DOCTOR'S ADVICE: Too much pain during sex

Q Doctor, I would really love your advice. I have pain during sex and it is really affecting my relationship with my boyfriend. He is pretty big, and whenever we have sex, I have to ask him to stop. I am afraid that if this continues, he may leave me. I really need your help.

A I am sorry to hear about this. Painful intercourse can ruin a relationship. Roughly around 10 per cent of women suffer from this at some time.

The good news is that most cases can be solved. There are some possible causes for this. That can be divided into the following categories.

Near the opening

Common causes of pain in this area include:

Vulvitis: This means inflammation of the opening of the vagina, often because of infections such as thrush or trichomoniasis.

Vaginismus: This is a common condition in which a form of 'muscle contract' occurs whenever the penis approaches the vagina. It is largely psychological, but maybe triggered by the presence of some other painful condition.

Urethral caruncle: This is a tender swelling in the urinary opening.

Bartholinitis: This is an inflammation of the Bartholin's glands, which are lubricating structures located near the opening.

Tender obstetric scar: This sometimes occurs when a woman has been stitched after childbirth.

'Ageing' change, because of lack of hormones: This is mainly a disorder in women over 50, caused by a decrease in the female hormone levels.

Allergic reactions: Allergy caused from contraceptive foam or medication, or allergy to condoms. Very rarely, allergy to a particular man's sperm occurs.

Deep inside

Pain occurring deep inside may be linked to one of the following:

Cervicitis: This means inflammation of the cervix (the neck of the womb). This area can become very tender if it's banged repeatedly by the man's penis.

Salpingitis: That means inflammation of the tubes, usually caused by infections.

Pelvic inflammatory disease (PID): This is a generalised infection inside the pelvis, usually caused from infections, such as VD.

Endometriosis: A common condition in women over the age of 25, and because of pieces of womb lining somehow developing in the wrong place.

Ovarian cysts: These are little fluid-filled swellings in the ovary. If the penis hits against them during sex, that can be very painful.

Fibroids: These are very common and are swellings in the wall of the womb. Though there may not be any symptoms, they can hurt during sex.

Retroverted womb: About five to 10 per cent of women are 'retroverted'. This means that their womb points backwards instead of forwards. Sometimes the male organ strikes the retroverted womb in such a way that it causes pain.

As you can see, there are about 14 different causes of painful intercourse. I assure you that all of them can be successfully treated!

Therefore, your next move should be to consult a doctor, who will give you an examination to determine the cause of your pain.

It should then be possible to correct the problem. However, you may need to make some minor adjustments to your sexual positions.

Q I am a man living in Falmouth. On a recent trip to Ocho Rios, I had sex with a girl. A few days later, I developed a discharge that stains the inside of my pants.

Why?

A You have almost certainly caught an infection called urethritis from this young woman. It is easily treated, but you should abstain from sex until you have been advised by your doctor that you have been cured, using antibiotics.

Incidentally, this young woman may not know that she has an infection so, if possible, you should urge her to get treatment.

Q Doctor, I have been troubled with many strange symptoms since 1989. These include the sensation of tiny drops of water going down my back and left shoulder, followed by itching and sometimes a burning sensation.

That area is very sensitive and sometimes tender. I also get spasms in my body at different times, and sometimes I feel like there is a creature moving around in my muscles.

I also experience headaches, and sometimes my head itches as if I have been stung by sandflies. My throat is also bothering me.

I have done many blood tests, including for HIV, and the results have always been negative.

Sometimes I have a burning sensation on my tongue and an ache in the left side of my abdomen. I am currently being treated for a reflux condition.

What do you think is wrong with me, Doctor?

A Well, I think you should take note of the fact that you have had all these symptoms at various times for 20 years. Yet you are still alive!

This suggests that the symptoms are probably not of great significance. Also, the fact that your tests have all come back negative strongly suggests that you don't have much wrong.

I presume that you must have been examined repeatedly by doctors. But if you haven't had a physical check-up in the last year, I feel you should have one now.

Please ask the doctor to check for worms, just in case.

But it may be that you just have to accept that you have many different symptoms, and that they are not caused by anything serious, in which case you must try and ignore them. I wish you well.

Q I do not know whether I was circumcised as a child or not. How could I tell, Doctor?

A Just get a doctor to examine your penis and he will be able to tell you.

Q I am 35 years old and I have not seen my period in three months. Is this menopause?

A This is very unlikely at such such an early age, although possible.

Have you done a pregnancy test? If your period does not return in a month, please see a doctor.

Q How could I find out if I am anaemic?

A The only way to be certain is to have a blood test. But persons who are anaemic are usually tired, experience weakness and sometimes breathlessness.

Also, when you look in a mirror and pull on the lower lid of your eye, is the area as pink as it should be?

Q I am a 38-year-old female, and I just met a great man. But we don't orgasm at the same time. How can we expect it?

A When you get use to each other's body reactions, you should be able to tell.

A good tip is to ask your new man not to climax until he is sure that you are about to. Then he can go ahead as fast as he can.

Email questions to editor@gleanerjm.com.