Sex and pleasure are part of a package deal – it feels good, and that’s one of the reasons we keep doing it! But recent research shows 30% of women are experiencing pain during the act. Though the hurt could be a symptom of a serious issue such as endometriosis, more often the cause is less grave.

“Most conditions that cause painful intercourse are very treatable,” says Dr Debby Herbenick, author of Sex Made Easy. Read on to find sex-wrecking culprits and their cures.

1. It feels like his penis is made of sandpaper

Vaginal dryness. “A lack of lubrication is hands down the most common cause of painful sex,” says Dr Herbenick. Certain medication – including the Pill, antidepressants, some allergy and cold meds – can stop your juices from flowing. So ditch the pre-sex soak in a warm bath, which dries out vaginal tissue.

Read more: 4 common reasons why you’re suffering from vaginal dryness

Apply a dollop of water-based lubricant to your girl parts during foreplay. A US study found that women who used lube while doing the deed reported significantly less pain and – bonus! – much higher levels of satisfaction.

Opt for positions that allow you to control the pacing (like woman on top) and stop to reapply if needed. Still in pain? If only certain positions are hurting you, common causes are constipation, muscle spasms, endometriosis, cysts or other organic causes, says WH sex expert Dr Elna Rudolph.

2. Your genitals itch and penetration makes it feel worse

Though various conditions can lead to itchiness, the most common cause is a yeast infection, which may result from taking antibiotics. Research also suggests a link between lots of oral sex and recurrent yeast infections; women who suffer from the condition are three times as likely to be on the receiving end of frequent oral loving. However, this is rare, according to Dr Rudolph. “Likely offenders are scented bubble baths, lubes and harmful activities like douching,” she says.

Read more: How much vaginal discharge is normal?

If you think you have a yeast infection, use an over-the-counter treatment, says Dr Rudolph. “If it’s not better within five days, see your gynae and have her take a vaginal swab,” she says. Keep getting that itch? It’s okay to use an OTC treatment up to five times a year – if you need it more often, have another swab taken.

“You may have a resistant infection, or it may not be a yeast infection at all,” says Dr Rudolph. “Conditions like lichen sclerosus also cause itching, and it’s harmful to treat it as a yeast infection.”

3. It seems as if he’s going to burst through your cervix

No, he’s not too big for you. You’re probably just rushing things. “If you’re sufficiently aroused, ‘ballooning’ of the vagina takes place,” says Dr Rudolph. “The uterus is pulled up into the abdomen and the muscles around the vagina relax, creating space for him.”

Read more: 7 cervical cancer symptoms you should absolutely never ignore

Don’t skimp on the pre-game warm-up. Most women need 20 minutes of foreplay to make sure their parts are ready for action. Simply adding lube isn’t a good short cut. “It might make entry easier, but it won’t change the length or shape of your vagina,” says Dr Herbenick.

Still uncomfortable? “It shouldn’t be painful if a penis hits a healthy cervix,” adds Dr Rudolph. If you still feel there isn’t enough space, see your gynae.

4. Post-baby nooky leaves you achy and raw

New moms, especially those who are breastfeeding, can experience plummeting oestrogen levels that leave the vagina drier than the Sahara and the vaginal walls prone to tearing. Scar tissue on a poorly healed episiotomy can also cause penetration woes.

Read more: The 5 best sex positions for after you have a baby

Take a break from intercourse. Many women aren’t physically ready for three months or longer, says obstetrics gynaecologist Dr Elizabeth Stewart. But don’t cut down on intimacy altogether, says Dr Rudolph. Start by using a finger and then try penetration – with plenty of lube.

5. It feels as if shards of glass are cutting up your outer vagina

Provoked vestibulodynia – a problem thought to involve the pelvic muscles, fascia and nerves.

If it’s mild, your doctor can prescribe Remicaine jelly or Emla cream containing a local anaesthetic, says Dr Rudolph. Once your gynae has ruled out obvious causes like infections, see somebody who specialises in genital pain. “Management will be a combo of medical treatment, physiotherapy and, in some cases, psychological interventions.”

