Dear Reader,

One of the most common causes of painful intercourse in men is a condition called phimosis. With phimosis, the foreskin is too tight to be completely retracted (pushed back) over the glans (head of the penis). The majority of uncircumcised infants cannot have their foreskin fully retracted because of natural, connective tissue between the foreskin and the glans, but this similar, non-phimotic condition typically resolves in early childhood. By adolescence, most uncircumcised men can fully and painlessly retract their foreskin. Occasionally, penile infections, or forced retraction of the foreskin (either during bathing or sex), can cause scar tissue to develop in the foreskin. Tight bands of scar tissue do not stretch easily and can prevent full retraction of the foreskin.

Depending on the severity of the problem (some men with phimosis cannot retract their foreskin at all, while others have problems with difficult or painful retraction only when their penis is erect), there are a few solutions, including:

• gentle stretching of the foreskin, sometimes with the help of creams or steroids to provide extra lubrication and relieve inflammation, that can relieve mild cases of phimosis
• making a slit in the dorsal (top) side of the foreskin, a medical provider's procedure that allows the foreskin to be more easily retracted
• circumcision, the surgical removal of the foreskin (typically done with a local anesthetic), that cures phimosis

Your boyfriend can make an appointment with a urologist who can help him decide which type(s) of treatment would best suit his condition.

You mentioned that your boyfriend has never had an orgasm during sex. Does he mean from intercourse? Oral sex? Touching? Masturbating? This is important to determine in order to assist him in feeling pleasure and in having orgasms during sex or otherwise.

After the phimosis has been correctly diagnosed and treated, your boyfriend can be more certain about the cause of his absent orgasms. Then he can learn or begin to explore or expand the feelings of pleasure during intercourse, and you can enjoy the feelings of pleasure together.

Alice

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