When Pain Becomes Pleasure

What happens when your partner thrusts deeply or vigorously and causes pain internally that arouses you? It is a tricky question and can be a real concern for your partner, who is probably not expecting for you to be aroused by pain.

Here's a way to think your way through it: If your partner can accept that some people can be aroused due to specific kinds of pain, that would be a positive sign.

If he thinks that it's "crazy," then you have a more difficult row to hoe. In that case, I would simply leave it at this: "I like it when you thrust deep and firmly, it feels really good to me and excites me."

If he is a very gentle man or particularly sensitive, he may have difficulty causing you pain -- particularly if he cannot wrap his mind around the idea that pain could cause pleasure.

Why does pain create a pleasurable response? If you are the victim of sexual assault, it's possible that your assaults are linked to this. Sometimes people unconsciously do their best to make lemonade out of lemons. They attach sexual arousal to circumstances that have been difficult for them.

I once had a client who was very brutally treated by his parents as a child. He had several choices as a child: Run away from home, try to kill himself, try to kill his parents, go crazy, or eroticize physical pain and humiliation. He chose the last option (unconsciously, of course). He really desired physical pain of many sorts and/or humiliation to be orgasmic.

The problem was he did not disclose this to the woman he married before they married. He kept his sex with her of the "vanilla" nature. After about two years of marriage, he revealed his true preferences to her.

The difficulty was that she had been sexually exploited as a child by her stepfather. She wanted nothing to do with the dynamic of humiliation, force or pain -- in either direction. You can see the difficulty inherent in this situation.

You may have a partner who is complying with your sexual wishes without understanding the full nature of what is occurring. It's tempting to suggest full disclosure to him, but I would ask just how many couples really know why the sexual behaviors they share arouse their partner?

Test the waters with a general question, such as this. "I was reading about this the other day: What do you think about people who say that they sometimes get sexual pleasure from certain kinds of pain?" You'll probably get a pretty good indication of what to do next.

Related Topics: Heat Up Your Relationship This Summer, Good Food For Better Sex?

Technorati Tags: Sex Matters, sexual communication,

Sexless Marriage

Many marriages and other long term relationships face the dilemma of a discrepancy in sexual frequency. Some are a little bit different and some are a lot different. Several of you are facing very large differences in desire.

You may have read the FAQ about "One of us wants sex more than the other." If you haven't, that would be good to do.

In the case of a male wanting considerably less, there are definite steps to take -- if the male is willing and wants to increase his desire and willingness to be more sexual.

There are also steps for the female. I'll cover them both here since both sides of the dilemma were raised in this discussion.

First things first. There must be some kind of communication between the people involved. This involves (as others have suggested) deciding whether this level of discrepancy is a deal breaker for the relationship. If you assert that it is, you need to follow through or you will be in a relationship in which your mate will not take you seriously.

This communication cannot be stymied by silence, changing the topic, or similar tactics. You need to say that this really matters to you.

Both males and females can supplement with testosterone topically. There will eventually be a patch for women (last I heard in the fall, the FDA were hoping to fast track the patch for women).

But, in the meantime, women can use a product designed for men, but use it in a much lower dose. A male would use a tube of Testim per day. A female would use one tube over a ten day period. Men generally apply it to the arms. Women can do the "Macarena method" -- applying it to the hips and calves.

Women and men should have some blood tests done before jumping in with supplementation. Both should have a prolactin test -- particularly a man with remarkably low sexual interest and particularly if he once had way more.

In very, very rare cases there can be a high level of prolactin for a male and there can be a brain tumor underlying that. In my 23 years doing this, I've had only one case, but he was glad I encouraged him to have the test. He was treated and last I knew was fine.

On the topic of prolactin for women -- when women give birth and breastfeed, their prolactin levels naturally go up. That's what permits breastfeeding. After a birth, not all women's hormones go back to "normal." And, they certainly won't really until breastfeeding is done (though this does not mean a woman should rush her child through it).

Women need a balance of estradial, progesterone, and testosterone -- to name the big three. When looking at testosterone levels for both males and females, the free testosterone and total testosterone should be measured. In cases of extremely low male interest and somewhat low interest for women, I would also recommend a blood test for SHBG (sex hormone binding globulin).

So, those are all the physiologic issues that relate to hormones. Of course, there may be other issues such as diabetes, thyroid conditions, medications that suppress sexual desire, life stress, and relationship issues (that may not all be on the table -- think extra-relationship sex or "affairs"). So, it's best to take a very large look at what could be causing what.