6. Your vagina clamps shut when he tries to enter

Vaginismus. This painful but treatable condition causes the muscles at the entrance to the vagina to spasm at penetration, making intercourse all but impossible.

Read more: Two gynae-approved ways to tell if your vagina is too weak or too tight

Vaginismus is the fear of penetration associated with involuntary muscle spasm, and treatment involves overcoming the fear, learning to control the pelvic floor muscles and stretching them sufficiently to allow penetration, says Dr Rudolph. Stretching exercises begin with tiny objects like ear buds, moving on to a pencil, small tampon and vaginal dilators.

Your doctor might also prescribe sex therapy, psychotherapy and pelvic-floor physiotherapy to break down muscle knots through massage. Botox also works to relax overactive vaginal muscles, but it’s still experimental.

7. You get an itchy, hive-like rash around your vulva after sex

An allergic reaction, probably due to latex condoms or your lube. Choose plain condoms with no flavourants, and water or silicone-based lube. If it’s still a problem, see a doctor.

^{This article was originally published on www.womenshealthsa.co.za}

^{Image credit: iStock} 

Tracy Erb Middleton

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

In an interview with British Vogue, singer Adriana Grande opened up about her struggles with post-traumatic stress disorder (PTSD). The singer told the magazine she is still haunted by the Manchester Arena bombing on 22 May 2017. Ariana had just finished her concert on that night when a suicide bomber detonated an explosive device at the venue. 

“I know those families and my fans, and everyone there experienced a tremendous amount of it as well,” said Grande. “My anxiety has anxiety… I’ve always had anxiety. I’ve never really spoken about it because I thought everyone had it, but when I got home from tour it was the most severe I think it’s ever been.”

She says it is still difficult for her to talk about the issue without crying. “I feel like I shouldn’t even be talking about my own experience – like I shouldn’t even say anything.” 

It’s clearly been a difficult journey for Grande, but what exactly is PTSD and how prevalent is it in SA? 

What is it? 

According to the South African Depression and Anxiety Group (SADAG), PTSD is a “debilitating condition which follows a traumatic event”. Patients often relive the traumatic events and it is most often accompanied by sudden and vivid memories. 

Alternative names: Shell shock, battle fatigue, soldier’s heart and accident neurosis 

Symptoms

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) specifies five criteria for a person to be diagnosed with the disorder. 

Criterion one: The person was exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence in at least one of the following ways: 

• Direct exposure
• Witnessing the trauma
• Learning that a relative or close friend was exposed to a trauma
• Indirect exposure to aversive details of the trauma, usually in the course of professional duties  

Criterion two: The traumatic event is persistently re-experienced, in at least one of the following ways:

• Unwanted upsetting memories
• Nightmares
• Flashbacks
• Emotional distress after exposure to traumatic reminders
• Physical reactivity after exposure to traumatic reminders

Criterion three: Avoidance of trauma-related stimuli after the trauma, in one of the following ways:

• Trauma-related thoughts or feelings
• Trauma-related reminders

Criterion four: Negative thoughts or feelings that began or worsened after the trauma, in two of following ways:

• Inability to recall key features of the trauma
• Overly negative thoughts and assumptions about oneself or the world
• Exaggerated blame of self or others for causing the trauma
• Negative affect
• Decreased interest in activities
• Feeling isolated
• Difficulty experiencing positive affect

Criterion five: Trauma-related arousal and reactivity that began or worsened after the trauma, in at least two of the following ways:

• Irritability or aggression
• Risky or destructive behaviour
• Hypervigilance
• Heightened startle reaction
• Difficulty concentrating
• Difficulty sleeping

These symptoms must last for more that a month; they must create distress or cause impaired function; and the symptoms can’t be due to medication, substance use, or another illness.

PTSD in South Africa

According to a recent study from the University of Cape Town, our “unique history, characterised by apartheid, and a long period of political violence and state-sponsored oppression ending only in 1994, suggests a high level of trauma exposure in the general population”. This study conducted a national survey with more than 4 000 adults participating and revealed that the lifetime and 12-month prevalence rates of PTSD were 2.3% and 0.7% respectively. 

