Rita loved her husband. The only problem was the extreme discomfort she experienced while having sex. Some times it would hurt so much that she’d beg her husband to stop and soon the couple started having less and less sex. Pain during sex or dyspareunia is more common among women than men and it’s estimated it affects one of out every  five woman at some point in their lives.  Sadly, more often than not the issue gets swept under the rug and people don’t discuss the issue. Rachel Hercman, a psychotherapist specialising in sexuality, dating and relationships writes more about the issue. 

In my work treating female sexual dysfunction, I often meet women who are suffering silently from pain before, during, or after sexual intercourse, clinically known as dyspareunia.  For some, the pain has been there since their first intercourse and for others it only manifested later on.  Dyspareunia is not a disease, but rather a symptom of a core physical or psychological condition. A woman suffering from dyspareunia may experience mild or severe pain in almost any area of the vagina or pelvic region.

Most women with dyspareunia experience pain upon penetration. Other symptoms include:

• Pain at entry
• Pain with any penetration (including a tampon)
• Sudden pain after intercourse
• Deep pain during thrusting
• Burning pain
• Aching pain

Causes of dyspareunia include:

• Insufficient lubrication that may cause friction between the penis and the skin
• Muscles that may have tightened due to age, childbirth, disuse or other reasons
• Possible nerves positioned in such a way that the penis pushes against them, causing pain during intercourse
• A muscular or bone formation that has shifted, causing pain during sex or any other type of contact
• Stress
• Psychological factors

Also read: Sex education: The need of the hour?

The goal of treating dyspareunia is to reduce the pain or discomfort.  Treatment may include:

• Use of vaginal dilators
• Trying to increase lubrication through topical creams or gels
• Using hormone therapy
• Increasing the blood flow with Viagra, a vibrator or a suction/pump
• Trying different lubrications
• Stretching exercises
• Physical therapy to strengthen supporting muscles to alleviate pressure from other muscles
• Exploring psychological factors that may be contributing

Since there are a number of different types of pain a woman may experience during sexual intercourse, it is important to see a medical practitioner who is able to help identify the source and location of the pain, something that may be difficult for the woman herself to do.  Once a practitioner can determine the source of pain, one or more conditions can be specified. As defined by us here at the Medical Center for Female Sexuality:

• Vulvodynia and Vulvar Vestibulitus are conditions of dyspareunia where the outside of the vagina, known as the vulva, is irritated or in pain.  The vulvar region includes the pad of mons pubis – the fatty tissue at the base of your abdomen, the labia, the clitoris and the vagina opening.
• Vaginismus is a condition where the vaginal muscles involuntarily contract, making penetration painful and sometimes impossible. In its mildest form, a woman can get a penis into the vagina for very short periods, but it’s unpleasant and painful. Or it can be so severe that she can’t touch herself near her vagina, can’t have a gynaecological exam and can’t insert a tampon because the pain is so severe and the fear is so great.

Coping with dyspareunia can be a confusing and isolating experience for a woman and can affect her relationship with her partner beyond the bedroom.  The good news is that there is effective treatment that can restore a woman’s ability to enjoy pain-free intercourse or be able to finally experience it in the first place.  However, many women continue to suffer with dyspareunia because they feel uncomfortable discussing the issue or don’t know where to turn for help.

If you are suffering from painful sex, know that there is help out there.  Talk to your medical provider and if they can’t help you, find a specialist in your area who is familiar with treating female sexual dysfunction.  Don’t give up!  It takes courage to reach out for treatment, but you deserve to have a pleasurable sex life with your partner.   

Check out the various symptoms of dyspareunia on our Symptoms Search feature. 

Rachel Hercman, LCSW (Licensed Clinical Social Worker) is a psychotherapist specializing in sexuality, dating, and relationships. She works at the Medical Center for Female Sexuality in New York, a center that provides cutting-edge medical and psychological treatment for female sexual dysfunction, where she helps women improve their sexual functioning, body image and relationship satisfaction.

 He claims to have read almost all the sexual self-help books out there, and has a veteran sex guru to guide him.  Eric, 35, is a sex life coach, who watches couples while in the act, and tells them where they might be going wrong. He earns 108 pounds an hour, encouraging people to delve into their erotic side.

