SEXUAL HEALTH: When intimacy is unbearable

Friday October 6 2017

Dr Joachim Osur explains the medical reasons

Dr Joachim Osur explains the medical reasons why sex can be painful – and what to do about it. PHOTO| FILE| NATION MEDIA GROUP 

By JOACHIM OSUR
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The natural response to painful sex is to avoid it – and this is totally understandable. But one must then seek medical to find a lasting solution, and to enable the resumption of conjugal activities. If not, the relationship may fall apart.

“I do not support your position,” Rita interjected as I explained how to deal with painful sex.

It had been a week of tribulations for her. On Monday of that week, her husband had stopped talking to her; on Tuesday he locked her out of the house until midnight. He said there was no value in sharing the bedroom with her. On Wednesday he came home and declared that he would file for divorce. She woke up on Thursday and instead of going to work, walked into the sexology clinic at 8am with the aim of saving her marriage.

Rita was 34 years old and a mother of two. She had been married three years. Life had been good for her and her husband until she developed a rather nagging pain during sex. The pain was initially bearable but worsened with time. She thought things would normalise if she stopped having sex, upon which she could resume. Six months down the line, she had not resumed sex.

Rita’s husband initially appeared sympathetic. Then he became impatient, making demands for sex. When he realised that his demands would not be honoured, he started accusing Rita of having affairs. Things progressed from bad to worse, culminating in this week of heightened activities.

“I am not saying that he is doing the right thing,” I explained my position to Rita. “I just feel that you took too long to seek care and this has resulted in additional problems which could have been avoided.”

Rita wiped tears from her bloodshot eyes. She stared into the distance, her unkempt hair, dry lips and poorly ironed clothes telling the story of a woman in deep distress. It dawned on me that she could be sliding into depression.

“But what evil is this that has entered my life? Why should I be in so much pain? What wrong have I done?” she blurted out, weeping even more.

I took my time to explain the various causes of painful sex. It is not a punishment for any misbehaviour and one should not persecute oneself when it happens. It is just a disease like any other.

In fact, sometimes, painful sex is caused by diseases of the skin around the genitals. A mere pimple can cause havoc in the bedroom. Some skin lesions can signify serious medical problems, like sexually transmitted infections such as herpes. Other infections, e.g. vaginitis, may affect the inner parts of the vagina and lead to pain and sometimes abnormal vaginal discharge.

Occasionally, an abnormality of the nerves and muscles can cause pain. Hypersensitive nerves can cause pain in the clitoris or other parts of the vagina. Painful contractions of the pelvic muscles are also known to cause pain in a condition called vaginismus.

Pain can also be the result of poor lubrication during sex, which results from inadequate stimulation during foreplay.

“Wow, are you trying to scare me?” Rita asked, frowning, “I just thought it was a small injury that should have disappeared with time but now you make it sound like I could be having many serious diseases.”

I interrogated Rita further. Her pain was deep inside and spread into the lower abdomen during sex. It was a dull but unbearable pain. “It is like someone crushing your uterus with a big hammer,” Rita explained.

I examined her and true to my suspicion, she had signs of pelvic inflammatory disease. An ultrasound scan of the pelvis found features consistent with the diagnosis. I put Rita on two weeks of antibiotics and painkillers. I also booked her and her husband for counseling.

“I want to register my sincere apologies to my dear wife for my misbehaviour,” Charles, Rita’s husband, said on their last session of counseling. “It is only that when you love someone you want to be intimate always, and it is frustrating when things do not work!”

Rita stood up and hugged Charles, tears rolling down her cheeks. Charles also started weeping. And thus they resolved their marital issue.