Why Does Sex Hurt?—And 3 More Questions You’re Too Embarrassed to Ask Your Doctor

By , Category : General Health ,Sexual Health

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Identifying Pubic Bumps and Other Embarrassing QuestionsThe human body is a complex series of biochemical reactions that produces fascinating and wondrous results. It also creates a large amount of problems you’d rather not talk about in polite company—not even to your doctor. As much as we did the first time around, this article will cover topics people often feel self-conscious, uncomfortable, or just downright embarrassed to talk about or ask for help with.

1. Why Do I Have an Itchy Rash on My Thigh or Groin?

An itchy rash on the groin or inner thigh is usually a case of ringworm, also known as “jock itch”. The good news is that it’s not actually a worm. The bad news is that it’s a fungus. There is no one kind of fungus that’s responsible for jock itch and there is also some overlap between it and the culprits behind athlete’s foot.

Fungi thrive in warm, dark, moist areas. This means that your inner thigh, groin, and buttocks are all ideal candidates. As the name implies, jock itch is more common among men due to in part things like jockstraps and cups helping to trap moisture, but either gender can get it. Public showers and steamy areas filled with sweaty clothes, wet floors, and damp towels (like locker rooms) are all good breeding grounds for fungus and make transferring them to your body easier.

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The main way to tell the difference between jock itch and regular dry or irritated skin is to inspect the rash itself. Rashes caused by fungal infections tend to spread out in a donut-like shape with a bumpy or scaly edge. In cases of ringworm, the center of the donut may be reddish-brown as well. Ringworm rashes also do not normally travel onto the scrotum or penis in men.

Solutions

  • Keep the affected area dry.
  • Wear clean clothes and avoid tight-fitting outfits.
  • If you have athlete’s foot, get it taken care of.
  • Apply an over-the-counter antifungal twice a day for at least ten days (even if it goes away before then).

See Your Doctor If

  • Over the counter treatments are ineffective as it may require a prescription-strength antifungal.
  • You have a weakened or compromised immune system.

2. Why Does Sex Hurt?

The medical term for painful intercourse is dyspareunia and it is not restricted to a single cause, although women are more prone to it than men. The best way to narrow down the answer is to figure out where specifically the pain is coming from and whether it’s a new problem or one that’s more recent.

The most common reason for painful sex is that the vaginal canal is too dry. This can be due to insufficient foreplay or lubrication. Lubrication is often the issue after childbirth, while breastfeeding, or after menopause as a drop in estrogen can dry up the vaginal canal. Other causes of pain during intercourse include inherited structural problems such as an imperforate hymen (a membrane blocking vagina access) or involuntary spasms of the vaginal wall (vaginismus). Other possibilities include something creating an internal obstruction like a fibroid, cyst, or tumor. Injury from trauma or surgery, infections, skin disorders, and certain medications can also be responsible. Lastly, being stressed can tighten the pelvic floor muscles and make intercourse painful.

Solutions

  • Try using lubricants or additional foreplay.
  • Get tested or treated for a urinary tract infection or STD.
  • If you have had recent surgery or injury to the pelvic area, wait for the area to heal.
  • Try a topical treatment for dry skin or eczema.

See Your Doctor If

  • The pain is accompanied by changes in urinary quality or a discharge.
  • It is a throbbing pain that can last up to several hours.

3. Why Do I Have “Man Boobs”?

Gynecomastia is the term for excessive breast enlargement and tends to get applied to what are colloquially referred to as “man boobs” or “moobs”. It usually begins around puberty and starts as a small lump under the nipple before growing from there. Cases can vary in severity and are normally harmless. Breast tissue is made up of a mixture of fat, glands, and muscle. Hormone changes or imbalances in men can cause the glands to grow larger than normal and result in visible enlargement of the breast. Alternatively, being overweight can cause fat to build up within the breast and create a similar enlargement. Certain substances like medication, steroids, alcohol, heroin, and marijuana can also cause breast gynecomastia. It is also possible for a thyroid disorder or a tumor to be responsible.

In cases of gynecomastia, squeezing the tissue under the nipple can sometimes give insights into the nature of the enlargement. If the problem is an enlarged gland, there should be a semi-rubbery feeling of a “disk” under the nipple that is painful when squeezed. This technique is not to be substituted for an actual doctor’s analysis.

Solutions

  • Lose weight.
  • If applicable, stop using heroin, marijuana, or steroids.
  • If you are on a medication that has gynecomastia as a side effect, talk to your doctor about alternatives.

See Your Doctor If

  • The enlargement is only present in one breast.
  • There is a discharge from the nipple.
  • You feel a mass outside of the nipple/areola area.
  • You feel a firm or hard lump that feels attached to the tissue.

4. Do These Bumps Mean I Have an STD?

Bumps around the genitals do not automatically mean an STD, but their presence can easily unnerve and worry people. The easiest way to tell what the bump is would be to look at and feel it. If you have waxed or shaved the area recently, then follicle irritation can cause raised, harmless red or white marks that resemble pimples. It is also possible for the bumps to be actual pimples. Rare, but it happens.

In men, if the bump is a swelling in the penile shaft that appears after intercourse, another possibility is a “lymphocele”, a blockage of the lymphatic channels that will go away on its own. For women, the remains of the hymen will persist even after virginity is lost and can produce a lumpy feeling around the vulva.

The more problematic causes of genital lumps are STDs, specifically herpes or genital warts. Generally speaking, herpes appears more as a blister, sore, or lesion than an outright lump and warts will be a cluster of skin-colored or gray lumps. Warts caused by HPV tend to have a raised, cauliflower-like appearance.

Solutions

  • If the bump is not from a disease, waiting will usually resolve the matter.
  • Practice safe sex.
  • If you are unsure about a lump, talk to your doctor.

See Your Doctor If

  • The lump appears to be growing.
  • Its presence is accompanied by a discharge, pain, or burning sensation when you pee.
  • You suspect it is an STD.

Sources for Today’s Article:
MedlinePlus Medical Encyclopedia, “Breast Enlargement in Males,” U.S. National Library of Medicine web site, https://www.nlm.nih.gov/medlineplus/ency/article/003165.htm, last accessed November 16, 2015.
“Jock Itch,” Mayo Clinic web site, http://www.mayoclinic.org/diseases-conditions/jock-itch/basics/definition/con-20021468, last accessed November 16, 2015.
“Lumps on Genitals in Men,” Embarrassingproblems.com, http://www.embarrassingproblems.com/problem/lumps-genitals-men, last accessed November 16, 2015.
“Painful Intercourse (dyspareunia),” Mayo Clinic web site, http://www.mayoclinic.org/diseases-conditions/painful-intercourse/basics/definition/con-20033293, last accessed November 16, 2015.


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Dr. Victor Marchione, MD

About the Author, Browse Victor's Articles

Victor Marchione, MD received his Bachelor of Science Degree in 1973 and his Medical Degree from the University of Messina in 1981. He has been licensed and practicing medicine in New York and New Jersey for over 20 years. Dr. Marchione is a respected leader in the field of smoking cessation and pulmonary medicine. He has been featured on ABC News and World Report, CBS Evening News and the NBC Today Show and is the editor of the popular The... Read Full Bio »