Demand for his service has soared after the release of erotica novel ’50 Shades Of Grey’. He says the book has opened up a new avenue for couples, and has women demanding the right kind of loving between the sheets. His services are requested from couples all over the world willing to let him watch via Skype, and add spice to their mundane sex lives.

According to Eric, women are willing to submit to more than just the standard spanking in the bedroom, but men shy away, because they feel it would be wrong to do that to the women they love. He says men don’t know how to be kinky.

Despite what you might think, Eric will only treat people who want to improve their love lives, and not those who have sexual hangups or have been abused. He says that such people need to visit a psychiatrist first.

A large number of his clientele are from the US and no subject is taboo when it comes to advice. Most just want to discuss their sexual faux pas sprinkled with a few sessions of hands on training (not literally, Eric just watches them in the act, in order to give them  tips on improvement). He has strict rules when it comes to sessions. He will not touch his clients, and will never submit to join in. According to Eric he is an instructor and touching or any other involvement is strictly off limits. He also does not help people who have been diagnosed with nymphomania (sex addiction). Most of his clients are normal people who just want to get that spark back into their sex lives.

 Eric, admits that he was an ugly duckling when he was younger, and could not get a girlfriend. To enhance his appeal he started reading up on ways to improve his techniques, and struck up an email conversation with Betty Dodson,69, a long-term advocate of sexual rights for women and a pioneer in erotic art. Betty has a remarkable reputation as a sex expert and Eric’s life took a twist when Betty invited him to visit her. After knowing her intimately, Eric begged her to allow him to become her disciple, during which they ended up living together for 10 years. They split when he met his current girlfriend. Despite their vast age difference and the comments people had to make about the odd couple, Eric and Betty remain friends, and she calls him her best student.

As a self proclaimed master of the sexual art, he claims the secret lies in coordination and the ability to do a number of things at the same time. Eric spends up to 20 hours a week coaching clients and giving them guided classes where he goes to a customer’s home or hotel suite. He says it’s not just about sex, it’s about communication. People need to know how to ask for what they want. He adds that when he watches couples, he gives regular feedbacks and that they are not completely naked while he is in the room. Soon the couple improves so much that they forget that he is even there.

One of his clients is renowned actress Aniela, who appeared in Tom Cruise’s hit movie Rock Of Ages. She admits that the first time she found out about her partner’s call to Eric she was apprehensive, but later she consented to give it a try. After a 4 hour long session, she says, she doesn’t regret the move. Aniela was especially impressed with new techniques she learned about oral sex. Usually most couples are either shy or find oral sex a bit tiring, according to Aniela, Eric taught her the exact techniques that made the whole process much more exciting. She also adds that after the sessions, she realized how lazy he had been in bed. She says, that most women think that since their man loves them they don’t need to put in any work. After learning how important her role in the act was, she says she is now equipped with a number of positions and techniques. According to Aniela she is very please to have met with Eric, and says that he had saved their relationship.

Eric’s tips:

• Men should use deep voices- 95% women agreed that they get turned on by deep voices in the bedroom.
• When it comes to breast stimulation, men should start soft and only progress to a firmer form if she likes it. Remember it’s not a squeezing toy.
• Not everybody likes the same zones, but the neck area has been a consistent winner when it comes to turning women on.
• Inner thighs are more sensitive than to outer thighs, be sure to stimulate the inner thighs to warm things up.
• If you want to ask your partner what he/she likes, make it sound sexy, and ask while in the mood. Avoid sounding quizzical.
• Massage is a girl’s best friend when it comes to getting her into ‘the mood’.
• Be careful of the way you kiss. Do not use too much saliva unless you know she likes it.
• Use lubricant during the act.
• Talk to each other. Women prefer you tell her what you want and listen when she tells you what she wants.
• Sex should be fun- try to include new and unchartered moves into your routine once you both are comfortable with each other.

 What do you think ? Would you consent to getting live feedback on your technique? Let us know and maybe we can find him for you.

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Source: Health Guru