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Heart To Heart

Monday, September 03, 2018

Unprotected sex
I am on oral contraceptive pills. My fiancé tells me that he doesn’t need to use a condom during intercourse because he was tested for HIV and other STDs and doesn't have any. What is your opinion?

Testing is good, however there are STDs such as genital Herpes, Human Papilloma Virus infection, Chlamydia and even Gonorrhoea that can remain dormant and unmanifested in many individuals, but may cause suffering in others if transmitted through sex. There are STDs for which there are no tests available such as Human Papilloma Virus infection that causes warts on genitals or in the mouth. These warts increase the possibility of developing cervical cancer in women. As far as HIV/AIDS in concern, the test for HIV antibodies comes negative even in infected people during the first 13 weeks of the Window period. It may also be difficult for you to know whether your fiancé has abstained from any sexual relationships with anyone for 13 weeks? That is the period of abstinence required for an accurate HIV antibodies test.

‘Look through’ him
A few months ago, I broke up with my boyfriend of almost a year. It was very painful for me, but I am much better now. The problem is that we both stay in the same locality, and I see him almost every day. And, when we cross paths, he is very rude to me and unfriendly. So much that he makes an obvious effort to embarrass me around others. How can I handle running into him when he is so rude? It would be so much better if he was at least civil.
Your discomfort around him could be giving him some pleasure and he is feeding on it. Go up to him when there is no one else around him, and assertively tell him that if he cannot be civil with you and take the break-up maturely and healthily, then he should refrain from any communication with you, whether alone or when there are others. Also stay away from groups that he tends to be with for a while, and ‘look through’ him if he does not change his ways. If you maintain a dignified silence and are comfortable within yourself, and if people notice him resorting to immature rudeness in spite of your dignified approach, over a period of time, he will come across as a crude person to all. In the mean time, also mingle with new people, get into activities you enjoy, and make new acquaintances, so that you find joy. As you get more busy finding joy in other things, you will find it easier to ignore your ex’s immature behavior.

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.

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Heart To Heart
Dr. Rajan B. Bhonsle, M.D. (Bom)
Consulting Sex Therapist & Counsellor
Dr. (Mrs.) Minnu R. Bhonsle, Ph.D.
Consulting Psychotherapist & Counsellor
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