₦airaland Forum

Painful orgasms (dysorgasmia)

Written by Dr David Delvin (GP and family planning specialist)

Getty – painful orgasms
Women sometimes find that their orgasms have suddenly become painful, even though they enjoy having sex.

Research suggests that this kind of pain is commoner than was previously thought.

Characteristically, what happens is that the woman climaxes, and she almost immediately feels a severe cramp-like pain in the lower part of her abdomen. Or it may happen in her bottom.

This may last anything from a few minutes to a few hours, making any further sexual enjoyment almost impossible.

Not much is known about this condition. Some years ago, I called it: female dysorgasmia. The Greek prefix 'dys' is generally used in medicine to mean 'pain', and male dysorgasmia occurs in some men who have had prostate surgery.

Until very recently, I was unable to find any mention of it in any standard medical or gynaecological textbooks. Nor was there any study of it in medical journals.

However, recent headlines in the USA have suggested that orgasm pain was 'caused by the Pill'. As we shall see in a moment, that appears doubtful.

Dysorgasmia and the menopause
Orgasmic pain may well occur most often in women aged 35 to 55, as evidenced by the fact that a number of females in that age group have posted their experiences on the internet.

I've seen many women with this condition, and I've been struck by the fact that the majority of them were at, or fairly near, the menopause.

Because of this, I suggest the pain is probably linked to the fall in female hormone levels that invariably occurs at about this time.

Typically, the problem starts out of the blue – when a woman experiences an orgasm, either with a partner or on her own. Then, quite suddenly, a 'cramping' feeling starts in the lowest part of the abdomen.

Most patients describe it as 'pretty bad' or 'quite severe'. In some cases, it radiates up into the lower back. In others, it affects the area round the rectum.

Their descriptions of this particular form of distress sound rather similar to the rectal pain of 'proctalgia fugax' – which is a well-known condition in both sexes, thought to be due to spasm of the muscles on either side of the rectum.

Patients have told me that the pain of dysorgasmia is alarming at the time, but it passes within anything from a few minutes to a few hours.

It generally recurs at subsequent orgasms over the next few weeks, but it becomes less severe over a period of months and as a rule eventually disappears altogether.

Other causes
Many of these women, who have posted their stories on the internet, say that they have other gynaecological conditions as well – such as ovarian cysts, fibroids or endometriosis.

But these disorders are extremely common in the 40 to 55 age group, so there may be no causative link with the pain.

However, if you have this symptom, it’s perhaps worth having a gynaecological check-up for endometriosis.

In virtually all cases, these accounts say that the woman's physician or gynaecologist was unable to find a cause for the problem.

Many doctors said that they had 'never heard of' pain occurring at the same as an orgasm.

New findings
Professor Jennifer Hillman of Penn State University has published a book, claiming that dysorgasmia could be caused by a range of medications such as antidepressants (including Prozac), other psychoactive drugs and the well-known natural remedy, St John's wort.

While I have not yet found confirmation of her views, it's obvious that if you experience orgasmic pain while on any of these medications, it would be wise to ask your doctor to switch you to something else and see what happens.

There has also been much publicity about a claim that low-dose contraceptive pills may cause painful orgasms.

American women's magazines have featured this idea prominently. I was rather surprised by that news item, since personally I don't think I have never seen a woman with dysorgasmia who was on a low-dose Pill.

On further investigation, it transpires that the story is based on some research done in New York recently, which appeared as a 'poster presentation' at a urology conference in San Diego in May 2013.

The researchers were reported to have found that one quarter of New York women who were taking low-dose contraceptive Pills reported pain on orgasm. That seems astounding.

Even more astonishing is the claim that around one in eight of all women experience orgasmic pain. I felt that this finding might perhaps suggest some linguistic confusion in New York City.

On looking more closely at the research, it became clear that it was entirely based on an email survey. This is not always the best way to collect medical data,because it may not give accurate information about what medication people are really on.

The most striking finding of the survey is that long-term (non-orgasmic) pelvic pain was commoner among women who said they were on low-dose Pills than among those who said they were on normal-dose Pills.

This is not too surprising, since the standard-dose Pill is well-known for its capacity to reduce the pain associated with periods.

As regards to orgasmic pain, the New York study claims that women who aren't on the Pill and women who are on normal-dose Pills have roughly the same incidence of dysorgasmia (about 12 per cent).

But allegedly, women who are taking low-dose Pills have a 25.2 per cent incidence of 'pain or discomfort during or after sexual climax'. Clearly, more research needs to be done on this subject.

Immediate treatment
In most of the cases I have seen, women felt better if they immediately took a pain-killer or a 'non-steroidal' anti-inflammatory drug, such as ibuprofen or aspirin.

Warmth, in the form of a hot water bottle applied to the lower part of the tummy, was also helpful.

One woman, whose pain was mainly in the rectal area, told me that she got relief of the symptoms by inserting a 50mg diclofenac suppository into the rectum.

Long-term treatment
If you experience dysorgasmia, I would recommend that over the next few months, you take a painkiller or an NSAID before having sex.

Try to take it about two to three hours before orgasm, if possible. Please bear in mind that these drugs can have side-effects.

If in doubt, take your GP's advice.

Because of my theory that the problem is linked to a fall in female hormone levels at around the time of the menopause, I have put most patients on hormone replacement therapy (HRT) for a few months.

This seems to have helped quite a few women. But unfortunately, I've been unable to carry out a proper clinical trial, or make any systematic follow-ups.

Also, we now know that HRT is not without its risks, though these are small when the treatment is just taken for a short time.

Finally, a recent paper by a group of gynaecologists in England has suggested that taking the antidepressant amitriptyline for a few months may help.

Outlook
If you do get dysorgasmia, the outlook is good.

You'll probably be fine in the long term and be able to enjoy pain-free sex once again.

Nevertheless, if the pain happens more than once – I recommend that you should consult your GP or a family planning clinic doctor, and have a check-up.

Having an examination by a gynaecologist is also a good idea, and they may perhaps recommend a scan.

Finally, do discuss the problem with your partner. If he (or she) doesn't know what you're experiencing, this may lead to misunderstandings and feelings of rejection.

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Exactmando
I gree

Liar is you
Shior

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Cos it can happen even at school
Kids can be funny
Even me
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I can't shout

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If anyone touches your totoyo
Slap
Bite

Reminds me a 6 yr old girl that came visiting
I heard her crying and I moved to ask why
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She said my son
I called my lil man
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He said she touch my totoyo
Mama*grandma* e say I slap anyone touch my totoyo
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Whatever rocks your boat
No sex before
Sex before
Nothing of such guarantees a happy home

Uche


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3

Op
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?.

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I give Mrs Nwanchukwu
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Ok
Thank you

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