13 Sex Problems You Should Take Seriously
Updated: Mar. 22, 2021
Some of the symptoms and conditions you and your partner experience during sex may seem normal but aren't. Here's when you need medical attention.
Sex problems you shouldn’t ignore
Sex therapists want people to overcome obstacles that can get in the way of healthy sex lives. That not only starts with learning about common sex myths but also recognizing sex problems that you should take seriously. Here are some of the most common issues and advice from doctors.
Burning vaginal pain at penetration
Vestibulodynia is a fairly common condition, which occurs when there is a burning pain in the vestibule area of the vagina. The vestibule is where the vulva (area of the skin on the outside of a woman’s genitals) meets the vagina. The condition often causes pain with initial penetration, rather than deep penetration. “There are various subtypes of vestibulodynia which should be pinpointed based on an extensive history, visual exam, musculoskeletal exam of the pelvic floor, labs and neurosensory testing,” says Lisa M. Valle, DO, ob-gyn and medical director of Oasis Women’s Sexual Function Center in Santa Monica, California. (Here are other causes of painful sex.)
Persistent pain during intercourse
Although similar to vestibulodynia in that it causes genital pain linked to sex, dyspareunia can happen in both men and women. “It can be caused by a multiple of factors both medical, physical and psychological,” says Dawn Michael, PhD, clinical sexologist, relationship expert and author of My Husband Won’t Have Sex With Me. This type of condition, she explains, can affect a person’s relationship drastically.
To help mitigate the pain, Tammy Nelson, PhD, certified sex therapist and author of Getting the Sex You Want, recommends using a silicone-based lubricant and reducing the use of antihistamines which can dry out vaginal tissues. “If you’re still in pain, see a gynecologist or a urologist,” she adds.
Premature ejaculation
This condition involves ejaculating involuntarily right before or right after penetration, explains Nelson. “Keep in mind that most men last an average of four minutes, so don’t sweat it if you are close to that—you are probably within the normal range,” she adds. However, if you consistently ejaculate immediately when you are aroused, see a sex therapist for behavioural techniques to work on the problem. (Here are a few ways to stop premature ejaculation.)
Vaginal dryness
This incredibly common sexual problem often goes unresolved for most women. It is a common reason why sex is painful for some women. According to Dr. Valle, dryness down there can result from breastfeeding, hormonal changes as a woman approaches menopause, or medication side effects. “Low estrogen levels occur naturally with consistent breastfeeding, which can contribute to decreased vaginal lubrication,” she explains. “Hormonal changes close to menopause also cause decreased lubrication and thinning of the vaginal tissues.” Over-the-counter lubricants and moisturizers can help, although Dr. Valle recommends organic brands; many of the preservatives in non-organic lubes haven’t been tested for long-term safety in the vagina.
Pain from deep penetration
This type of pain results from the cervix being hit during intercourse and is more common in certain sex positions (sex from behind, for example), according to Michael. “The cervix can be more sensitive around menstruation as well as when the vagina is dry,” she says. “I refer to it as the cervix bump—sometimes, depending on arousal and position it can feel good, but other times it can feel like a sharp pain.” Her best advice is to adjust and communicate with your partner to get the maximum pleasure without the pain.
Endometriosis
Pain that’s felt deep within the pelvic region is a possible sign of endometriosis, a condition that affects an estimated 11 percent of women, according to the Office on Women’s Health. There’s no known cause of endometriosis and it’s unfortunately difficult to diagnose.
Erectile dysfunction
While erectile dysfunction can have multiple causes, one of them is coronary artery disease. According to Michael, clogged arteries can cause erectile dysfunction because they disrupt blood flow. “Make an appointment with your doctor to have tests run, as this could be a sign of loss of blood flow to other areas of the body aside from the penis,” she says.
Burning or itching of the vagina
If you’re experiencing itching or a burning sensation down “there,” it may be due to a yeast infection or bacterial vaginosis. “A yeast infection occurs when candida yeast becomes out of balance, which can be the result of anything from hormones to douches and vaginal sprays and even health conditions such as a weakened immune system or diabetes,” says Michael. Because it can be transferred between sexual partners, it’s best to avoid intercourse until both partners have been treated. Yeast infections often can be treated by over-the-counter creams. Bacterial vaginosis must be treated by a doctor. Because it can be hard to tell the difference, it’s always a good idea to check in with your doctor.
Pelvic inflammatory disease
Another potential cause of deep pain in the pelvis is a pelvic inflammatory disease. “PID is an infection of the uterus and fallopian tubes and it is often caused by the sexually transmitted infections, chlamydia or gonorrhea, but can potentially be caused by other bacteria as well,” says Wendi L. Dumbroff, a licensed professional counselor. “If left untreated, PID can potentially lead to an ectopic pregnancy (a pregnancy in the fallopian tube) or infertility, because it may leave scar tissue inside and outside the fallopian tubes which can block the eggs from passing through to the uterus.”
Difficulty having an orgasm
Some women have difficulties with orgasm. However, explains Mary Jane Minkin, MD, clinical professor of 0b-gyn at Yale University, many women who think they have a problem actually don’t. “Most women require some degree of clitoral stimulation to achieve orgasm—they will not achieve orgasm with vaginal stimulation alone.” If clitoral stimulation doesn’t do the trick, there may be a reason—and it may be fixable, she says. “Medication, such as certain antidepressants, can blunt the orgasmic response.” If you think this might be your issue, speak with your doctor about switching to a different medication. (Here are other reasons why you can’t orgasm during sex.)
Penis fracture
While uncommon, it is possible for a man to experience a fracture of the penis. “The name is confusing because it isn’t a fracture of a bone, but the spongy tissue in the penis called the tunica albuginea or can extend into the corpus cavernosum below it,” explains Steve McGough, director of research and development at Women and Couples Wellness and associate professor of clinical sexology at the Institute for Advanced Study of Human Sexuality in San Francisco. In more extreme cases, the urethra is also damaged. It’s possible to sustain this type of injury during sex if there’s a sudden movement that bends the penis too much or during masturbation where it is bent too hard, as well as from trauma in an accident. If this happens, McGough recommends seeking immediate medical attention. “Depending on the degree of injury, this can result in permanent injury to the penis or urethra.”
Genital warts
This common sexually transmitted disease goes often unnoticed. Since genital warts can cause cervical cancer, as well as oral and anal cancers, McGough stresses the importance of detecting and treating the condition as soon as possible. “The outcomes of these types of cancer are generally not good, both due to the location of these cancers and they’re often not diagnosed until it at an advanced state,” he says. “If you or your partner notice what you think may be genital warts, see your doctor for treatment.”
Persistent genital arousal
Although some people have trouble becoming aroused, others have the opposite issue: They’re constantly aroused. In women, this means that they have persistent clitoral orgasms even when they don’t want them. “This is not as fun as it sounds,” says Nelson. “In fact, it can be painful, embarrassing, and mess with your life in negative ways.” She recommends seeing a gynecologist or pelvic floor therapist who specializes in persistent genital arousal disorder.
Next, check out the exercises that’ll help you have better sex.
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