Why sex is painful for women and other coitus conundrums, decoded

Seven problems that most couples face at some point in their lives

Watching an actual sex tape is all the discouragement you need to dissuade you from making one. Unlike those beautifully choreographed, softly lit sex scenes in 50 Shades Of Grey, the IRL act of love-making is punctuated by awkward pauses, strange noises and the sweaty gymnastics of limbs flying around as we bumble our way through unfamiliar territory.

Apart from your de rigeur discomfort, there’s also the unexpected stuff that goes tails-up. You know, the kind that may seem funny a week from now when you finally confess to your best friend after making her sign an NDA/ pinky swear.

Because we don’t ever want to leave you hanging, here are some coitus conundrums you need to be prepared for.

‘Honeymoon’ Cystitis: Don’t let the sweetness of the word ‘honeymoon’ fool you. It simply refers to either the ‘honeymoon’ period of a relationship or literally your honeymoon, a time when you and your partner are hopefully having a lot of sex. Cystitis is a form of urinary tract infection (UTI) that commonly occurs following a women’s first few sexual encounters, or after she’s been abstinent for some time.

The act of frequent intercourse could potentially push bacteria from the your vaginal area, perineum and anus up into the urethra where it doesn’t belong, causing irritation and inflammation. It’s also a risk factor in women who do not wipe their privates in the correct direction (vagina to anus) after a bowel movement. Studies show that 50–60% of women in the world will develop a UTI in their lifetimes, so make sure you don’t miss your visits to the gynaecologist.

According to urologic oncologist Dr David Samadi, drinking plenty of water, wiping correctly, urinating after intercourse and avoiding vaginal sprays or douches could help considerably reduce your risk of contracting a UTI.

Erectile dysfunction: Stress, anxiety and alcohol consumption– multiple things can contribute to a slump in the heat of the moment, regardless of how aroused you may be. It’s often an awkward, even embarrassing moment. What do you do when there’s no coordination between your penis and your raging hormones? Alcohol-induced dilation of the blood vessels allows the blood to flow in and out making it difficult to maintain an erection.

This is also more than just a physical thing. The day’s stress, performance anxiety mingled with self-consciousness all play a part. Sexologist Dr Mahinder Watsa reminds his patients to “not get too worked up about the ‘one’ instance, because overreacting to an isolated incident will ruin it for the next time as well. Laugh it off and move on.”

Vaginal flatulence: Referred to as queefing, these aren’t real farts. During intercourse, with long thrusts, air can get pushed up into the vagina. And of course, what goes up must come down, or out, in this case. Your body expels this air that has nowhere to go, out the same way it came in.

It’s embarrassing because we associate the noise with flatulence, its odour and overall digestion – basically the opposite of sexy. It’s normal and can happen to anyone with a vagina. In some cases, according to OB/GYN Dr Jen Gunter, it could be more serious. The first step is “ruling out a fistula.” If all clear, try physical therapy to strengthen the pelvic floor muscles, especially if you’ve given birth.

Vaginismus: The exact cause of vaginismus isn’t clear at the moment, but it signifies pelvic floor muscles spasming and contracting uncontrollably during penetration. This makes it difficult, even painful, to have sex, insert tampons and even get gynaecological examinations. Your vagina pretty much shuts shop, in a way.

It is believed to be a psychological condition resulting from a fear of physical penetration. This could stem from a history of sexual abuse, past experiences of painful sex, a fear of sex and even anxiety. According to Dr Ashok Koparday, “Treatment of painful sex requires sensitivity and experience on the part of the health care professional.” He doesn’t recommend surgical intervention or pills in cases of seconday vaginismus— where the patient has had non-painful penetrative intercourse before — but consultations with a sexologist to treat the problem. A study published in the Indian Journal Of Psychiatry found that Kegel exercises could also be helpful in controlling the pubococcygeus muscle which surrounds the entrance to the vagina.

Bleeding: Bleeding during or after sex occurs usually after the first time you have intercourse as the hymen tears. But who hasn’t been caught off-guard by an early visit from the period fairy? If you’ve recently finished menstruating, it’s also possible to have residual blood and spotting when you have sex right after.

Flatulence: The very many positions that we’re willing to experiment with could give you better cardio and strength workout than any gym routine. Stretching limbs and contorting bodies, it’s pretty normal that somewhere along the line you’re in just the right spot for your body to release gas. No matter how much you clench, it’s not always in your control. There’s no real way around it, laugh it off and carry on.

Vaginal dryness: It’s not just a hormonal imbalance caused by low estrogen or menopause that can cause a lack of lubrication. Medication, mental health and urban lifestyle choices can also affect your vagina’s natural ability to lubricate itself.

Products like douches, soaps and vaginal washes can cause irritation and unwanted reactions. Medicines like steroids, antibiotics, antihistamines and even gut imbalance can lead to vaginal dryness. Maybe you need more foreplay or some lube. Even when you’re incredibly aroused but just not wet enough, trying to force it will do more damage to your ego and genitals. Dr Shari Lawson says, “”It’s important to talk to your doctor if you’re having pain with intercourse in any position you try, lubricants do not help with vaginal dryness or you have bleeding after intercourse.”

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