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Pain during intercourse is a troubling secret for many women. They might have intercourse about as often as other couples do but hide the pain from their partners. For a small number of people, “genital fit” can be a cause of pain during intercourse—meaning your partner’s quite large, and you’re extra petite. Lube can. Active vaginal infections, such as yeast infections, bacterial vaginosis, or some STDs, can cause vaginal discomfort during intercourse.

If painful intercourse is relatively new, pay your OB/GYN a visit to get things checked out. Painful sex can make you worry. Anxiety reduces lubrication even more and may cause you to clench the muscles of your vagina during sex. If sex becomes too painful, you may avoid it entirely. Beyond the immediate effects of the pain itself, pain during sex (or simply fear or anticipation of pain during sex) can trigger performance anxiety or future arousal problems in some women.

Worry over whether pain will come back can diminish lubrication or cause involuntary—and painful—tightening of the vaginal muscles, called vaginismus. In many cases, sex can be painful when lubrication is not sufficient. In these cases, the pain can be remedied with the use of a lubricant, such as KY or by changing up your sexual script in the. Dryness can not only make sex painful, it throws off the vagina’s balance of good bacteria, which can result in infections that contribute to painful sex. ‘Try using a lubricant if dryness is causing you pain during sex. Many conditions may cause pain during sex.

Once atrophy is advanced, they’re less helpful and may be irritating, as you’ve experienced. The most likely effective treatment is localized estrogens like the most recently approved lmvexxy, which is a vaginal insert. There are also localized estrogens available in cream, ring, or tablet form.

Applying lubricating gels to the outer sexual organs, the vulva and labia, as well as using lubricating products in the vagina may be helpful to some women and ease pain during intercourse. Sex toys, such as vibrators or dildos, may also be useful. The first port of call for women suffering from painful sex is usually the GP, who will check for infection or injury and make a referral to a specialist if necessary.

However, those suffering from painful sex can also visit a genitourinary medicine (GUM) clinic.

List of related literature:

Painful Intercourse In women, painful intercourse can be caused by vaginal infections, insufficient vaginal lubrication before intercourse (usually the result of not being sufficiently sexually aroused), and anxietyproduced spasms of the muscles surrounding the vagina, which makes vaginal penetration painful.

“Health & Wellness”
from Health & Wellness
by
, 2008

You can prevent the pain by changing positions during intercourse to avoid hitting the cervix and doing exercises to strengthen the pelvic floor, or by working with a pelvic floor physical therapist.[41] Do not continue to engage in any sexual activity that triggers pain, because pain perpetuates more pain.

“Enjoy!: The Gift of Sexual Pleasure for Women” by Joyce J. Penner, Clifford L. Penner
from Enjoy!: The Gift of Sexual Pleasure for Women
by Joyce J. Penner, Clifford L. Penner
Focus on the Family, 2017

For such women, painful intercourse can also be a problem and this can be treated with OTC lubricants or prescribed products (e.g. oestrogen creams).

“Symptoms in the Pharmacy: A Guide to the Management of Common Illness” by Alison Blenkinsopp, Paul Paxton, John Blenkinsopp
from Symptoms in the Pharmacy: A Guide to the Management of Common Illness
by Alison Blenkinsopp, Paul Paxton, John Blenkinsopp
Wiley, 2013

Painful intercourse, or dyspareunia, may be the result of lack of arousal but is most often due to physical factors such as pelvic infection; anatomical conditions; congenital deformities; or vaginal atrophy due to inadequate estrogen exposure.

“Infertility Counseling: A Comprehensive Handbook for Clinicians” by Sharon N. Covington, Linda Hammer Burns
from Infertility Counseling: A Comprehensive Handbook for Clinicians
by Sharon N. Covington, Linda Hammer Burns
Cambridge University Press, 2006

The pain or injury associated with an abrupt resumption of sexual activity can lead to a secondary female sexual dysfunction of dyspareunia or vaginismus (respectively, painful intercourse and severe contraction of the vagina – see below).