That's where a sex therapist comes in. A skillful one can help you assess and manage all the variables that can play a part in creating the discrepancy.

If you're up for an excellent and challenging book, consider David Schnarch's book "Passionate Marriage." It deals with many of the issues in an in-depth manner and you may find it quite helpful in your quest to decide what to do.

Related Links: Why We Cheat, Testosterone testing

Technorati Tags: Sex frequency, loss of libido, sex drive, testosterone

Orgasm and Migraines

Although orgasm is generally a pleasant and positive experience, for some it can become very painful. Post-orgasm headaches and muscle cramps are common complaints.

Most headaches that occur related to sex are not serious. Nevertheless, they can be quite painful. It's best for your partner to see his doctor, who can also rule out the relatively rare possibility of it being a tumor or something serious.

The doctor will likely ask questions about the headaches themselves -- whether they occur only after sex, during sex, or after other strenuous activity.

If it turns out to be a sexual headache, the doctor will probably say that these headaches are very common and that they usually occur right after orgasm due to the sudden change in blood flow and blood pressure.

When getting sexually aroused hands, feet, and the head fill with blood. Following orgasm, there is a sudden drop in this pressure. In your partner's case, it may be that the drop in pressure is accompanied by pain.

These headaches seem to occur in men much more than women. They also may be triggered by the adrenaline that floods the body during intense activity.

The doctor may order tests like a CT scan, a special X-ray, to check that there are no problems with the blood vessels in the brain. If the tests come back normal, and they often do, your partner could ask your doctor about taking an over-the-counter pain reliever or a prescription medicine before sex.

Headache specialists may have more knowledge of what pain relievers work best, so encourage your partner to start there if he can.

The muscle cramps may be due to exertion. If this is a problem, I would suggest that you investigate the possibility of increasing potassium intake either with vitamins or bananas. That might relieve some of the muscle cramps.

Related Links: Female Sexual Problems, Male Sexual Problems

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Sex Education for All Ages

Recently I had a post on my message board from a concerned parent of a 4-year old. He had noticed that his son was playing with his genitals often, and was concerned that it was unhealthy. He wasn't sure what to say to his son, and since it hadn't happened with any of his other children, he was also concerned that it was a problem.

Here's my answer:

Keeping it low key and remembering that kids require a lot of repetition to learn things will help you not grow overly worried.

I do suspect that your other kids may have been more subtle about their interests in their genitals and those of others. And, it is important to remember that children from the same family do vary.

When children do have these behaviors, I always encourage parents to make sure that there is enough accurate sexual information in their environment. This will help them know that they can ask questions of you about bodies. This gives YOU the chance to give them accurate information, rather than what a playmate may offer.

This advice REALLY came home to roost about a year ago.

At dinner one night, my husband asked our then six-year old what he wanted to do for work he grew up. After a few moments of thinking, he replied, "I don't want to work, I just want to be a dad." My husband and I exchanged smiles over our son's picture of fathering.

But then, without missing a beat, my son continued: "But, I'm not sure I want to do that either because then you have to pee in your wife."

This follow up comment came so unexpectedly that I nearly choked on my mashed potatoes. There I was, the sex therapist openly answering questions (along with my husband) about bodies and feelings for my son for the last few years and somehow a school yard friend had managed to plant this misinformation!

On the spot, I vowed to redouble my efforts to proactively provide accurate sexual information to my son -- without always waiting for the questions to be asked. So, at that point, I explained that while daddies sometimes do put a fluid in the mommies bodies in the space between her legs, it was not pee. It was a very special fluid called semen that sometimes can cause the mommy to grow a baby inside of her. He said, "OK, Mom."

My three-year old, sensing that something important had just been said, proceeded to exuberantly sing, "Pee in your wife, pee in your wife, pee in your wife...!"

My husband then said, "Mom, would you please pass me some more mashed potatoes?"

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If you are looking for sources to help you provide this type of information, I'm a real fan of these two books to help out parents. Both are by Robie Harris. "It's Perfectly Normal: Changing Bodies, Growing Up, Sex and Sexual Health" and "It's So Amazing: A Book About Eggs, Sperm, Birth, Babies, and Families." Keep the information matter of fact and available. And remember, it takes repetition.

Related Topics: Sex Ed for the Suddenly Single, Syphilis Rising in the US

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