SEX AND PAIN
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VAGINISMUS AND SEXUAL PAIN
Sex is not supposed to hurt, but for many women it does. There are many medical reasons for painful intercourse, and a physician should always be consulted. Pain might occur around the lips and clitoris, right around the vaginal opening, or deep within the vagina or abdomen. The pain might be a burning sensation, a sharp pain, or a dull ache. Women should be willing to talk with their doctors in detail, describing the location of the pain, the nature of the pain, and the activities that trigger the discomfort.
There are some women who, even though aroused, do not lubricate will. This might be because of age or medications being taken... or just something about the woman's biology. If this is all it is, this is easily solved with the use of a good, safe, water-soluble lubricant such as ASTROGLIDE. There is an article on this site that addresses the use of artificial lubrication.
Vaginal dryness can be a consequence of the hormonal changes associated with menopause. To learn more of this and the sexual impact of menopause, read the menopause article on this site.
There can also be discomfort during intercourse if a partner's penis is too long or too thick. This can be a real concern for some couples. If the problem is one of length and the woman feels discomfort when something internal is bumped, it might help if after being entered she closes her legs. This prevents deep penetration and might help avoid that particular kind of pain. The problem of girth or thickness is not so easily solved. With time and learning to relax, this might eventually resolve itself.
There are some women who feel discomfort with attempted penetration of even the smallest penis, finger or tampon. This might be the result of a condition known as Vaginismus. Vaginismus is the involuntary contraction of the muscles that surround the vaginal opening. The tightness prevents entry and the resulting pain causes the muscles to contract even more. The woman feels out of control of this and is unaware of the involuntary tightening at the opening of her vagina. Sometimes the harder she or her partner tries, the worse it gets.
Well over 85 percent of women treated for vaginismus will be having pain-free intercourse within six months of beginning treatment. The problem is best treated by a qualified sex therapist who will give the woman relaxation exercises to do at home. As the woman learns to relax her body in general and especially her troublesome pelvic floor muscles, the therapist will introduce her to homework using vaginal dilators. These dilators come in a graduated series of sizes. A woman works her way up from a dilator perhaps no thicker than a piece of chalk to a dilator approximating the size of her partner's erection.
Much of what a woman needs to learn about relaxing and being comfortble with vaginal containment can be learned alone. However, if the woman is in a relationship, her partner is likely to be involved early in the treatment so that he understands what the purpose of the homework. He will become increasingly involved later in the therapy as the couple nears the point in the therapy when the "homework" calls for the insertion of his penis.
©2001 Robert W. Birch, Ph.D.
A free brochure is available on the topic of vaginismus, but remember, this condition is best treated by a qualified sex therapist, in consultation with a gynecologist.
For the free brochure on vaginismus e-mail Dr. Birch. Write Vaginismus Brochure in the SUBJECT line and be sure to include your complete mailing address.
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PHYSICAL PAIN AND THE SEXUAL RESPONSE
Pain, whether it is chronic or acute, is distracting. It can disrupt your concentration on work, interfere with your enjoyment of a concert, ruin your conversation with friends, and rob you of your sexual pleasures. Pain can disturb sleep, lead to depression, or cause one to be irritable with those you love. Being in pain, being tired, being depressed, and feeling irritable is not conducive to a relaxed and exciting sexual encounter. The impact of pain is further complicated by impaired mobility or loss of flexibility. Sour muscles, stiff joints, head aches or back pain can severely dampen the enthusiasm of even the most highly motivated lover.
If you are in pain and on medication, you should be knowledgeable about their medications and must be aware of any sexual impact of any pain pills, muscles relaxants, or other medications (prescription and otherwise) you are taking. If in pain and taking medication, do not hesitate to ask your physician and pharmacist about any possible sexual side effects.
People living with chronic pain are more likely to need to plan sexual activities in advance than are those who are pain free. If you know there are no sexual side effects with your medication and know when it kicks in, sexual "dates" can be synchronized with the medication regimen. Make love with then pain relief is at its maximum/ Of course, spontaneity is lost, but loving couples are able to start from scratch and make good things happen.
When beginning from scratch, relaxation is essential. Create a romantic atmosphere... light candles and put on some soft sensual music. A hot bath might loosen joints, relieve some pain, and help with mental and physical relaxation. A pain-free partner might find it exciting to kneel beside the tub and bathe his or her loved one.
People with pain must protect themselves and should never feel guilty about being "selfish." If you are the partner with pain, ask for a slower pace, more attention, and even less active participation. It is OK to ask for pleasure and, furthermore, to ask for it in a way that does not cause discomfort or exacerbate the pain.
In a sexual relationship in which one or both partners experience pain, creativity becomes a requirement. A woman with arthritic hips might not be able to open her legs without discomfort, a man with back pain might be unable to actively thrust. New positions of intercourse should be tried, and couples should not shy away for oral sex if intercourse triggers pain. Manual stimulation to orgasm for one or both might be the only option available.
If pain or medication has dulled genital sensitivity, couples should explore the possibility of incorporating a vibrator into their sex play. Some electric body massagers double as sex toys, and never forget, a vibrator feels as good to a man as it does to a woman!
It has been said, "Sex is perfectly natural. However, it is not naturally perfect." Sexuality is not just for the young, the able-bodied and the pain-free. Sex is not a competitive sport... there are no scores for acrobatic performances. The success of a sexual encounter is dependent only on two loving human beings spending time exchanging intimate touch, giving and receiving pleasure, and bonding with their hearts. Bonding with genitals is also quite nice, but not a necessity!
©2002 Robert W. Birch, Ph.D.
Read articles on Erectile Dysfunction and Viagra
Articles on Sex and Pain
Information on Sex and Menopause
Find information on sexuality and disability at SexualHealth.com
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