The following question is addressed to sex therapists Dr Clifford and Joyce Penner:

QUESTION: My husband and I have been married six years and have a good sex life. But I always experience pain at the moment of penetration. We take things slowly, and after the initial pain things go well. But what can I do about that early discomfort?

God intended sex in marriage to bring pleasure. When that pleasure is interrupted because of pain, the entire process of “becoming one” is affected.

Unfortunately, pain is often difficult to relieve because the reason for it can’t be identified. To help you and your doctor determine why you are having discomfort, for the next four of five times you have intercourse, write down a description of the pain. Describe exactly when you feel the pain begin and when it lessens, the exact location of the pain, and the type of pain (stinging, burning, jabbing, or a feeling of pressure).

It’s also helpful to write down information from a vaginal self-examination. In a comfortable position, and using a vaginal lubricant and holding a mirror, examine the opening of your vagina for redness, irritation, rash or sores. Is there tightness or pain when you insert a finger? Note any sensations you feel when tightening or relaxing your vaginal muscle around your finger or when pressing your finger against your vaginal wall. Write down what you discover.

Once you have recorded the data, schedule an appointment with your physician. If he or she still can’t help, try to locate a medical doctor who is both a gynecologist and urologist who specializes in treating painful intercourse (dyspareunia).

Inflammation or irritation of any of the structures of the genital area will cause pain and will require medical attention. Chronic infections such as genital warts or herpes also can cause pain upon entry.

As sexual therapists, we treat a common cause of painful intercourse called vaginismus, the involuntary spastic tightening of the muscle controlling the entrance to the vagina. To relieve vaginismus, the woman uses a series of graduated dilators to stretch and relax the muscles that control the opening of the vagina.

She begins by inserting the smallest dilator that she can comfortably insert —several times a week —using the same process as recommended for vaginal self-examination. She leaves the dilator in place for 15 to 30 minutes while tightening and relaxing the vaginal muscle.

When she feels ready, she tries the next largest dilator. She continues to graduate to large dilators until she is able to comfortable insert a dilator of the same or larger circumference as the head of her husband’s erect penis. You are fortunate to have a good sex life in spite of your initial discomfort. But you need to pursue a solution that will enable you to have entry without any pain.

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The above article originally appeared in a back issue of Marriage Partnership Magazine www.marriagepartnership.com. Since that time they’ve included it along with other articles in the book, The Healthy Marriage Handbook, published by Broadman & Holman Publishers. In this insightful book you’ll find more than 200 confidential, personal questions that real people asked the editors of Marriage Partnership.

“It’s almost like having a trusted, wise couple come alongside—ready at a moment’s notice to help you safely clear the inevitable hurdles husbands and wives encounter. This advice is offered with compassion and understanding, and most important, based on the counsel of God’s Word, the Bible.”

Dr Clifford Penner, and Joyce Penner are the authors of The Gift of Sex and Restoring the Pleasure (both published by Word Publishing). Clifford is a clinical psychologist and Joyce is a clinical nurse specialist. The Penners are sex therapists in private practice in Pasadena, California.

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To read additional related articles on this subject which are posted on other helpful web sites, please click onto the links provided below: 

• PAINFUL INTERCOURSE
• WHEN SEX HURTS