SEXUAL HEALTH: Not all infections are STDs

The glands can get infected – normally, one at a time – by any bacteria, not necessarily those that are sexually transmitted. The infected gland accumulates pus mixed and lubricating fluid. This process takes a few days and the pain becomes unbearable. PHOTO| FILE| NATION MEDIA GROUP

What you need to know:

  • They had been married for three years and had one child. The child was a year old. I questioned Rose to establish what could have gone wrong.
  • Most of the time, sudden onset of pain during sex is caused by a lack of lubrication, leading to bruises.
  • However, the couple reported that lubrication had never been a problem for them.

Rose and her husband, Dave were going through a most difficult time of their marriage when they came to the sexology clinic to seek what they called a fair judgment. It started when Rose developed pain during intercourse. Within two days she could not walk. The pain was unbearable. She also noted a swelling in her private parts.

“All along in our marriage I have persuaded my husband to be gentle in bed but he never listens,” Rose explained, writhing in pain. “I am sure he has damaged something in my private parts, it is so painful!”

“It is a lie, I did nothing out of the ordinary, if you no longer want to have sex with me just say so, I am tired of these never ending accusations,” Dave raged.

I pleaded with the couple to let me assess the condition. Rose was 27 and her husband 30 years old. They had been married for three years and had one child. The child was a year old. I questioned Rose to establish what could have gone wrong. Most of the time, sudden onset of pain during sex is caused by a lack of lubrication, leading to bruises. However, the couple reported that lubrication had never been a problem for them.

On rare occasions, there may be tears in parts of the vagina if sex is rough. This is however quite unusual given that the vagina is elastic and can accommodate rather rough activity without tearing. 

Relationships and intimacy issues also complicate sex, and so I did a thorough assessment of these. Except for Rose’s complaint of rough sex, the couple had a happy marriage and I could not identify any pointers to disharmony.

SWOLLEN LABIUM

I went straight to examining Rose. The main finding was on her left labium. Labium is the spongy flap that closes the vaginal opening. There are two labia – on the left and on the right. Rose’s left labium was swollen, red and very painful to touch.

No wonder she was limping.

The swelling was full of fluid and was well demarcated. It did not extend into the vaginal canal. I made a diagnosis of Bartholin’s abscess, and explained what this was.

Inside each labium is a gland that produces lubrication when a woman is stimulated. These glands are named after the biologist who first described them. They are called Bartholin’s glands. There are two glands, one on the right and one on the left.

The glands can get infected – normally, one at a time – by any bacteria, not necessarily those that are sexually transmitted. The infected gland accumulates pus mixed and lubricating fluid. This process takes a few days and the pain becomes unbearable.

“So you mean Dave has infected me with a disease?” Rose asked anxiously.

“You need to behave. If you continue talking trash I will walk out of this clinic,” Dave interjected.

I once again asked the couple to be patient as I took specimens of the fluid from the abscess for laboratory examination to determine the type of infection. Treatment of Bartholin’s abscess requires marsupialisation – the opening up and drainage of the pus. The procedure is done under general anesthesia in theatre. “What? You mean it is that serious?” Dave interrupted, showing some concern. Surgery always scares people. The procedure took 30 minutes. Rose had to spend the night in the hospital recovering from anesthesia. She then had to sit in warm salty water for 30 minutes every eight hours while at home until the wound healed. Sex was suspended for four weeks.

A week later the couple came for review. The pain and swelling had almost totally subsided. Laboratory tests showed that the bacterium was non-sexually transmitted. “You see, I am faithful to my wife and that is why I got annoyed when she insinuated that I could have infected her with a venereal disease,” Dave said. Rose looked at Dave, tears welling up in her eyes. She stood up and hugged Dave tightly for a couple of minutes.

“I am sorry,” she whispered, “and just know that you are not rough sexually. I just didn’t know what was happening to me and I had to find an explanation so I accused you falsely!”

As the couple waved goodbye and walked out of the clinic, Rose leading the way, I was left thinking about how a small, infected gland can wreak havoc and even threaten a marriage simply because it is located close to the vaginal canal.