In South Africa physical violence is the most prevalent form of exposure. A breakdown of the “triggers” is as follows:

Unfortunately, not only adults are plagued by PTSD. A study from Stellenbosch University shows that more than 20% of South African children have symptoms of the disorder. “We hope our study can help increase the access of adolescents with PTSD to much-needed support in a developing country such as South Africa,” said principal researcher Jaco Rossouw. 

Treatment

A combination of therapy and medication is often effective and according to SADAG “a person who has survived a trauma cannot expect to function as they normally do immediately after the trauma”. Cognitive Behavioural Therapy (CBT) has been successfully used in the treatment of many patients and an experienced psychologist is often one’s first point of call. 

SADAG’s 24-hour Helpline is 0800 12 13 14.

Joshua Carstens

If there’s one thing I’ve learnt about guys during my years as a sex writer, it’s that they’re desperate to feel okay about their junk – and with nicknames like that, it’s no wonder. This is true regardless of what a guy is packing, from micro-members to skyscraper schlongs.

In fact, I once interviewed Jonah Falcon, the man with the world’s biggest penis, and found him living a secluded “asexual” lifestyle that he called “depressing”. You see? The grass is not always greener… on the other side of the locker room.

Even men who aren’t worried about their size are often deeply concerned that their penises are ugly or weird, smelly or bad-tasting. Guys with foreskin sometimes feel like freaks; guys without it wonder if sex would be better with it.

Read more: The best sex positions for every penis size

Then there are the aesthetic anxieties about scars, curving, colouring, freckles, warts, moles and pubic hair. Testicles come with their own magnum-sized worries about sagging and unevenness.

This is all before sex even begins. Then you get your performance-related insecurities: “Is my penis hard enough?”, “Did I last long enough”, “Does my cum taste revolting?”

I have one thing to say about this rampant penis anxiety: You’re tripping so damn hard.

As a so-called sexpert, and a red-blooded heterosexual woman, I can tell you there is every reason to love your penis – and you’ll find some of the most important examples below.

Vaginas are only so big

We tend to apply bigger-is-better thinking to a man’s erection – but the average vagina is only 7 to 10cm deep. And the all-important G-spot is generally only 5 to 7cm inside. So you really don’t need to reach very far in to get to the important bit!

Read more: How to please a woman: Secrets from a man with a hot wife and a tiny penis

You have no idea what an average penis looks like!

If you insist on disregarding what I have to say about the relative unimportance of size, consider that you probably don’t have an accurate picture of what an average penis looks like anyway. Fortunately, science reveals the average penis size. How do you stack up?

Just think about it: If you’re straight, you typically only see other guys’ junk in porn and the locker room, right? Surely you already realise that X-rated stars do not have average-sized man parts. But here’s something you may not know about those seemingly gifted dudes who insist on letting their members air-dry at the gym: They might not be what they appear.

According to the Kinsey Institute, “In general, smaller flaccid penises lengthen at erection by a greater percentage than do larger flaccid penises, with most men reaching an average size of 12 to 17cm, so the flaccid size of a penis is not a good predictor of erect size.”

Penises smell great

Popular wisdom seems to be that penises are stinky. Sure, if you play a bunch of basketball and don’t shower for a week, it’s going to have a nasty funk. But if you exercise basic hygiene, it’s not a problem. (There are a few simple fixes you can do if your penis really does stink.) If anything, it might have the slight woody scent of a manly cologne. We women like manly cologne.

And taste good too

Again, if you shower like a civilised human, there just isn’t any bad taste to speak of. Unless you plan on having a couple ribs removed so that you can try it for yourself, you’ll just have to take my word for it.

You can pee anywhere, for crying out loud

Clearly this isn’t sexy-times related – unless golden showers are your thing – but, man, I have been waiting to get this off my chest. You men get to urinate anywhere you want. Just whip out that pee tunnel and you’re good to go. In the woods, on the side of the road, in the snow. You’ll never have to know the misery of squatting to pee.

Read more: This poll found out how important size really is to women

Foreskin is awesome

Lots of guys think foreskin looks funny. What they’re failing to see is the beauty of the mechanics of the thing, and the way a woman will appreciate being able to effortlessly glide her hand over the head.

