Sex with both men is painful

Q. Good day, Doctor. I am a divorced mother of three, and I must tell you that I have a pretty active sex life.

But a problem has arisen. During the last couple of years, I have been experiencing pain during sex. At first, I thought it was just with one of my boyfriends. But now it is happening with both of them.

While I was on holiday in Miami, I went to a doctor there, and he told me that the problem is called 'dyspareunia'.

Is dyspareunia serious, Doc? What causes it? And is there a cure?

A. Sorry to hear you have been having this trouble. I'm afraid I must tell you that the word 'dyspareunia' just means 'pain during sex.' So it isn't a diagnosis at all.

Pain occurring during intercourse is very common in all age groups. There are at least 50 different causes of this symptom.

Let me present a short 'guide to dyspareunia,' which would be useful to all my female readers who sometimes experience this kind of pain.

Firstly, is the pain superficial or deep?

Superficial pain is the kind that occurs near the vaginal opening, when the penis enters you. Possible causes include:

- Insufficient lubrication: For instance, because of a lack of 'foreplay,' or to a decrease in female hormone levels at menopause.

- Infection: Such as yeast or trichomonas.

- Inflammatory skin diseases like eczema.

- Injury to the vulva (the opening) - for instance, injury caused from episiotomy, which is the cut that is often performed during childbirth.

- Occasionally, medications such as antihistamines, or sometimes antidepressants.

- Psychological problems, such as vaginismus - a sort of 'muscle contract,' which occurs when a woman is very uptight about sex.

- Vestibulitis, which is a female condition that has only been recognised in the last 30 years. It is increased sensitivity in the nerves that supply the lowest part of the vagina.

Deep pain occurs far inside the woman's body, and is often 'triggered' by the thrusting of the tip of the man's penis. Possible causes include:

- Pelvic inflammatory disease: A common type of inflammation, often caused from episodes of sexually transmitted infection (STI) in the past.

- Prolapsed (fallen) womb.

- Ovary problems.

- Endometriosis - an extremely common disorder in which bits of womb lining turn up in the wrong place and cause tenderness and pain.

- Previous surgery - including during childbirth.

- Bowel problems.

You can see that it takes some skill to work out which of these many conditions is the cause of the sexual pain. Therefore, I urge you to try to see a gynaecologist as soon as possible, for an examination and tests. In the meantime, you can have sex if you want to, but I would recommend incorporating a lot of K-Y Jelly.

Also, please consider carefully whether it is wise to have two lovers. Maybe you could just tell one of them 'goodbye?'

 

Q. I am a 28-year-old man, and a month ago, I had sex with a widow in St Andrew. Ever since, I have had a curious itching around my foreskin.

It is pretty bad, Doc, and sometimes wakes me up at night. What could it be?

A. The likeliest cause is a fungal infection, such as yeast. The little fungi loves living in warm, moist places, such as between the folds of men's foreskins.

Best thing you can do is to go to a pharmacy and buy some anti-fungal cream. You don't have to tell them about which part of the body you want to put it on!

Use it about three times per day, but if you are not better in a week, then let a doctor take a look at your penis.

Q. I am a woman who has been having lower abdominal pain for some years now. I had a Pap smear and it showed something called 'ASCUS'.

Is that serious?

A. That word 'ASCUS' does sometimes cause alarm for women, if they see it on their Pap test results. But it is just a doctor's abbreviation for 'Atypical Squamous Celle of Undetermined Significance.'

And what that means is you have some slightly unusual cells on your cervix - but nobody knows if they will ever cause you any problems, so this is a very minor abnormality.

Now, there is no way that ASCUS could cause your bellyache. Generally speaking, a pain in the lower abdomen is due to one of three things:

- Something wrong in the bowels;

- Something wrong in the womb or associated organs;

- Something wrong in the bladder.

You should go to a doctor who can examine you thoroughly in order to find out which of those three areas is causing you problems. I wish you well.

 

Q. I am a 37-year-old guy, and I recently went to Costa Rica to visit some very distant relatives. While there, I visited what they call a bordello - which is a house where girls provide services to men.

Doc, a few weeks after I came back, I noticed I had some sort of red patch on the tip of my organ, plus a tender swelling in the groin.

Is this a sex disease, please?

A. Almost certainly. I am not sure exactly what it is, but it could be syphilis, or one of the less common 'tropical' sexually transmitted infections (STIs).

But you must at once go to a clinic and have the various tests for STIs done. The infection will certainly be treatable at this early stage, but please do not have sex with anyone until you have been cured.

 

Q. Doc, I am a 33-year-old married woman and I am not sure whether I have been unfaithful or not. Last week, I went to a celebratory function at my workplace, and unfortunately, there was a lot of strong drink flowing.

I had more than I should have. As a result, I allowed my account manager to take me to a quiet room, where we kissed and cuddled. In fact, he got me to fondle him, and he actually discharged. I am embarrassed to admit that he fingered me in return.

Next day, I felt very bad. But of course, I did not tell my husband.

Doctor, what I would like to know is this: Does what I did count as infidelity? Or adultery?

A. Well, what you did was not adultery - because that has to involve sexual intercourse. But many persons would regard it as 'unfaithfulness,' or 'infidelity' or 'cheating'.

One word of warning: if this account manager is like other men, he will want to try and lure you into full sex pretty soon. My advice: steer clear of him.

 

Q. I am 34 and thinking of going on the Pill. But I have to admit that I am a heavy smoker, Doc.

A. Heavy smokers should not go on the Pill, particularly if they are over 30 years old. This is because of the risk of thrombosis (clotting).

Why not ask your doctor to help you give up cigarettes?