Home' LOTL : April 2004 Contents HEALTH
Q Lately my girlfriend gets a terrible pain in her pelvis when she has
an orgasm. It doesn't last long, but it's putting rather a damper on
our previously great sex life. She's 48. An ultrasound showed small
fibroids but everything else was OK. Am I doing something wrong?
A I don't think the fibroids or you are really the likely culprits here. Fibroids are a
common incidental finding on ultrasounds. If they are going to cause pain, it's more
likely the pain will be constant or related to changes in position. During orgasm, the
uterus contracts. Most women don't notice these contractions, but others can find them
painful. Prostaglandins, the same chemicals that cause period pain, may be the cause.
The uterus pulling on adhesions caused by surgery or endometriosis when it contracts
could also increase orgasm pain. Taking an anti-inflammatory tablet, such as ibuprofen
(Nurofen) before sex will block the effects of prostaglandins. It's worth a try. There's
also some research that suggests stretched uterine ligaments, caused by childbirth and
lack of oestrogen in menopause can cause pain on orgasm. In this case, hormone
therapy or even surgery may be needed. Your girlfriend needs a good check up with
Q I went to a new GP recently about a gynaecological problem. To
save her going through all the usual hetero stuff, I told her up front
I am a lesbian. She said, "That doesn't matter." But when she wrote
a referral to a specialist, the first line (of a two line letter) read, "This
32 year old lesbian"... Am I right to feel offended?
A I think you have a valid point. I think you did the right thing by being up front with
her and avoiding all the second guessing that can happen in this situation for both
patient and doctor. Speaking from the other side of the desk, I have often struggled to
get around this issue when no info is forthcoming. Once you've asked a leading
question about a 'partner' and the answer comes back gender non-specific, you really
are stuck with having to ask, "Is your partner male or female?" and risking any
subsequent embarrassment or offense. Assuming your sexuality was relevant to the
clinical problem, your doctor had two options. She could have assumed you would
be equally up front with the gynaecologist, and left it to you. Or she could have
included the information further down in the letter, with other information relevant to the
problem. Still, a two line referral doesn't help anyone much and I can only assume this
doctor didn't do much ground work for you before passing the buck to someone else.
My advice is to find a more involved and sympathetic GP next time. The Australian
Lesbian Medical Association (http://www.almas.net.au/) may be able to point you
in the right direction.
LOTL'S health columnist is a lesbian GP on the NSW north coast.
The opinions expressed in this column are those of the author and
are not intended as a substitute for medical advice. If you have
concerns about your health please consult your health practitioner.
ONCE YOU'VE ASKED A LEADING QUESTION ABOUT A
'PARTNER' AND THE ANSWER COMES BACK GENDER
NON-SPECIFIC, YOU REALLY ARE STUCK WITH HAVING
TO ASK, "IS YOUR PARTNER MALE OR FEMALE?"
THERE'S ALSO SOME RESEARCH THAT SUGGESTS
STRETCHED UTERINE LIGAMENTS, CAUSED BY
CHILDBIRTH AND LACK OF OESTROGEN IN
MENOPAUSE CAN CAUSE PAIN ON ORGASM.
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