So is no skin

A circumsised penis is like a present without the wrapping – it’s 100% immediate gratification. No woman will argue with that.

Read more: Is it better to have a circumcised penis?

Penises are ‘morning people’

Man, first thing every morning, without fail, your little guy pops right up out of bed like you never will. It’s inspiring, really. That dude has a real zest for life. In terms of role models for how to be in the world, it’s a toss up between the penis and the Dalai Lama.

Not getting the morning wood the way you used to? No problem. Here are eight ways to protect your erection.

Ejaculation is awesome

I guess I don’t have to try too hard to convince you of this. I don’t just mean the awesomeness of the associated ecstasy, though. It’s also the dramatic visual display of pleasure. Nature’s fireworks, man! It makes ladies’ jaws drop in awe – and, OK, I’ll admit, a bit of jealousy. Now, some women do ejaculate, but it’s much less common, and more difficult to achieve. So count your blessings, penis-owners.

Your wang is a beautiful thing

The delicate ridges and veins. The mind-bending smoothness, even when it’s hard. (I could write a 1 000-word ode to the beauty of the frenulum alone, you guys.) It all makes for a breathtaking sight – and any woman who’s any fun to have sex with will agree.

^{This article was originally published on www.menshealth.com}

^{Image credit: iStock} 

Tracy Clark

She thought her life was ending after she was diagnosed with stage 3 bone cancer. “But when I started my first cycle of chemotherapy [she underwent 18], I realised there was no turning back,” says Nomsa Tshingowe.

Today, Tshingowe is a 27-year-old social worker who wants to share her cancer journey and help raise awareness. 

A life-changing diagnosis

“I think the symptoms had always been there, but I wasn’t aware that it might be something serious until I moved from Ha-Mulima to Sekhukhune, where I currently live,” she says. Her symptoms worsened over time. “My right knee was swollen – it was incredibly painful and I couldn’t walk. My symptoms seemed to be triggered by cold weather.”

This went on for a year – Tshingowe’s treatment consisted of pain medication from the local clinic. But she couldn’t continue like this. “In 2014, I demanded a referral to the hospital.”

She finally had a biopsy on 5 September 2014. “In October, at the age of 23, I was diagnosed with stage 3 osteosarcoma cancer. I thought my life was ending.”

It was a terrifying time for Tshingowe. “I was young; I had just got a permanent job. I did not understand how a young person could have cancer,” she says. “My life came to a standstill. I had to deal with chemotherapy treatment and surgery; the after effects were the worst. I remember asking the doctor to stop giving me the treatment; I just wanted him to end my suffering.”

But she didn’t give up and says her family was incredibly supportive. “They were always there by my side – seeing them beside my hospital bed gave me courage to fight even more. I had highly skilled doctors, supportive friends and colleagues.”

Losing her leg

Tshingowe endured endless blood transfusions, blood tests, scans and pain all over her body during treatment. On 27 April 2015 she had her last surgery – a total knee replacement where doctors removed her right leg and gave her a prosthesis.

“I remember coming out of theatre,” she says. “I couldn’t move, I couldn’t feel my leg and cried uncontrollably. I had to use a walking stick and other walking support devices for months.”

Offering advice

“The day you were diagnosed with cancer, that’s the day you won your first battle,” says Tshingowe. “And chemotherapy? That’s just another battle. Instead of getting angry or sad, use the energy to document your journey for other survivors –every survivor is the inspiration to the other survivor. I am here because of well documented cancer journeys of other people.

“Even when cancer stripped me to zero, it couldn’t take away my voice and my courage to fight. I came out a stronger person than I was before.”

What she’s doing today

In 2016, she decided to start creating awareness around cancer.

“I created Cancer 0 Thirty 5 Awareness when I realised there is a lack of cancer knowledge, especially in our black communities. It is aimed at promoting cancer education and awareness. The main targets are children and youth in Limpopo and the mission is to provide support to children and youth cancer survivors and their families so that they can also enjoy quality life.”

Tshingowe is currently doing her Masters in Public Health at the University of Limpopo.

^{Image credit: Supplied}

Compiled by Mandy Freeman