CLEO (Malaysia) - - QA SEX -

Q My boyfriend com­plains of painful erections and his pe­nis is no­tice­ably bent when erect. It is get­ting us down as it af­fects our sex life. What is caus­ing this and what can be done?

Sounds very much like Pey­ronie’s dis­ease, in which fi­brous plaques of scar tis­sue in the tunica al­bug­inea of the pe­nis re­sult in vary­ing de­grees of cur­va­ture of the pe­nis. While a mild de­gree of curve may be con­sid­ered nor­mal, ex­treme bend­ing can cause pain with erections and dif­fi­culty with pen­e­tra­tion, not to men­tion em­bar­rass­ment and de­creased sex­ual con­fi­dence. Your part­ner should see his doc­tor for treat­ment op­tions. Mild cases may not re­quire any treat­ment and may im­prove over time but for se­vere or un­re­spon­sive cases, surgery may need to be a con­sid­er­a­tion.

Q I am con­cerned about the pain I get deep in­side at the top of my vagina, es­pe­cially with deep thrust­ing. What causes this?

Deep pain with in­ter­course may have a va­ri­ety of causes in­clud­ing en­dometrio­sis, fibroids, pelvic in­flam­ma­tory dis­ease, and ovar­ian cysts. In­fec­tions af­fect­ing the sex­ual and re­pro­duc­tive or­gans could also re­sult in deep pelvic or vagi­nal pain with deep pen­e­tra­tion. Hav­ing had re­cent surgery in the pelvic re­gion, uter­ine pro­lapse, ir­ri­ta­ble bowel syn­drome, in­flam­ma­tory bowel dis­ease, and even uri­nary tract in­fec­tion can also be po­ten­tial causes, though there might be other as­so­ci­ated symp­toms point­ing to th­ese se di­ag­noses. You should see your gy­nae­col­o­gist t for fur­ther as­sess­ment. The doc­tor can ex­am­ine ne you in­ter­nally and or­gan­ise ap­pro­pri­ate tests. In some cases, chang­ing po­si­tion or al­ter­ing the an­gle of pen­e­tra­tion may help.

Q My part­ner has been di­ag­nosed with testos­terone de­fi­ciency. What can be done to man­age this and is it safe?

Testos­terone de­fi­ciency may have a range of causes and is as­so­ci­ated with ad­vanc­ing age to vary­ing de­grees. For­tu­nately, it is pos­si­ble to in­crease testos­terone lev­els into the nor­mal range with an­dro­gen re­place­ment ther­apy. Risks in­clude pos­si­ble stim­u­la­tion of prostate growth and po­ten­tial pro­mo­tion of la­tent prostate can­cer. Other side ef­fects in­clude liver dam­age, wors­en­ing of sleep ap­nea, changes in choles­terol lev­els, red cell ab­nor­mal­i­ties, and breast de­vel­op­ment.


hus­band uses a vac­uum de­vice and con­strict­ing ring at the base of his pe­nis to en­hance his erec­tion for more in­tense or­gasms. Is it safe?

Vac­uum and con­strict­ing ring-in­duced erections should not be main­tained for more than 30 min­utes. Fall­ing asleep with the ring on or use whilst in­tox­i­cated can be danger­ous as pro­longed wear can have dire con­se­quences, in­clud­ing per­ma­nent dam­age to the pe­nis. If your part­ner ex­pe­ri­ences numb­ness or blue dis­coloura­tion of the pe­nis, the ring should be re­moved im­me­di­ately. If the erec­tion is pro­longed and will not de­tumesce, seek med­i­cal treat­ment im­me­di­ately.

Q Ever since the trau­matic birth of our first child, my hus­band and I have been un­able to en­joy sex­ual in­ter­course, as I am just so fear­ful of pain. What can we do?

You may have sec­ondary vagin­is­mus, a con­di­tion that oc­curs as a re­sult of fac­tors like pain or sore­ness from thrush, trau­matic vagi­nal de­liv­ery, dry vagina in menopause, or psy­cho­log­i­cal is­sues. Talk to your doc­tor who can as­sess your con­di­tion and of­fer ad­vice. Treat­ment may in­volve re­lax­ation ex­er­cises and use of vagi­nal dila­tors of pro­gres­sively in­creas­ing di­men­sions. Hope­fully your fears will sub­side and your re­la­tion­ship will re­turn to what it was or even bet­ter than be­fore.

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