Help when sexual intercourse is painful

I find sex painful. Will I ever enjoy intercourse again?

Q. About a year ago, I developed vaginal thrush following a course of antibiotics.

Medication helped to clear it up but I still find sex painful. My partner is very understanding but I worry if I’ll ever enjoy sex again. We are both in our mid-30s.

A. Vaginal thrush is very common and most women experience at least one episode. It is a distressing condition.

It’s not clear from your letter if the medication you used was prescribed by your GP. Pessaries and creams can be bought over the counter and work very well for most. However, a GP I consulted warned that repeated use of these may cause sensitivity.

I suggest you make an appointment with your GP and have a full vaginal check, including a swab for thrush and tests for other infections. It is important to be sure there is no infection of any kind. Also, if using condoms, you may be sensitive to latex. There are non-latex options available. Your GP will be able to give you more information.

Hygiene is essential to your recovery. Never use soap or shower gels or any product with perfume on the vaginal area. Water is the best as it doesn’t destroy the natural flora in the body.

Another key point that many women are not aware of is to wipe from front to back after using the toilet.

As the vagina is a warm area of the body, wearing cotton underwear is recommended. And tight-fitting clothes are to be avoided. Also, when washing clothes, chose natural detergents over perfumed products.

Diet also plays an important role: steer clear of excessive sugar and make sure you eat a wide variety of wholefoods.

It is possible you are aware of all of all these steps and still experience difficulty with sex.

A physical problem causes stress and especially so when it interferes with your sex life. Stress can also affect your libido.

You started with thrush but subsequently the pain you are experiencing is affecting your desire and causing stress and anxiety. This cycle causes pain and fear. It can leave you feeling helpless and frustrated.

To have good sex we need to be relaxed. And you are unlikely to feel aroused if you are tense. So take the pressure off about intercourse — it does not have to be the end point. You can show affection, without penetration, kissing, cuddling, massage, mutual masturbation are all good.

Spend plenty of time on the sensual side. Try to break the cycle of anticipation of pain. Stay with the warm sensations you are feeling when your partner cuddles and massages you. Also enjoy lingering over his body and giving him pleasure. Staying within our bodies when giving pleasure as well as receiving can be such fun.

Try and put aside expectations. If you go onto intercourse use plenty of lubricant, but again not perfumed.

If there are no medical problems and you continue to have difficulties do talk to a psychosexual therapist, who can help you to get back to enjoyable sex.

* Marie Daly is a psychosexual therapist with Mind and Body Works. Visit www.mindandbodyworks.com.

* Please send your letters to feelgood@examiner.ie
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