SEXUAL HEALTH: Parched like the Sahara

After four children and 17 years of marriage, Maria and Edwin were having a crisis in the bedroom. Sex left them with excruciating wounds in their genitals.

“A lot of thoughts have crossed my mind,” Maria said when they came to the clinic. “Could we be having a sexually transmitted disease? And where would it have come from?”

Edwin frowned at her and shook his head. “I hope Maria is not insinuating that I have been unfaithful,” he turned to me.

Yes, sexually transmitted diseases could this, but there are many other reasons. Occasionally, the pain is a result of muscle spasms during penetration as happens with vaginismus. In this case, only the woman feels the pain. The pain can also be psychological, arising from past trauma.

As I sat there listening to the couple narrating their ordeal, I knew we would have to investigate many possibilities. I interviewed them in detail to narrow down the possible cause of their pain. I then examined both of them.

One thing was clear: the couple was having dry sex. There was no lubrication before penetration, causing them friction and bruises in their genitals. We had to find out why Maria was unable to lubricate.

This condition affects about 16 per cent of women, and can be very depressing. Most couples choose to avoid sex under such circumstances, whether consciously or not. This can lead to a condition called sexless marriage (where coitus happens less than 15 times a year). Sexless marriage is a serious diagnosis because it can lead to divorce.

REASONS FOR DRY SEX

I explained the reasons for dry sex; physical illness of the blood or nervous system, or an abnormality of sex hormones. It can also arise from psychological causes, for example a bad sex experience in the past which then escalates into anxiety, making it difficult for a woman to get sexually aroused. A bad relationship in itself can also be the cause of dryness. When the relationship is in crisis, sexual arousal dies off naturally and lubrication becomes a problem.

Negative socialisation around sex is another common cause. As children, we are bombarded with negative sexual messages in school, church and everywhere. This can numb sexual feelings. Such beliefs cause withdrawal and numbness towards sex and lack of arousal and lubrication can be the result.

Back to Maria and Edwin: The diagnosis was that sex had become routine after 17 years of doing it the same way. They did not excite each other anymore, and they both rushed into penetration to finish it off.

Sexual arousal is at its maximum when you try out new things and take your partner to new places, and not when you do the same thing all the time. Lack of variety is the number one killer of intimacy. The more you explore new ways of doing things, the better your marriage is in the bedroom.

“Wow! Well put but you know what? I am totally blank when you talk of bringing variety to our sexual lives, I do not know how to explore,” Edwin laughed.

Skills enhancement is the work of sex coaches. Maria and Edwin were enrolled into a sex coaching class. After a month’s sessions their lubrication was back. I wished them happy times ahead in their marriage as they disengaged from the clinic, albeit for a while since sex concerns keep arising and require professional attention all the time.