Sex is meant to be pleasurable, but at times it can be painful and agonising.

Sex is meant to be pleasurable, but at times it can be painful and agonising. Jane described the pain so figuratively that it moved my imagination to another level.

“It’s like someone cutting you with a rough blade of a saw, the very rough one that they use for felling large logs,” she said, “the pain is unbearable and I usually spend the rest of my night crying.”

Unfortunately, many men will not understand what she’s going through. In fact, it’s said that men feel heroic when the lady is writhing in pain. They mistake this for unbearable pleasure. No wonder some ladies just choose to take off, literally.

“I left my first boyfriend because he could not understand what I was going through and kept insisting on having sex,” she said, “but now I am married and I cannot just quit!” I nodded with understanding as tears welled up Jane’s eyes. I could only imagine the agony she was going through each day.

Occurrence of some pain when losing virginity is normal. A virgin has a thin membrane covering most of the vaginal opening. This membrane, also called hymen, stretches and even tears during the first sexual intercourse, and this causes pain. This should, however, end after the first, second or third attempt at sex.

When pain persists after virginity is broken, other causes should be investigated. A common cause of pain is what I may call self-inflicted pain. There is this evil called douching. It is the physical cleaning of the vagina.

In an attempt to be really clean, some women douche with soap, detergents and other chemicals and even spray perfume in the vagina. The sensitive vaginal tissue reacts with water and the chemicals. Once the irritation and inflammation has happened, the sore vagina hurts during sex.

For others, pain may be due to inadequate preparation before penetration. Foreplay helps the woman to relax, leading to lubrication of the vagina.

A tensed woman with a dry vagina experiences unbearable pain during intercourse due to friction and anxiety. While men may get instant erections, a woman needs time to be psychologically and physically ready, and this calls for foreplay.

Ironically, there are communities who believe that sex should be dry. They believe that a man will enjoy intercourse more when the woman is dry, and that women should not enjoy intimacy. This is sad. In such communities, herbs are used to dry up the vagina, and old women teach young ones how to do this. Sex is a nightmare for the woman in such communities.

An unusual cause of pain is stimulation of the clitoris. For most women, gently rubbing the clitoris causes pleasure. But for others, it causes great pain. Some men may insist on rubbing the clitoris even when the woman is agonising.

Vagina, cervix and pelvis infections also cause pain. In addition to painful sexual intercourse, other symptoms of infection may occur including smelly discharge, itchiness, and pain even when there is no sex. One absurd cause of pain is getting intimate before healing completely after delivery.

GROWTHS

For some reason, some people just want to have sex immediately the woman leaves hospital after delivery. This is despite the fact that a lot of injuries happen to the birth canal during delivery and most women will have raw wounds and stitches that need up to six weeks to heal.

After delivery, a number of women have been readmitted to hospitals with torn stitches and infections because of this sad scenario.

Occasional growths in the pelvis, uterus or vagina can cause pain during sex. Although most of these growths are not cancerous, some can be. Most of such growths occur in internal reproductive organs, especially in the ovaries and the uterus.

Then there are women who just get spontaneous involuntary spasms of vaginal muscles during sex. This is called vaginismus. It causes terrible pain during sex. A woman with vaginismus gets anxious at the imagination of anything penetrating her. They fear the pain and tend to avoid sex.

“I think mine may be vaginismus,” Jane interjected, “if you don’t treat me doctor I will leave this marriage and stay single, and I am serious about this.”

After a full assessment, I agreed with Jane that hers was a case of vaginismus. Treating vaginismus is not easy. It takes time, and the support of the man is very important. I therefore involved Jane’s husband in the treatment. I was very humbled last week when Jane reported having orgasm for the first time. It had been six months of treatment and she had progressively improved.

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