When sex gives more pain than pleasure

For many women, painful sex comes as a surprise because it is not supposed to hurt. Although with first-time sex there may be some discomfort, experts say that sexual pain is not normal and needs to be treated, reports Sade Oguntola.
Not long after going through menopause, Deborah Igwe (not her real name) began to feel severe pain during sexual intercourse with her husband. “My husband and I always had a great sexual relationship but with age, I started to experience vaginal dryness. Even though he suggested that we used lubricants, intercourse still hurt,” said Mrs Igwe, a 45-year-old civil servant.

Mrs Idowu Haruna’s problem started after she gave birth to her second baby. She said: “Sex was not painful until the birth of my second boy. The delivery was relatively normal, although painful. Although there was a slight tear, the nurse after suturing assured that there was no problem since it would heal, leaving no noticeable scar.
“Now, sex gives me burning pain, discomfort and anxiety. I have started to hate sex. My husband and I fight a lot more and I know he is growing impatient. I don’t want my children to be another victim of divorce because of this.”
Millions of women experience pains before, during or after sexual intercourse, a medical condition called dyspareunia. They suffer in silence because they’re embarrassed to talk about it or seek medical assistance to treat the cause of their pain.
Unfortunately, the problem saps their sexual desire and pleasure, strains relationships, and erodes their quality of life. For postmenopausal women, in particular, it can bring up issues of ageing and body image. This is really unfortunate, because treatments are available for many of the problems that rob them and their spouse of the enjoyment of sexual intercourse.
But Dr Chinedu Nkwocha, a consultant obstetrics and gynaecologist, University College Hospital (UCH), Ibadan, Oyo State, stated that painful sex among women is common and could be due to different causes.
“It is a sad experience and several women have been suffering in silence. But we know in our culture, women, when they do not have the rapport or confidence in the healthcare provider they are relating with, may find it difficult to talk about openly.”
There are two types of dyspareunia- superficial dyspareunia and deep dyspareunia. Dyspareunia can start suddenly or develop gradually. Pain may occur every time with sex, or only occasionally. For some women, simply thinking about intercourse can start a cycle of tightness, pain, and avoidance of sex.
Superficial dyspareunia can actually be as a result of fear, anxiety, depression, guilt, a history of sexual abuse, relationship troubles and other psychological factors around sex.
“When a woman is not adequately prepared for sex because there is no adequate foreplay to ensure she is wet, that could cause some pain at the opening of the vagina,” he stated.
However, deep dyspareunia, Dr Nkwocha described as pain that women experience inside their vagina during sex that could be from other medical conditions such as endometriosis, yeast infection and pelvic inflammatory disease.
Dr Nkwocha, stating that only few educated and exposed women find it easy to talk about their sexual life, declared that painful sex among women can cause marital discord and disharmony, subsequently resulting to divorce if left unresolved.
The expert added that women who have just given birth may also experience painful sex, and need more time to heal.
Also, another cause of pain could be menopause. Older women going through menopause often experience painful sex because of lower levels of oestrogen. The pain can range from mild to excruciating; sufferers describe it as burning, stinging, sharpness, or extreme tenderness. Lower amounts of the hormone lead to vaginal and genital tissues getting thinner.
Other causes of pain in intercourse include female genital mutilation (FGM), skin diseases in the genital area, such as eczema and psoriasis; conditions such as bladder prolapse, and infections of the urinary tract, vagina, or reproductive organs; certain cancer treatments; injury to the pelvic area from childbirth; damage to the pudendal nerve, which supplies the vaginal area; musculoskeletal complaints, such as arthritis or tight hip or pelvic muscles; and some kinds of male sexual dysfunction (prolonged intercourse may increase vaginal friction and pain).
Nonetheless, Dr Nkwocha said since painful sex is a medical problem, women should see a medical doctor, preferably a gynaecologist who would take them through what to do and how to deal with the situation.
He stressed that men have a role in helping women that experience painful sex to overcome the problem. “Men need to be patient because the problem is not the making of the woman or that she is pretending. It is a treatable condition and men only need to encourage them to seek medical help.
“In fact, it is advised that the women come to the hospital with their husbands, so that the medical doctor can equally counsel them on the issue as well as teach them what could be done in, some instances to overcome the problem.
Dr Nkwocha explained that painful sex was sadly also a contributor to infertility problem in Nigeria. “For instance, I had a patient who came for infertility treatment. When she was asked about sex, she said that she was afraid of sex because of pain.  It was later discovered that she had undergone female genital mutilation. It turned out that the mutilation was a contributory factor to her problem.”
Of course, some women are taken to be frigid. But this is understandable if sex always hurts or is uncomfortable. Unfortunately, painful sex will not go away on its own. It requires treatment. The earlier treatment is initiated, the more pain-free intercourse will be attained.
 culled from Tribune