SEXUAL HEALTH: The pain of intimacy

It is the dream of every woman to orgasm during sex. In fact, women who have never had one, or those who only get them infrequently, often visit the sexology clinic looking for answers.. PHOTO | FILE

What you need to know:

  • Almost a year ago, Mary had developed a rather strange pain that accompanied orgasm.
  • There was no pain during intercourse but as soon as she reached climax, it was like someone was slicing her pelvic organs with a blunt saw.
  • “It is so painful. It goes for hours and I even have to miss work,” she explained.

It is the dream of every woman to orgasm during sex. In fact, women who have never had one, or those who only get them infrequently, often visit the sexology clinic looking for answers. I was therefore taken aback when Mary came to see me asking for medicine that could suppress orgasm.

“I love sex but I hate orgasm,” she said after noticing my inability to hide my disagreement with her request.

She was 37 years old and was married to one Alfred, 40. They had been married nine years with three children to show for it. Both Mary and her husband were lawyers. “So why would you want to run away from pleasure, my learned friend? Are you among the few in the world who have a phobia for good things?” I joked, trying to break the ice.

“Pain, doctor. It is so painful that I have kept off sex for the last several months,” she replied, sounding concerned.

Almost a year ago, Mary had developed a rather strange pain that accompanied orgasm. There was no pain during intercourse but as soon as she reached climax, it was like someone was slicing her pelvic organs with a blunt saw. “It is so painful. It goes for hours and I even have to miss work,” she explained.

After repeated episodes of the nasty experience, Mary decided to call it quits. She said bye to sex, since the pain could not be compensated by the pleasure of it. It had been almost 11 months into quitting sex when it became obvious to Mary that her marriage could not survive without sex. The relationship between her and Alfred was getting strained and, according to her assessment, divorce was beckoning.

“And so I feel you hold the key to saving this marriage,” she said. “If you can get me medicine to suppress orgasm, I will resume sex.”

Mary’s approach was the wrong one. Pain during or after orgasm requires medical investigation. A number of complicated diseases such as endometriosis and pelvic congestion, as well as medicines taken to treat other diseases, could cause pain associated with orgasm. A number of cases are also found to be idiopathic, i.e. of unknown cause.

As such I subjected Mary to physical examination after a detailed medical history. I could not put a finger to her diagnosis and so I ordered for tests, including ultrasound of the pelvis. Everything turned out to be normal. “So your tests show that I have no disease; do I conclude that I have been bewitched?” Mary asked.

 NO CAUSE FOR PAIN

I could feel her frustration. A diagnosis would have been comforting and conclusive, but I had no choice but to conclude that hers was idiopathic. Many theories have been advanced to explain idiopathic orgasmic pain but nothing has been scientifically confirmed. To some researchers, idiopathic orgasmic pain is the result of declining female hormones as one approaches menopause. Some doctors give hormone therapy to ease the pain. This however did not work.

Other researchers relate idiopathic orgasmic pain to use of low-dose oral contraceptive pills. Such researchers have stopped affected women from using the pills but again this did not stop Mary’s orgasmic pain. There is no end to the theories that can be advanced to explain this syndrome. As scientists always say, when we do not know the answers we cleverly hide our ignorance by inventing reasonable theories and we keep changing them in the hope that we will bump into an answer some day.

“So are you saying that my marriage is destined for the dogs?” Mary asked. She was visibly irritated. To save the marriage, the couple had to come to the clinic for counseling sessions. Alfred needed to understand Mary’s problem.

“Well, doctor, if I knew exactly what I would have to deal with when I said the ‘for sickness or for health’ part of our wedding vows I would have given exceptions,” Alfred laughed. He had a pleasant personality and this made the counseling sessions relaxed and interesting. In fact after three sessions we had fully covered what needed to be covered. The couple had learnt how to have sex without reaching orgasm, or alternatively reaching a painful orgasm.