Men and painful sex (Dyspareunia)

Men and painful sex (Dyspareunia)

Men can get pain before, during, and after sex, and it is important to be clear about when and exactly where the pain arises. It may be in the shaft or glans of the penis, scrotum, anus, or sometimes another area, the most common being a headache after orgasm. It can happen during arousal, in the erection, or with ejaculation and orgasm, or as everything returns to its non-aroused state. The first step is to see a doctor, as the pain may have a medical cause which could need medical treatment. A common medical cause is genito-urinary infection. For non-medical causes of painful sex – sexual abuse, fear of sex, repressed anxiety, the services of a Sex Therapist may be required. A combination of both medication and Sex Therapy is often the right solution for men having the problem of painful sex. Sometimes body tension causes pain, and Relaxation Training can help. Deeper reasons may be helped by Self Hypnosis, which may also be effective as a pain control. But there is also the realization that in some cases no cause can be found at all. Unfortunately, painful intercourse can often have a destructive emotional effect on a relationship. Sometimes couples part because of it. So that’s a clear reason why you should get the problem sorted out as soon as possible.

Men suffer from painful sex or ‘dyspareunia’ less commonly than do women this is probably because the penis being an external organ is less prone to ailments than the vagina or the female pelvic organs. The commonest causes of painful sex in men is associated with the foreskin. Some men have a foreskin that doesn’t retract fully over the glans or head of the penis during erection. The foreskin stretches to the point where it actually cuts into the glans and inevitably causes pain with all but the shallowest of penetration. Sometimes this condition can be helped if the man or his partner can stretch the foreskin back while soaking in a warm bath until it is pulled completely over the head of the penis. If this is not possible, then the man will need to be circumcised to allow a normal sex life. Rarely, circumcision is advised for chronic infection (balanitis) under the foreskin of uncircumcised men, another cause of pain during sex.

A man may also experience tenderness or pain during intercourse or masturbation if there are any small tears in the frenulum (the small raised ridge of tissue on the underside of the head of the penis). This trauma is usually caused from excessive manipulation/masturbation of the penis or more commonly resulting from human bites.

Any lesion on the skin of the penis can make intercourse painful. These lesions may be due to unlubricated masturbation, rapid intercourse or STDs. The blisters, lesions or sores, caused by genital herpes, are often preceded by 5 or 6 days of burning, itching or pain, and can make intercourse extremely painful. If penis pain is caused by a sexually transmitted disease, it is important for the sexual partner to also be medically treated.

Men also sometimes have penis deformities – Peyronie’s disease, a bend in the penis that occurs during erection. The vascular pathway that runs the length of the penis (corpora cavernosa) normally fills with blood during an erection. In Peyronie’s disease (curvature of the penis) fibrous tissue, a lump, develops within the shaft obstructing the corpora cavernosa of the penis. When the penis becomes erect, it inflates unevenly and tends to bend around the plaque, causing the characteristic deformed appearance of Peyronie’s disease. Some of these bends are quite pronounced and can be quite painful both to the man and the woman during sex. I have a friend who almost has to be at right angles to the female to afford entry into the vagina.

An infection of the prostate gland – prostatitis or even an infection of structures such as epididymis in the scrotum can cause some pain on ejaculation. Aching type pain can also be caused in the testicles and groin following prolonged periods of sexual arousal without ejaculation – often referred to as ‘lover’s balls’ or ‘blue balls’, which is often a part of CBT Play – this discomfort is usually relieved upon ejaculation.

Inflammation of the urethra or Urethritis is another possibly for painful sex in men. Urethritis may be caused by the same organisms that cause bladder or kidney infections (for example, E coli or Klebsiella) and some sexually-transmitted diseases (for example, Chlamydia, gonorrhea, and Ureaplasma urealyticum infections). Urethritis may also develop because of a chemical sensitivity that results in irritation (such as spermatocide in condoms, contraceptive jelly, cream, or foam). Trauma from insertion of an object into the urethra may also cause urethritis. Increased risk is associated with men between 20 and 35 years old, multiple sexual partners, and those who engage in high-risk sexual behavior (such as lack of condom use or anal intercourse). Some causes of urethritis may be avoided with good personal hygiene and by practicing safe sex and the use of condoms. Generally the symptoms of urethritis are:

  • Dysuria (pain with urination).
  • Increased urinary frequency or urgency.
  • Tenderness or enlarged inguinal lymph nodes in groin area.
  • Fever.
  • Discharge from penis.
  • Pain with intercourse or ejaculation.
  • A tender and enlarged testicle.
  • Blood in the semen.
  • A tender and enlarged epididymis

Another possible cause of painful ejaculation – Benign Prostatic Hyperplasia or benign prostatic hypertrophy. The prostate gland normally begins to increase in size, enough to be noticed, as a man moves into his 50’s. This enlargement will squeeze the urethra, the tube through which both urine and semen flow, and slow down the stream of both.

