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Painful Sexual Intercourse

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A question from a husband: My wife complains of searing vaginal pain upon intercourse and as a result she has been avoiding sex altogether. When I met my wife, she seemed to be so eager and interested in sex that I eventually married her… I am glad I did because we have a good life together – I just miss sex. Help!

Discussion and reply:

Has your wife consulted with her doctor to make sure there is no medical cause for her pain? Assuming she has and was cleared medically, read on.

Of course you miss sex and there is no need to end one’s sex life when intercourse is not possible, especially because sexual intimacy is the cementing force of any intimate relationship, the vehicle for entering that ‘special zone’ that is not shared by the closest of friendships.

A typical sexual menu will include two main entries:

  • Intercourse: a ‘penis in vagina’ act, lending to the definition of virginity = one who did not have intercourse (male or female);
  • Outercourse: any sexual act that does not involve intercourse: foreplay, oral sex, manual sex, masturbation, humping, rubbing, use of sexual toys on genitals, etc.

Men and women will mix and match intercourse and outercourse as per their sexual preferences and style. There may be other factors which will influence one’s choice, such as a physical limitation, hormonal influence, pregnancy and childbirth, aging, etc.

And then there is the difference between men (male) and women (female): Whereas a male is easily aroused through his senses (vision, smell, touch, imagery, etc.), the female will filter her sexual interest regardless of arousal level, thus being susceptible to ‘killing the mood‘ upon a fleeting negative thought. Example: “I am still mad at you for (whatever the reason may be) and you want to have sex????????” Or, “I am rushing to work and my mind is not on sex,” or “I am worried the kids are going to hear us,” etc.

From a psychophysical point of view, men need to be reminded that intercourse is about their penis entering the woman’s body — being the ‘do-er’ to her being ‘done to’ — and, therefore, they need to be invited and welcomed into her vagina when her body and mind are in sexual balance.

Naturally, when intercourse is painful, whether it is vaginismus or dyspareunia, the woman will want to avoid the act in self-protection. Furthermore, she will often decline outercourse too because she does not want to be reminded of the pain, of disappointing the partner, or because she is worried about his ‘surprise move’ into her vagina during outercourse.

This is when it would be very important for the couple to hold a candid discussion about the situation. The man will need to promise NOT to attempt any vaginal penetration (finger and/or penis) while the woman is being encouraged to enjoy herself as much as she can (remember the ‘filter’ that was mentioned above?) without pressure to orgasm — let it happen if/when it does. Make it fun, friendly, and stress-free!

Additionally, sexual counseling may be of great value in order to resolve underlying causes for this sexual breakdown, and to guide the couple onto a positive intimate journey.

The goal is to maintain an agreed-upon style of comfortable sexual intimacy and avoid slipping into asexual existence, or living like ‘brother and sister,’ which will put quite a bid of pressure on the relationship.

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