’s immune system as well as cardiovascular health, that to avoid it or endure it is not practicing a healthy life style.

The medical name for painful sex is dyspareunia. It is experienced right before sex, during, or after intercourse. It can happen in both men and women, but we seem to hear more about it happening with women. There a several common reasons which include: rapid intercourse, an inflamed bladder, dryness, scar tissue, positioning, nerve inflammation, STDs, and sometimes spermicides.

Men may specifically suffer more pain with conditions such as Peyronie’s disease (a curvature of the penis caused by scar tissue build up), and inflammation of the urethra or prostate. Women more specifically suffer when there is a lack of moisture in the vagina, fibroids, yeast infections, hormonal deficiencies, and genital fit with their partner’s penis.

What can be done depends on the cause. Research in this area has suggested that as many as 80% of people who suffer from painful sex learn to live with the symptoms. One in three endured painful sex weekly. Half of those surveyed never discussed the problem with their health care provider. If you suffer from painful sex the suggestions I recommend below can help you get started in resolving them.

  1. Begin by talking to your partner and make an appointment together (if comfortable) to see your health care provider.

  2. Ask your health care provider for a referral to a counselor who works with couples sexual issues.

  3. Reassure one another by exploring other options of expressing intimacy. Couples become more frustrated if their options of sexual expression no longer work. Exploring what feels good, and what you are willing to try often solves the problem.

Sex is one aspect of a healthy relationship. It is powerful and when working well is only 5% to 10% of the relationship. When it is not working well it becomes 90% of the focus. A healthy lifestyle includes pain-free enjoyable sex.


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