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.