Note: This post does NOT contain sensuality or sexually graphic information.

God created sex and declared it good. How do we know? 

God created man in His own image, in the image of God He created him; male and female He  created them. God blessed them, and God said to them, “Be fruitful and multiply, and fill the  earth, and subdue it…” And God saw all that He had made, and behold, it was very good. (Ge  1:26-31) 

Therefore a man shall leave his father and his mother, and cleave to his wife; and they shall become one flesh. And the man and his wife were both naked and were not ashamed. (Ge 2:24-25)

God intends for married couples to enjoy sex. However, when Adam sinned, disease and death entered  humanity. Bodies were no longer perfect. They malfunction. This includes malfunctions in sex. 

Those malfunctions are prolific. American women suffer from many syndromes associated with genital and sexual pain, called dyspareunia, about six million from just one of the pain-causing syndromes alone. At least 40 percent of women with dyspareunia do not seek help from a doctor. Although the body can look normal to the doctor, there are many possible reasons for the pain and the knowledge of how to diagnose and treat those causes is only recently being discovered and developed. Since few doctors know how to diagnose the problem, many women see five, ten, even twenty doctors before they find one who diagnoses accurately and offers effective solutions.

When Sex Hurts: A Woman’s Guide to Banishing Sexual Pain is written to address dyspareunia.1 Written by two medical doctors and a psychologist, the book comes in three sections. The first introduces the problem and explains female anatomy. The second explains many of the causes, symptoms, and treatment options. The third discusses how to progress after the pain is lessened or gone.

A woman in pain will be comforted by learning she is not alone and the pain is not just in her head. While the authors provide some self-diagnostic and self-help measures, they strongly and wisely encourage women to apply to trained doctors and therapists for the most effective help. Some sections practically helpful include:

• How to find and work with a doctor 

• Websites for organizations specializing in the study and relief of pain in sex 

• Exercises for the woman to do 

• Discussions of myths about sex and about pain 

I appreciate that the authors say there is far more to relationship than sex and that couples may have close, intimate, mutually satisfying relationships even if sexual intercourse is not an option.

I recommend this book with qualifications. First, I do not have the medical expertise to critique the  medical information. Second, I did not read other books on this topic so as to compare. Most importantly,  the reader needs to be aware that the book is written without God in mind at all. The authors are not  misleading anyone. Rather, a Christian reader needs to read discerningly. Some negative results of by passing God include:

• There is no use of the Word of God for shaping perspective of, and finding solutions to, pain, sex, and relational conflicts. Without the Word of God to regulate behavior, people can arrive at ungodly ideas and methods, such as the suggestion of masturbation as one option in the overall recovery plan (pp 192-193).

• The view of sex is totally man-centered. There is no understanding of God’s origination of sex, His ownership, or His higher purpose for it in expressing marital union as image-bearers.

• For solutions, there is emphasis on cognitive-behavioral therapy (CBT) which, while it contains some methods which can be helpful, such as changing what you think, it also contains several substantial deficiencies.

• CBT holds a totally man-centered goal. Focus is on self-improvement, not the glory of God.

• CBT works to change the thoughts but not the spiritual-moral heart underlying the thoughts.

• Because it ignores the Word of God, replacement thoughts are developed under the influence of cultural winds and personal preference. As a result, some suggested thoughts will not be true. None will be theologically rich, so they lack spiritual edification.

• Relying on man’s strength of mind and will rather than on the Spirit of God and the Word, CBT promotes trust in self rather than trust in God.

If you suffer pain with sexual intercourse or even just pain “down there,” don’t just quietly endure it. Tell your spouse and go find medical help! Be persistent until you find a doctor who accurately diagnoses you. And read this book. As you find help for the physical pain, be sure to search the Word of God and heed what it says about pain, sex, conflicts, and how to change. The Bible explains and empowers change far superior to CBT.

Male or female, if you teach on sex or counsel women or married couples, consider reading this book. At least familiarize yourself with the fact of dyspareunia and possible resources to recommend. Some women do not know pain with sex is not normal. Many remain silent about it because the husband forbids telling or if they told a doctor or counselor the husband would become very angry for talking about their sex life. Many suffer needlessly for years. Counselors need to be aware and, when checking on the role of sex in the relationship, not presume a woman’s silence means pain is not a factor. A theologically sound counselor can gain much helpful understanding from this book while bringing a biblical view to bear upon his/her counselee.

1When Sex Hurts: A Woman’s Guide to Banishing Sexual Pain, by Andrew Goldstein, Caroline Pukali, and Irwin Goldstein. Da Capo Lifelong Books, January 11, 2011. ISBN: 978-0738213989