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When Sex Hurts

Written by Dr. Marty Klein

Your inner tiger may like a little playful and physical love making, but sex shouldn't hurt when you don't want it to.

The only time sex should hurt is when you want it to hurt. Spanking, nipple pinching, and other kinds of rough play have an honorable history among consenting adults. But sometimes sex hurts when you don't want it to.

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Sexual acts themselves can be painful. Causes can be mechanical: tiny fissures around the labia or penile shaft, too much friction due to inadequate lubrication, awkward angles of insertion or containment. Active lesions from STDs such as herpes can make even light pressure painful. More serious physical causes include endometriosis, fibroids and Peyronie's disease.

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Some causes are psychological: Anxiety or anger can narrow the vaginal opening. Even simple touch can hurt when you're grappling with strong feelings. Our gag reflex can be triggered by smell, sound, making kissing or oral sex an ordeal.

People over 40 often start noticing something new: Sex begins to hurt because it involves stretching, twisting, weight bearing, and aerobic stress. As you age you may have less tolerance, for example, for tilting your neck when performing cunnilingus, hyper-extending your lower back during traditional intercourse, or squeezing and pulling.

What can we do about this? If something aches, move it or rest it. Develop a repertoire of sexual activities that hurt less. Tell your partners what's uncomfortable so they'll stop expecting those things. To warm up for sex, stretch, take a hot bath and perhaps some aspirin. At 40 or 50, it's part of sex.

Coming to terms with our sexual limitations is part of coming to terms with middle age. It's rarely discussed; people talk freely about having to give up running or tennis, but not about how, say, tendonitis limits their masturbation.

But ignoring these changes can undermine the sex, while exacerbating the pain. Ultimately, having good sex in the shadow of our physical limitations requires that we admit what's going on, and adapt accordingly. That means finding ways to deal with the grief of losing cherished sexual activities because of joint pain or limited range of motion.

In middle age, grief is a sexual frontier.

Marty Klein, Ph.D., has spent his 24-year career as a Marriage Counselor and Sex Therapist helping people understand and accept their sexuality. You can read more about his books, tapes and appearances on his Web site, SexEd.org

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