(Preview) June, 1997 column

Once again, Lonna and Jack found themselves in a doctor's office. Confused, embarrassed and stressed, they had already seen three other health care providers to find out why Lonna felt severe pain during intercourse, and each time the health care provider could find nothing wrong. Lonna recalls wondering whether she had "some awful sexual hangup and didn't know it."

Feeling guilty, she tried to fake pleasure, but the pain spoiled her deception. Jack, meanwhile, had begun to turn his frustration inward. "I loathed myself," he says. "I tried to be gentle, but it always hurt her."

On this fourth try, however, a specialist succeeded in locating a physiological reason for Lonna's pain, and was able to prescribe treatment for a bacterial infection.

While Lonna and Jack found their way back to a satisfying sex life relatively quickly, many couples faced with similar problems are still searching for answers. Here we offer readers some practical suggestions to help guide their clinicians' detective work. The bottom line: Intercourse should never be painful; if you have this problem, pursue therapeutic solutions rather than accept it as a given.

A Common Scenario:
Painful intercourse (medically termed "dyspareunia") is the most common sexual complaint that women report to their gynecologists. Surveys show that 15 percent to 30 percent of all women experience physical pain with sex some of the time. Unfortunately, there are numerous causes for this condition: most physiological, some psychological, so it is not easily diagnosed. Finally, pain is frequently experienced by those having sex for the first time. This is completely normal, as the vaginal channel is often so naturally tight at first intercourse that inserting even a finger might be painful. The vagina becomes more elastic over time and generally will adapt to penetration, though it may tighten in response to pain, anticipated pain, or a general fear of penetration. Therapists encourage using generous amounts of a commercial lubricant and penetrating very gradually, perhaps starting with a finger, then two, until entry is more comfortable.

Return to Dr. Pepper Schwartz's Home Page