FOXSexpert: When Sex Hurts

Sudden cramping, burning sensations, discomfort, sharp pain . . .

When “Ohhh!” becomes “Ow!!” during sex, many lovers are at a loss. That’s because many don’t know about dyspareunia — a painful condition that can occur in men or women for a number of reasons, and research indicates that many people are suffering in silence.

A study conducted by the pharmaceutical company Wyeth, involving 1,000 post-menopausal women ages 45 – 65, found that one in four experienced dyspareunia. Yet the study, done in collaboration with and headed by Dr. Sheryl Kingsberg of Case Western Reserve University School of Medicine, also found that talking openly about pain during sex is seen as a taboo topic.

So what is this sexual disorder all about? And can it be treated?

Dyspareunia is a general term for persistent or recurrent genital pain, which is experienced right before, during, or after intercourse.

For both sexes, the list of reasons for dyspareunia includes:

— Rapid intercourse;

— An awkward sexual position that makes for uncomfortable penetration;

— Traumatic injury to the genitals;

— Urinary tract infection;

— Sexually transmitted disease;

— An inflamed bladder;

— Scar tissue or tight, inflexible skin and connective tissue;

— Nerve inflammation;

— Exposure to birth control products like spermicide.

In men specifically, dyspareunia may be experienced while erect or during emission. First, any lesion on the penis can make intercourse unbearably painful.

Second, conditions like Peyronie’s disease — a curvature of the erect penis that causes scar tissue to build up inside the penis so that the tissue doesn’t fill with blood — can make sex feel like torture.

Third, if uncircumcised, dyspareunia can be the result of a snugly fitting foreskin that may retract painfully during sex. Other reasons include inflammation of the urethra or prostate.

When it comes to women, dyspareunia is the most common sexual complaint that gynecologists hear from their patients.

Among the shopping list of reasons for pain or discomfort are:

— A lack of natural lubrication in the vagina;

— The uterus not being raised, so that the penis comes in contact with the cervix during penetration, most commonly due to lack of sexual arousal;

— Medical problems, like pelvic inflammatory disease, fibroids, vulval vestibulitis, or inflammation of the uterine lining;

— Vaginismus, a condition in which the vaginal muscles are extremely tight;

— Infections, such as a yeast infection;

— Creams, fabrics, or perfumes that may cause irritation;

— Use of lubricants or feminine hygiene products;

— Hormone deficiencies;

— Sex after vaginal childbirth;

— Genital fit (a relatively small vagina may have a tough time handling an especially large penis).

If the pain is located at the entrance of the vagina, vaginal infections, irritations, or a Bartholin’s cyst may be the cause. If the dyspareunia is experienced upon deep penetration, a physical cause, like endometriosis, is often suspected.

So what to do? The Wyeth study found that 80 percent of sufferers grow complacent and learn to live with their symptoms. Still, 73 percent report having sex at least once per month. One in three actually has painful sex weekly! A number believe that nothing can be done medically, with more than 40 percent failing to discuss the issue with their health care provider or significant other.

Since the vast majority of cases are physical and temporary in nature, lovers don’t have to sit back and tolerate the pain. Dyspareunia can be easily treated in most cases. Treatment depends on the diagnosis. For example, vaginal dryness can be combated simply by using a water-based lubricant.

If psychological reasons are the cause of pain, counseling or therapy is necessary. For those dealing with the emotional factors or the impact dyspareunia has on a relationship, it’s a good idea to work with a sex therapist.

In all cases, dyspareunia should be treated comprehensively following a thorough medical check-up.

Sex can and should be pain-free. To get to that point, it’s important to stay sexually connected. Cultivating your sensuality with sexual acts beyond intercourse is what every doctor should prescribe in order to get lovers to a healthier sexual state.

Dr. Yvonne K. Fulbright is a sex educator, relationship expert, columnist and founder of Sexuality Source Inc. She is the author of several books including, "Touch Me There! A Hands-On Guide to Your Orgasmic Hot Spots."

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