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Sex Hurts. Help!

Navigating a sensitive, and critical, topic.


It is a relatively common myth that penises can be too large.

As a professional, I can assure you they generally are not.

From time to time I receive a query from a girlfriend wondering if her potential new partner is perhaps too large. One of the perks of having an obstetrician and gynecologist as a friend is you can ask everything — and get informed answers.

I remind them that vaginas have been finely tuned by hundreds of thousands of years of evolution to stretch. If they are interested and if this gentleman is a safe choice, personally and medically, then break out the lubricant and have a ball. If it hurts, stop and give me a call — not immediately, but perhaps the next day.

It is also not uncommon for me to hear about penis size from people I barely know. Once I was out for dinner with my future ex-husband and some people I had never met. When the opportunity presented itself, the woman turned to me, just as I was taking a mouthful of pasta, and said, “We can’t have sex. His penis is just too big.”

It was one of those record-scratch freeze-frame moments, because I can almost guarantee that this man did not miss his calling in the pornography industry. If they both want to believe it is huge, great. But the truth is they probably do not have a size problem; they more likely have a medical condition known as dyspareunia.

“Does it feel like he is hitting a wall?” I asked.

They both looked at me as if I were psychic. I am not. Women for whom tampons and sex are painful because the vagina feels too tight or small almost always have a condition called vaginismus. This means the muscles of the pelvic floor that surround the vagina are inappropriately taut. Typically these muscles relax with sexual stimulation and then contract rhythmically with orgasm. When they are tight it can cause pain with sex, a fit issue and even pain or difficulty with orgasm. Sometimes the pain can be worse after sex.

This woman I met briefly is no different than the patients I have been seeing for 25 years. She has pain with sex, she had told multiple providers, and not only had she never been offered a treatment, but she also had never even been given a diagnosis. The best modern medicine has left her with is internet mythology — and not even vaginal mythology, but penis mythology! This enrages me.

Pain with sex is common; almost 75 percent of women have experienced it. For many, the pain comes and goes and reasons for this transient pain include inadequate foreplay, breast-feeding (which lowers estrogen), infection and other causes.

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