Painful Intercourse
Painful Intercourse
Turn "Owww" into "Ahhh"
As intensely pleasurable as sex can be, it can be downright painful now and then.
All sorts of things can make intercourse hurt. Vaginal infections, injuries, allergic reactions and insufficient lubrication can do it, says Barbara Bartlik, M.D., a psychiatrist and sex therapist with the Human Sexuality Program at New York Hospital-Cornell Medical Center in New York City. Sexually transmitted diseases, improperly healed adbominal surgical scars, bladder conditions, chronic constipation and reproductive organ disorders like endometriosis and fibroids can also lead to pain during or after sex. So can psychological conflicts.
MAKING LOVE, COMFORTABLY
If sex is painful, and your doctor has ruled out an underlying medical cause, you can get comfortable again by following these simple strategies.
Check your cabinets. Vaginal irritation can make sex agonizing, says Sharon Nathan, Ph.D., a sex therapist and clinical assistant professor of psychology in psychiatry at Cornell University Medical College in New York City. Common irritants include latex condoms and ingredients in laundry detergents, bubble baths, douches, contraceptive creams and spermicides. Try eliminating potential culprits for a week or so and see if the pain or irritation clears up, suggests Dr. Nathan. Bathe without bubbles. Use a different contraceptive cream. Try one of the new, nonlatex condoms.
But don't switch to lambskin condoms, unless you're absolutely sure that your partner is HIV-negative and monogamous. Lambskin condoms block sperm but won't block transmission of the human immunodeficiency virus, says Gretchen Lentz, M.D., assistant professor of obstetrics and gynecology at the University of Washington Medical Center in Seattle.
When To See A Doctor
If pain during intercourse is severe, see your gynecologist for an exam right away. If the pain is mild, try self-help strategies for a few days. If that doesn't do the trick, see your doctor, advises Barbara Bartlik, M.D., a psychiatrist and sex therapist with the Human Sexuality Program at New York Hospital-Cornell Medical Center in New York City.
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Extend foreplay. To give yourself more time to get aroused and lubricated, prolong the cuddling, stroking, caressing and kissing before intercourse, Dr. Bartlik says. Having sex when you're not fully lubricated can cause both irritation and pain.
If you always feel pain, you and your partner might try stimulating one another with your mouths or hands and saving intercourse until the very end, suggests Dr. Bartlik. In the event that penetration is still painful, skip intercourse and bring one another to climax orally or manually.
Assume a new position or two. Some positions make sex more comfortable than others. Experiment until you find the ones that work best for you, advises Dr. Bartlik.
Try an over-the-counter lubricant. Hormonal changes that occur during breastfeeding and menopause can make vaginal tissues drier and thinner and make sex painful, says Dr. Bartlik. Certain medications, like antihistamines, can also cause vaginal dryness.
Whatever the cause, applying over-the-counter water-soluble lubricants (like K-Y jelly, Replens or Gyne-Moistrin) before intercourse can help, says Dr. Bartlik. In fact, a New York University study that compared over-the-counter lubricants with prescription ones found that the former did an equally good job. Follow package directions.
Get comfortable. A combination of psychological and physical factors can contribute to a condition called vaginismus, in which the muscles around the vaginal entrance spasm involuntarily, making intercourse extremely painful, even impossible, explains Merle S. Kroop, M.D., a psychiatrist and sex therapist in New York City.
Often, women who experience vaginismus feel great anxiety about insertion or penetration. Some were raised in households where sex was considered bad or degrading. Others have had traumatic sexual experiences, says Dr. Kroop.
The following exercise, designed to dispel fear of sexual penetration and restore a sense of control during sex, may help, says Dr. Nathan.
Set aside some time when you can be alone and relax. Undress and lie in a comfortable position with your legs bent at your knees and your feet flat. Put a dollop of lubricant on your finger and insert just the tip into your vagina, pushing down as if you were trying to defecate. (This procedure relaxes the muscles at the entrace to the vagina without any risk of a bowel accident.) Leave your finger in your vagina for a minute until you get used to the feeling. Then move it further in, up to the first knuckle. Now practice tightening and relaxing your vaginal muscles around your finger. To tighten, contract the same muscles that you use to stop the flow of urine while on the toilet.
Continue practicing the technique, each time inserting your finger a little further, then tightening and relaxing your muscles around it. With practice, you should feel progressively more confident about your ability to control your muscles and more relaxed about having something in your vagina.
When one finger is easy, try inserting two. When that's comfortable, ask your partner to insert one, then two of his fingers. Eventually, he should be able to insert his penis, says Dr. Nathan.