“An Introduction to Gerontology” by Ian Stuart-Hamilton
from An Introduction to Gerontology
by Ian Stuart-Hamilton
Cambridge University Press, 2011

Depending on the cause of dyspareunia, counselling, extra lubrication, vaginal HT cream, or antidepressants may be prescribed, and surgery to expand or repair the vaginal opening is occasionally needed.

“Brunner & Suddarth's Textbook of Canadian Medical-surgical Nursing” by Rene A. Day, Pauline Paul, Beverly Williams
from Brunner & Suddarth’s Textbook of Canadian Medical-surgical Nursing
by Rene A. Day, Pauline Paul, Beverly Williams
Lippincott Williams & Wilkins, 2009

Some women experience dyspareunia, defined as pain or discomfort during sexual intercourse, which can be related to perineal problems.

“Mayes' Midwifery E-Book: A Textbook for Midwives” by Sue Macdonald
from Mayes’ Midwifery E-Book: A Textbook for Midwives
by Sue Macdonald
Elsevier Health Sciences, 2011

sexual pain can help the practitioner have confidence in discussing this area of distress with women and their partners.

“Conn's Current Therapy 2020, E-Book” by Rick D. Kellerman, KUSM-W Medical Practice Association, David Rakel
from Conn’s Current Therapy 2020, E-Book
by Rick D. Kellerman, KUSM-W Medical Practice Association, David Rakel
Elsevier Health Sciences, 2019

Work with a physician who treats dyspareunia—painful intercourse.

“The Gift of Sex: A Guide to Sexual Fulfillment” by Clifford Penner, Joyce J. Penner
from The Gift of Sex: A Guide to Sexual Fulfillment
by Clifford Penner, Joyce J. Penner
Thomas Nelson, 2003

Deep pelvic disorders such as infection, tumors, and cervical or uterine abnormalities can cause pain with intercourse.

“Pathophysiology: The Biologic Basis for Disease in Adults and Children” by Kathryn L. McCance, RN, PhD, Sue E. Huether, RN, PhD
from Pathophysiology: The Biologic Basis for Disease in Adults and Children
by Kathryn L. McCance, RN, PhD, Sue E. Huether, RN, PhD
Elsevier Health Sciences, 2014

Oktay Kutluk

Kutluk Oktay, MD, FACOG is one of the world's foremost experts in fertility preservation as well as ovarian stimulation and in vitro fertilization for infertility treatments. He developed and performed the world's first ovarian transplantation procedures as well as pioneered new ovarian stimulation protocols for embryo and oocyte freezing for breast and endometrial cancer patients.

Mail: [email protected]
Telephone: +1 (877) 492-3666

Biography: https://medicine.yale.edu/profile/kutluk_oktay/
Bibliography: oktay_bibliography

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26 comments

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  • Adding lubrication to the mix often helps with this. And as weird as this sounds… improving the man’s penis skin texture helps a lot too. This will cut down on friction and dry spots etc. He can do this by applying a penis skin moisturizer every day. These are kinda like hand cream for the penis and work really well. In my opinion, Man1 Man Oil is the best one out there. Check it out ladies and gents.

  • I would have liked to offer a dollar per month on Patreon.
    “The minimum price for this tier is $3.00”
    Not looking for perks. I like your channel and what you do.

