I AM in a relationship that is very healthy apart from one thing that is worrying me. I find sex to be traumatising though my boyfriend enjoys himself during the act. I have not told him that to me sex is painful for fear of hurting him. However, he is demanding to have sex more regularly now meaning I have to go through torture just to satisfy him. What should I do?
Belinda
Kasama

Dear Belinda
PAINFUL intercourse can occur for a variety of reasons — ranging from structural problems to psychological concerns. Many women experience painful intercourse at some point in their lives.
The medical term for painful intercourse is dyspareunia (dis-puh-ROO-nee-uh) — which is defined as persistent or recurrent genital pain that occurs just before, during or after intercourse. Talk to your doctor if you’re experiencing painful intercourse. Treatments focus on the underlying cause, and can help eliminate or reduce this common problem.

He pinches me during sex
MY boyfriend from Europe is quite strange in bed and I think he needs help. Despite being romantic, he pinches me during sex causing me a lot of pain. The more he gets excited sexually, the more he pinches me. What should I do?
Monica K
Lusaka

Dear Monica K
SEXUAL sadism is listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM) as a mental disorder.
A person who is living with this condition becomes aroused by fantasising or participating in scenarios where they are hurting or humiliating another individual.
Symptoms of Sexual Sadism
• This sexual disorder is named for Marquis Donatien de Sade, who wrote novels about the idea of getting pleasure from inflicting pain.
• Sexual fantasies about harming an adult, child or animal are part of the disorder. If an individual has been having fantasies of this nature for six months or more, they meet the criteria for diagnosis under the DSM.
• The person must be experiencing difficulties or impairment in his or her personal relationships or job as a result of their fantasies or behaviour to be diagnosed as a sexual sadist.
• The majority of sexual sadists are male.
• The sexual sadist will likely start having fantasies about domination and inflicting pain in adolescents.
• An individual who has these types of sexual fantasies may progress to the stage of starting to act them out in a real, as opposed to simulated, setting.
• Activities that a sexual sadist may engage in include hitting, whipping, burning, cutting or biting. He or she may wish to urinate or defecate on the other person.
• With time, the sexual sadist’s behaviour will escalate from exploring this theme with a consenting partner to performing acts on an unwilling one. The individual needs to increase the level of violence to get sexual gratification.
• In scenarios where the encounter with a sadist is not consensual, rape and or murder may be carried out. The stimulus for the sadist is domination over and fears of the victim during the acts of violence.
Treatment of Sexual Sadism
People who fit the criteria for sexual sadism may not seek treatment on their own due to feelings of shame or concerns about being reported to the authorities if they have been engaging in non-consensual sadistic activities.
Once a person has been charged with an offense, the justice system’s focus is on segregation from society and punishment.
Behaviour therapy is a common approach to treating sexual sadism patients. The individual learns how to change their arousal patterns to more socially accepted ones.
The therapy may also include social skills instruction to help the patient develop more positive ways of interacting with others.
Along with talk therapy, the sexual sadism patient may be prescribed medications. If there is concern about an individual harming someone else, administering female hormones or antiandrogen drugs can help to reduce testosterone levels.
Some SSRI (Selective Serotonin Reuptake Inhibitors), which are used to treat depression, may also be helpful in treating this disorder. The number and intensity of sadistic fantasies tends to decrease with age.
A person who knows or suspects that the definition of sexual sadism applies to them can be helped if they receive appropriate treatment from a trained professional.
Seeing a therapist with experience treating sexual sadism or going to a sexual addiction treatment facility can help the patient start his or her recovery.

My mother gets in the way of my relationships
Dear Josephine
I AM in my third marriage over a period of 10 years. Each time I marry a woman my mother disapproves of them to an extent of forcing me to divorce them.
She has attended all the divorces cases in the local court. I am hopelessly afraid of my mother whom I stay with since my father died.
My sisters have complained about her interference but they don’t know what control she has on me.
I remember the last divorce that ended acrimoniously and the part my mother played in the breakup.
She complained of anything my former wife did including things like ironing, where to put a flower vase, a missing button on a shirt.
I am trying to get rid of my mother after realising how intolerant she is of all other women in my life. However, I don’t have the courage. What should I do?
Peter G
Ndola

Dear Peter G
WHAT you are describing is a classic relationship triangle, and your position as ‘confidant’ to two people who don’t get along is not a healthy one for you or for them.
I feel your mother is a dangerous control freak and a selfish woman. I know since you are too attached to her you won’t see this.
For a start, you need to explain to both your mother the great pain and heartache her behaviour has caused you.
I also think your mother comes from the old school and thinks of the old adage of honouring one’s parents though she should understand that this does not require jeopardising a marriage.
If your wife is ever insulted by your mother in front of you, you need to make it immediately clear to your mother, as respectfully as possible, that you cannot allow her to continue to treat your wife in this way.
As a very last resort, if your mother continues to demean your wife, be prepared to leave, or to ask her to leave your home, in order to show her that you are serious.
While this sounds extreme, once is usually sufficient to demonstrate your commitment to your wife.
Send queries and comments: tellmejosephine@gmail.com