Your Sex Problems Solved

Deep pain during or after sex

It might be...

Endometriosis, if you're also experiencing heavy and very painful periods, says Dr Deborah Bateson, medical director at Family Planning NSW. Endometriosis is a condition in which tissue similar to the lining of the uterus grows in other parts of the body. It affects 10 per cent of women. Other causes: sexual position or a pelvic infection.

Fix it!

"Don't feel embarrassed, and don't wait until your next pap smear to raise it with your GP," urges Dr Bateson. If it is endometriosis, a laparoscopy is the only accurate way to diagnose: under a general anaesthetic, a small viewing instrument is inserted into the abdomen through the navel. Treatments include surgery and hormone therapy.

Regularly bleeding during or after sex

It might be...

Pre-malignant cells on the cervix; chlamydia (an STI that affects about 60,000 Australians annually); or break-through bleeding due to the pill, says Dr Bateson. It could also be a urinary tract infection (UTI), if accompanied by blood in the urine, adds Dr Philip Goldstone, medical director for Marie Stopes International.

Fix it!

"Bleeding can be completely normal with absolutely nothing wrong, but it should be checked out," says Dr Goldstone. A simple swab test can detect chlamydia, which can be easily treated with antibiotics; while a pap smear will pick up pre-malignant cells; and a urine test is used to diagnose UTIs.

Lubrication is non-existent

It might be...

Caused by hormonal meds (such as the pill), breastfeeding, menopause or lack of arousal, explains Dr Bateson. "It might also be due to a fear of getting pregnant. Unless you're sure you're covered by contraception, it can be difficult to relax and become aroused."

Fix it!

Once you've ruled out medical culprits (see your GP), just do it. "Women don't need to have desire before arousal...arousal can precede desire," states Dr Bateson. So, even if you're not (quite) in the mood, kick off foreplay and lubrication should follow. Get a leg up (or over) using petrochemical-free Sylk Natural Personal Lubricant, $18† (www.sylk.com.au.

A not-so-normal discharge

It might be...

Thrush – while not sexually transmitted – can be irritated by sex. The same goes for bacterial vaginosis, "which is caused by an overgrowth of bacteria because of a disruption to the pH of the vagina, such as [alkaline] semen", says Dr Bateson. A discharge may also indicate an allergy to condoms, creams, soap or washing powders.

Fix it!

Your GP will test for thrush and bacterial vaginosis using a swab (the latter is treated with antibiotics). Forget panty liners: they only exacerbate these problems, warns Dr Bateson. Switch from a latex to polyurethane condom, like Sagami 0.02, which is one third of the thickness of a latex condom, $31.95 for 12 (www.bliss4women.com.au).

You'd rather do your tax return than have sex

It might be...

Change. "Your feelings towards your partner might be different, or you might be stressed with something external," says sex therapist Dr Vivienne Cass. "Stress and anxiety make it hard to relax enough to want sex, even though sex may relieve this stress!" Or blame it on the natural fizzling of passion three or more months into a relationship.

Fix it!
Dr Cass suggests replacing the void left by "honeymoon" sex with trust and deeper intimacy to reignite great relations. Or assess your relationship; see a psychologist or a sexual therapist, but be careful whom you select. "Choose a therapist with a post-grad psychology degree and experience in sex therapy," she says. Visit www.psychology.org.au.