Pain with intercourse
Pain on entry is most commonly the result of insufficient arousal and lubrication. It can be particularly troublesome after the menopause for women who aren’t having hormone replacement. The solution is to ensure that you’re aroused enough before penetration. If you and your partner both want his penis in your vagina before you’re moist enough, use an additional lubricant such as K-Y Jelly on the penis and all around the introitus. If you don’t, the discomfort of dry penetration will turn you right off.
Entry can also be painful if there is any inflammation or ulceration of the vulva. It’s best to postpone intercourse until any genital inflammations have cleared up with treatment, both for your comfort and to prevent possible spread of infection.
Pain during deep penile thrusting is I symptom of pathology in the pelvis, and always needs medical investigation. Common causes are infections of the cervix, uterus, tubes or other pelvic organs and tissues; endometriosis; some ovarian conditions, pelvic scar tissue resulting from surgery or radiation treatment for cancer. A retroverted uterus is only likely to cause pain on deep thrusting if the uterus is stuck in the backwards position by scar tissue.
Pain after sex can also occur in conditions that cause pain on thrusting. Dull, prolonged aching in the pelvis can result from the pelvic congestion that follows arousal without orgasm, as described above.
Contractions of the uterus during orgasm are seldom painful. On the contrary, they’re believed to add to the pleasant sensations of orgasm.
Vaginismus
This is an involuntary, painful spasm of the muscles surrounding the entrance to the vagina. It begins as soon as sex (or pelvic examination) is anticipated. The contraction may be so powerful and persistent as to make sexual penetration impossible. This spasm can occur in women who have a deep-seated fear of sex. The dread may have developed after a traumatic sexual experience (often in childhood) or from having learned extreme negative attitudes towards sex. The fear may be buried so deeply in the mind that the woman is hardly aware of it.
Vaginismus can usually be overcome by psychotherapy and sexual counselling, though it can take months or years for a woman to learn that sex with a loving partner is ‘good’ and won’t harm her. Most sufferers recover to enjoy a normal sex life and bear children.
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Depression
This is worryingly common in teenagers. It usually comes on so gradually that it takes a long time or a desperate act before anyone realizes there’s a problem. When you’re depressed you feel worthless and hopeless. You become more and more sad, tearful, irritable and withdrawn. You lose all interests and can’t concentrate your thoughts. Schoolwork suffers. Depression is a really vicious cycle: the deeper it gets, the worse your feelings of hopelessness become; your behaviour becomes more withdrawn and unlikeable so that people avoid you. This convinces you even more that you’re unlovable.
Depression can be a reaction to thinking that you have an insoluble problem and that this means there must be something wrong with you. Often when teenagers and their families have had an easy life, they’ve had no experience of thinking their way through difficult situations, bit, by bit, and together. You may be depressed because you have no practice in facing difficulties. Others have faced the same human dilemmas, and have found their own answers. These may not be the right answers for you, but talking to others and learning how they’ve tackled problems can be a great help.
Depression can make you physically ill too. Common symptoms are headaches, muscle aches and pains, appetite disturbances leading to excess weight loss or gain, and stomach pains. Sleep is often disturbed: you sleep too much or can’t sleep.
Depressed kids often get up to uncharacteristic (for them), antisocial behaviour. Girls may ‘act out’ their depression sexually, becoming promiscuous or deliberately getting pregnant. They may become rude, aggressive, ill-tempered, disruptive and may even get into trouble with the law by stealing or damaging property. This confirms their belief that they are ‘no good’.
We all get the odd fit of the blues. Most of us can bounce back after a couple of days. Depression that continues to deepen for weeks or months is a dangerous illness with a high risk of suicide. If you feel that you or any of your friends may be depressed, speak to an adult you trust. Help is urgently needed. Depression can be associated with a chemical disorder in the brain, and this can be helped by medication. Drug treatments should always go along with counselling (psychotherapy) to help sort out and do something about problems that might be contributing to the depression.
Suicide
Over the past 20 years everyone’s become alarmed at the increase in suicide and suicidal behaviour among young people. The rate has tripled for young men, in whom it’s second only to road accidents as a cause of death. The rate for girls has stayed more or less the same, though more girls man boys attempt to kill themselves. Boys are more likely to use a successful method such as shooting or hanging themselves. Many road and drug-overdose ‘accidents’ are really disguised suicides.
Can something be done to save these young lives? I think that many suicides could be prevented by recognizing and treating depression earlier. The trouble is that many people don’t want to think about suicide or mental illness as things that could happen to them or anyone in their family. It’s something that happens to other people: that is, until it touches close to home.
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Holism
This is a belief that the body, intellect, emotions and spirit, as well as our relations with our families, society, the politics that influence our lives, our environment and the world are interconnected in promoting health and that none can be viewed in isolation.
It seems to me that holistic health care has become a bit of a bandwagon. The idea isn’t new (though the use of the word ‘holism’ in health care is): the philosophy that the whole is more than just the sum of its parts goes back a long way. People have always known that if the soul is unhappy, the body also ails. I hope that all health-care personnel would approach everyone as whole people whose health is influenced by everything in and around their lives.
Homeopathy
This therapy is based on several beliefs: that ‘like cures like’ or ‘what it can cause, it can cure’; that the more dilute a remedy is, the better it works; that people have an energy field that must be matched with the earth’s magnetic field to maintain health; that their treatments can make symptoms worse before they improve and can make old and different symptoms flare up to be healed; that during a cure, symptoms move from the inside to the outside of the body and from ‘more important to less important’ body systems.
It is very hard for someone (like myself) who is trained in conventional biology to understand homeopathic beliefs. But many people have great faith in the therapy, and a few studies have shown that in some cases it has produced benefits that could not be accounted for by placebo effect.
Homeopathic remedies are made from many substances, though mostly from plants. They are widely available in health-food shops and some pharmacies and: need not be prescribed by a homeopath. Because of their dilution, it’s unlikely that self-medication would be unsafe.
Hypnotherapy
Hypnotherapists use the state of mind between wakefulness and sleep. After inducing this trance-like state, the therapist attempts to influence a patient’s mind to improve health. Practitioners view the trance as a healing state that allows the mind and body to achieve changes that aren’t possible with full consciousness.
Hypnotherapy has been followed by physical healing, relief of some types of pain, and insight into present difficulties and past events that may be influencing health. Some orthodox health practitioners remain sceptical about hypnotherapy, in spite of its proven effectiveness in bringing about improvement in health, especially in phobias and physical symptoms associated with stress and anxiety.
Naturopathy
Naturopaths aim to help the body cure itself of disease. Like orthodox practitioners, they know that many illnesses occur when our natural resistance is reduced. While orthodox treatment concentrates on finding and eliminating the cause of illness, naturopaths concentrate on restoring resistance.
These days naturopaths often use a variety of alternative therapies as well as diet, exercise, relaxation and breathing techniques. They also encourage a natural’ lifestyle and positive attitudes to mental and physical health. Naturopathy forms a very good complement to orthodox health care.
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