Intimacy hurts, but you keep quiet because you think it is something women simply have to bear.

You should not have to endure it. Read!

Q: Hello Dr, I just got married and I always have pain in my bladder during sexual intercourse. What should I do? And what is the cause? Kindly help me please.

A: Pain during sexual intercourse is more common with women but can also happen in men. This condition is called dyspareunia in medicine.

Dyspareunia is a condition in which one experiences pain during or after sexual intercourse. In women, the cause may be due to:

• Vaginismus: a condition in which the vaginal muscles go into spasms when an attempt is made at penetration.

• Lack of adequate lubrication eg due to hasty foreplay etc

• Infections of the vagina (like candidiasis as mentioned in the question) or urinary tract can also cause pain during sexual intercourse.

• Injuries/wounds to the vagina

• Emotional issues like stress or emotional disconnect from partner.

• Fibroids around the vagina or cervix

In men, the cause of this problem could be due to:

• Infection of the urethra (the tube which conveys urine from the bladder out of the body and also conveys semen out during ejaculation)

• Infection of the prostate gland.

• Infections, some of which may be due to STI

• Emotional issues may also be involved eg feelings of guilt.

Treatment depends on cause.

If due to infections, they have to be treated. If it’s due to lack of lubrication, that has to be handled. Some lubricating gels may be suggested.

If no physical cause can be seen and the problem appears to be emotional, some counseling may be required. Understanding that when people get married, they are actually two ‘strangers’ trying to get to know each other, should form part of the incentive for slowing down and trying to find out what pleases each member of the union.

Get checked sooner if you also have bleeding after intercourse, unusual discharge or sores, fever, pain when urinating or persistent pelvic pain.

Today is World Sexual Health Day. Being able to speak about pain and receive appropriate care is part of sexual health.