(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.
                                            
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