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Heart To Heart

Monday, June 19, 2017

I hear many women suffering from dyspareunia. What is dyspareunia? What are the causes of dyspareunia?

Dyspareunia is painful sexual intercourse for women. It can have various causes. It is highly recommended to talk to your doctor about this problem, because there are effective treatments for most of the causes. Any part of the genitals can cause pain during sexual intercourse.

Some conditions affect the skin around the vagina. Some women have a bacterial, viral or fungal vaginal infection, but sometimes the cause is unknown.

Vaginismus is an involuntary spasm of the muscles around the vagina. In some women, the pain of the spasms is so severe that penile penetration becomes impossible. Vaginal dryness can also cause painful sex. This dryness may be caused by difficulty in becoming aroused due to psychological or relational reasons, lack of satisfying ‘foreplay’, changes in estrogen levels or due to menopause.

Sometimes the pain occurs not during penetration but once the penis is in the vagina. Some women report feeling as if “something is being bumped into”.  In such cases, the pain maybe due to fibroid growths, or if the uterus is unusually tilted or if the uterus prolapses into the vagina. Some conditions or infections of the ovaries may also cause pain during intercourse, particularly in certain sexual positions. Previous surgeries may leave scar tissue that can cause pain too.

We know that the body and mind work in tandem. This is seen in sexual problems too. Negative attitudes or misinformation about sex, and also misinformation about the functions of the woman's body, are often associated with some types of pain.

It is often seen that the problem that first caused the pain may go away, but you may have learned to expect the pain. This can lead to further problems because you may get tensed or may be unable to become aroused due to ‘anticipated’ pain, thus being caught in a vicious cycle. At such times, relaxation techniques help to break free from this cycle.

Have a Reality-Check
I am a 30-year-old woman and have a two-year-old daughter. A year back my husband passed away in a freak accident. I continued to stay with my in-laws after that although I could sense that they didn't want me staying with them anymore. They had never taken well to me since I belong to a different caste and my husband and I had eloped to get married. Now they want me to move out of the house because they claim there will be no space for me and my daughter once my two younger brothers-in-law get married. I don't know where to go because I have no family in the city and I barely earn enough to support myself and my child. They've started mentally harassing me about my inadequate financial status as well.

While I empathize with your extremely difficult situation, it is imperative that you have a reality-check, so that your expectations are realistic, and the course of action you chose, helps you to move on with your life, and raise your child in an environment of inner and outer harmony. The limitation of space and financial resources seems to be causing this strained relationship with your in-laws, along with the fact that the only binding factor (your husband) is no longer present. Legally no one can displace you from the home where your husband resided, however, it is for you to decide whether you and your daughter, want to live in a cramped up home (once your brothers-in-law get married), and whether all of you can together co-exist in an environment of physical and psychological harmony. If you think it is not possible, then you can use the time you spend in this house, to upgrade your skills and get any training necessary in order to scale up your income, in order to implement a long-term plan of moving to your own independent place. In the short-term it is important to examine the status of your relationship with your parental family, and to evaluate to what extent they can put the past (your eloping) behind them, and support you through this challenging phase in your life. What is important is that you think of what is the ‘least unpleasant’ scenario (short-term and long-term) under the given circumstances, and work towards that, rather than unrealistically looking for an ideal or perfect solution.

Without Vulnerability you cannot have Love
I am a 25-year old man about to leave the country for higher studies for about a year. A few months back, I met a girl and we became great friends. However I'm slowly realising that I'm developing feelings for her and see her as someone I can spend the rest of my life with. I don't know if it's fair for me to ask her to wait for me to come back and then take it forward and neither do I think I should get engaged to her right now. Of course, I don't even know how she feels for me although I do know she likes me a lot. I wouldn't want to ruin a great friendship by telling her my feelings. I'm confused to say the least!

You say you see her as ‘someone you can spend the rest of your life with’. This means that there is something special in this friendship, and this does not come by so easily. You are fortunate that you have such a friendship, and you should value it enough to share your feelings and be vulnerable, because without vulnerability you cannot have love in your life. It is true that a long distance relationship can be very challenging; however, no one said you do not pay a price for love. It is important that you express your true feelings and ask her to honestly share what she feels too. It is also imperative that you tell her that you are aware of the challenges ahead if you’ll decide to take it further, and that you do not want to pressure her one way or the other, and also that you cherish the friendship too much to allow it to be sabotaged by anything. If you do not communicate your feelings you could be plagued with the question, ‘What if?’ forever. Also know that if she does not reciprocate, it in no way means you are not lovable, but only that her dream is different. Remember, it is better to have loved and lost, than never to have loved at all.

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