  • This content needs a serious update. The issue of women’s sexual arousal is really not emphasized enough nor talked about. Sex is painful when the woman is not turned on and hardened yes, a woman’s clitoris needs to be aroused, too! Oftentimes the pain doesn’t need to be “treated” at all but simply either the moment or the the partner or both is wrong! Women are often raised not to listen to the cues coming from their bodies, or ignore the fact that they are not turned on enough it takes more time than for men and their partners rush and force themselves upon women. Even if enough talking is involved and things are not rushed, the chemistry still might not work and women’s bodies are not aroused enough. The result is painful sex for women and/or no orgasm. So really before we start to talk about “vaginismus” diagnoses, we really need to make sure that the precondition not only wetness in vagina/vulva but also hardened clitoris was met in the first place! This is really important and never the be merely assumed or dismissed in sex education, as female arousal and pleasure sadly is even today. It would be really important @TherapyinaNutshell for you to edit this video accordingly! Otherwise, by talking about vaginismus, you are uncounciously supporting a very harmful Christian fundamentalist bias of pathologizing and diagnosing wives who cannot have sex due to ‘vaginismus’, which in fact just a mismatch in body chemistry of the couple: a female body saying no to their husband’s body. Oftentimes this happnes when sex is taking place only after the marriage. There is no need for treatment or diagnosis there if the women are not turned on.

  • Hi, I used a product called vagi-wave to help me. I tried all sorts of things before this hypnotherapy visits to clueless gynaecologists etc. There is loads of things on this website which may help.

  • My long time partner is very well endowed. The only time it doesn’t hurt is during menstruation. It’s so frustrating that they have so many cures for men’s conditions but not for women!

  • I’m 52 and I’m going through menopause and this pain is new to me.It feels like razor blades.It just started a couple weeks ago and the bf isn’t having any of.We had great sex life that we both enjoyed…I’m desperate for answers and any advice before I go to the doctor

  • between the other problem is oxalic acid in food, look up Sally Norton and her experience!!! Oxalate is a crystal that loges into tissues and can cause pain.

  • Amazing Book to read: * “ Restoring the Pleasure by Joyce Penner and Clifford Penner”. It’s so informative and detailed, highly recommend it!

  • I hate this myth that women take longer to get aroused than a man.
    This is pretty much nonsense IMO.

    Basically if you’re not naturally lubed, you’re just not into him. You might even have thought you loved him. But your body is saying otherwise

  • Thank you for the suicide prevention line in the description,its nice to know that even on a video not about your still an amazing doctor and go the extra mile.im bad with words but honestly i think your brilliant

  • 4:10 Women ARE NOT, on average, “slower to get aroused and lubricated than men”.

    Studies, initially using IR cameras, but later precise sensors, ALL found that women took no longer to reach any stage of arousal in response to visual stimuli than men. In addition, when self-pleasuring sans edging women took no longer, on average, to achieve orgasm (e.g. 65% in under 3 minutes).

    At the heart of this misconception is comparing apples to oranges (e.g. erections vs lubrication). For example, women get clitoral erections actually slightly faster than men, and men produce peak lubrication (pre-cum) with the same average delay as women. In short, comparing an initial stage of arousal of one gender (erections) to a later stage in another (lubrication) makes no sense.

  • This information is so needed to be provided! Thank you for a wonderful lovingly presented video! I am very fortunate to have been sent to a gynecologist who specializes in women with post menopausal problems. He directed me to additional sources of information and “supplies” and he has physical therapists who work in his office who are also specialists. It is time for these issues to be brought out into the open and for men and women to have access to healthy education. You are such a gift to all of us who subscribe to your channel. Sending you and each of your daughters big hugs!

  • This is not a pertinent subject for me. But I appreciate that you are addressing it. And I just listen to all your stuff because it’s educational. and many things I share with others. And there are topics that you address that I have found helpful. Like the brain rewiring, trauma recovery, dealing with anxiety videos. And I REALLY appreciate your inclusion\respect of a person’s spirituality in dealing with issues.

  • I’m so glad awareness is being spread about this little-known topic. I had vaginismus as a young bride 25 years ago and got over it. The journey wasn’t easy but it is possible. I now have 4 kids ����

  • I’m 41 years old, never been married and never had a sexual partner who actually cares about me. In the very few times that I have been with men throughout my life, it has been very painful. It’s not the width, it’s the length. It feels like he’s hitting a wall inside me. And for some reason the man can’t feel this, but I certainly can. So would this also count as vaginismus? I assume I’m just involuntarily tensing? Is there anything else he could be hitting? I assume it would not be my cervix. Thank you!

