Tuesday, July 30, 2013

ARW: Painful Intercourse

WARNING: Explicit sexual content discussed below. Please do not read if you are concerned about the state of your soul, especially if you are not yet married.










A reader writes:


I married as a virgin and despite going slowly,  sex is quite painful. We tried the usual things - lots of foreplay, lots of lube, both of us eager and ready - but nothing has really worked. Things have gotten better since that time and we've tried a bunch of positions but cannot seem to find a pain-free one. Do you have any recommendations?


Indeed I do have recommendations, but I'm not sure that they will solve your problems.

Dyspareunia, or painful sex, can happen for any number of reasons. They usually fall into two categories: medical or mental. If it's a medical problem, then you really must go see your OBGYN. If it's a mental ones, I have some tips, but you still may need some counseling.

Medical reasons are manifold, but they may not just be you. It may be that your husband is very well endowed. Or you may have vaginismus, a medical condition where you tighten your muscles involuntarily when your husband enters you. For a rundown of possible problems, I found this pdf from the ACOG very helpful. No matter what, you'll have to see your doctor, but that handout may give you some talking points to start a conversation with your OBGYN. Before you go, think about the kind of pain you are having. Is it inside - like a painful stretching? Or outside, more like the skin around your opening? These could indicate different problems, so try to think about that so you can help your OBGYN diagnose you.

But what if you go, or have gone, and everything checks out? Then it may be a mental block. If you are newly married and you were a virgin when you married, you could still be getting used to the act. Everyone's body is different; for some women, it takes a long time to be truly comfortable with sex (although, as I said, don't assume this is you - check with your doctor!). You may be rather tight down below. I have heard from some women that they didn't actually have completely comfortable sex until after childbirth, because that loosened their vaginal muscles to a more comfortable degree.


If you are sure there are no relationship problems (including some more specific to your sex life, such as deep-seated worries about sexual enjoyment, mismatched libidos, or differing levels of sexual experience), then the next step is point-and-shoot with positions and lubrication - which you indicated you had tried. Have you tried coconut oil for lubrication? I know it's all the rage for everything else these days, but I highly recommend it as a personal lubricant. This is also where considering the type of pain is helpful; sex can be painful because he's hitting your cervix (if he's a bit longer than your vaginal cavity), if he's stretching you (a bit wider), or if the skin around your opening is irritated (which as the above PDF discusses can be caused by many things). Knowing what type of pain will help you choose a better position. If penetration is too deep, try a more shallow position - especially you on top, where you can control the depth. If he's too wide, I would actually suggest initiating sex before he is fully erect and allow him to grow inside you (don't worry, he won't get stuck).


I would suggest two things you had not mentioned: try perhaps to orgasm first before you try intercourse and/or, if you are enjoy drinking, have a glass of wine or scotch or whatever it is you enjoy. If women are particularly 'dry' or struggling with penetration, being on the receiving end of oral sex can do wonders. Your husband can to enter you directly after you have climaxed - when you're all dazed and endorphin-filled. Takes some of the pressure off. Also, some alcohol can help to relax you - although of course I am not recommending getting drunk.

Failing all else, and in combination with all of the above, pray! Do not pray in light hearted manner, but devote yourself to prayer on this issue. I have always sought the aid of the Holy Spirit in my lovemaking and have never found my prayers unanswered. Be confident in seeking the help you need, from God and man, and please let me know if you have any follow-up questions. I am sure this is a very trying experience. You and your husband are in my prayers.

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