If it has been sometime since the man has had an ejaculation, just a lack of sex rather than prolonged sexual arousal, the ejaculation is often quite thick and the man will suffer a burning sensation as the semen passes through the urethra tube.

For penis pain caused by priapism (persistent erection), ice packs may help the pain, a urinary catheter may be inserted to relieve urine retention, medications and or occasionally, surgery may be necessary.

Perhaps one not experienced by many – during heat play, if you intend at a later stage penetrating the woman vaginally or anally it is perhaps wise not to use Deep Heat, Tiger Balm, oils such as Peppermint, Cinnamon, Chilli, or finalgon or similar creams on the clitoris or openings of the vagina or anus – because the residue is certainly likely to rub onto the penis on entry. If one of these actually gets into the eye or urethra opening of the penis you will have an eye watering experience in pain you won’t believe.

An uncommon cause of painful intercourse in men may be psychological and involve painful ejaculation, even though no infection or prolonged sexual arousal does not apply, a pain in the groin or even a headache which comes on during sexual intercourse. Leading the men to claim that there is something wrong with their semen, they have a blockage or something similar. Excessive penile sensations are almost always a sign of an unconscious desire to avoid painful sex and can be often difficult to sort out by a trained sexual counsellor. The causes vary and are many and are often related to unconscious fears of women and sex generally. Some men for example have been brought up with conditioning to think of semen as a form of excretion, dirty, and cannot bring themselves to ‘defile’ the woman or man they love with it.

Some men learn to fear penetration. This occurs sometimes as the result of unfortunate experiences, or unusual ideas about the effect of penetration. Less often it occurs because of fear of causing pregnancy, or acquiring a sexually transmitted disease, or uncertainty about sex itself. Early sex accompanied by guilt, pain or discomfort, can lead to fear and avoidance. Sexual drive is not affected by this fear. The longer a man fears, the more skilled he gets at justifying his beliefs and he will take another path, for example masturbation. A therapist may help to identify his fear and help him work out the evidence for it.

A much more easier problem to fix as regards painful sex is the ‘dry’ vagina. This can happen if the partner is insufficiently aroused, has just removed a tampon, or has just finished her cycle. This type of friction pain, bit like rubbing the penis with grade O sandpaper, can be avoided by devoting more time to foreplay or by simply using a lubricating gel on the penis or inserted in the vagina.

A different type of painful sex and singularly the most common male sexual problem is the lack of ejaculatory control. Another equally as common is Erectile Dysfunction which is the inability to achieve a hard, erect penis sufficient for sexual intercourse. Traditionally, this inability has been called “impotence”. The term erectile dysfunction is more precise, because it refers only to erection problems. Men with erection problems often retain other sexual functions. For example, they may still have sexual desire and may still be able to have orgasms and ejaculate semen. This can cut right to the heart of man and his ‘maleness’ and if not handled properly by the partner with some compassion the whole relationship can be threatened.

Some men are unable to maintain an erection after putting on a condom as there is no direct contact between the penis and the vagina. Friction of the condom may diminish clitoral stimulation and reduce lubrication making intercourse less enjoyable or even uncomfortable. Lubricated condoms may alleviate this problem. Intercourse may be less pleasurable since the man must withdraw his penis immediately after ejaculation. Allergic reactions to latex condoms are rare, but they do occur.

But perhaps the worse painful sex of all is the one where you screw for three days and eventually you just have to shower or die. You turn on the water, step in the shower and the warm spray hits your cock….the scream can be heard 3 blocks away – the dreaded and to be avoided at all cost – ‘Screwing Chafe’ where you have worn three layers of skin off your penis by continued rubbing, lubricated or not inside that inviting and often irresistible female vagina.

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