  • Hey I have a question about therapy? Is online therapy still as safe as in person therapy? My parents r worried about my interest in online therapy bc they’re nervous about scammers which is valid. But I haven’t gone this whole quarantine since March without a therapy session and I’m not comfortable even with the tools given to me. I miss my old therapist but he’s going to retire this yr. so how and what are the best ways to transition to one therapist to the other? Do I have to start from the very beginning, bc that’s a lot of info? Thanks for reading!

  • So I’m going to go ahead and drop this bombshell on. I’m a single man and I am 40 years old my girlfriend is 38 years old and she is married to her husband unfortunately we are together and we live in Nashville Tennessee her husband lives in Virginiamy girlfriend has pelvic pain and we don’t have sex and have not have sex for a while at least nine months now we have attempted to have sex but we have not had complete sex now here is the things that I do not understand we have two kids one one year old and 1 3 year old so she had to be able to have kids and sex for the work but now we don’t have sex at all and I am a nympho and need sex.we have discussed sex and things that we can do we have tried different methods nothing is work and I’m in a stalematesome people in this world you need sex to survive other people feel like sex is something that you don’t need my girlfriend is a Capricorn and she feels like if it hurts her then we really don’t need it but vices first it is hurting me not to have sex so do we break up and go our separate ways and the kids get hurt or do I go and cheat �� and it is a bad situation for a female to feel like well if I can’t have sex neither can youyou got what you wanted out of the relationship which was kids now I just basically have to deal with the situation

  • This is a real thing. I know a lady who had pain for a long while. Hormone treatment.
    I dated a virgn years ago. I never really understood what turned her into a tiger. She was shy. She consulted a doctor and something changed. Don’t be afraid to ask your doctor for help.

  • Some women endure painful sex for years and years. It burns physically. Emotionally, I imagine self harming or floating up out of the room to escape.

  • Great video! It would be amazing if you record a video on fear of love and closeness. I think it’s really common in our world but people dont talk about it at all.

  • I had issues after my daughter was born, have to have surgery to remove hardened scar tissue in my vagina due to a bad tear during birth. The surgery helped some but by that time I was so tense my muscles were just tense all the time which caused more pain. I ended up having to see a pelvic therapist who essentially massaged the muscles until they finally relaxed. It took a year after my daughter’s birth to finally have sex pain free. I still have some nerve damage in one spot which can cause pain but being well-prepared solves that problem.

  • There are also “tools” to help slowly open things up and learn to relax. A set of glass “expanders” pops up if you type that word VAGINISMUS set into Google. They’re different sizes. You gradually move up to larger sizes. This helps if your vagina has “clamped up” way too tight. I didn’t know that it’s a “thing” but it definitely is.

    And certain vaginal cream helps your hormones to balance out again.

    Dr Christine Northrup suggests a good kind.

    Also there are some vitamins made to help with thyroid issues. They help with dryness and mood swings and depression and libido. Lots of good reviews.

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  • I’ve been in a functionally sexless marriage for twenty years due to this condition. I know there are treatments, but the issue is my wife has severe avoidance about addressing this. She becomes extremely defensive, and actually (verbally) violent and cruel when I force the discussion every six months or so.
    Thank you for addressing the issue, but as a man looking for resources to deal with my situation, forgive me, but this is yet another base level explanation for someone who’s never heard of the condition.
    I’d love someone to address the avoidance issue that comes with vaginismus. The base emotion is fearfear of pain, fear of rejection, fear of failure, fear of judgement. My wife will NOT engage in even discussion about this.
    How do you support someone you love who has this condition, who is unable to confront her fear enough to get treatment.
    Thank you.

  • I’m experiencing this. I’m only 28.
    I don’t know if it’s because I’m too small or if my bf is too big but I don’t like to experience pain. It’s discomforting and I have to stop.