Painful Sexual Intercourse (Frenulum Breve)

It’s quite common to experience discomfort during intercourse. Other than the common causes such as vaginal dryness due to under-stimulation, the other common cause for a male partner is a short frenulum. Frenulum breve is a medical term for short frenulum, which is a condition in which the skin that connects the foreskin to the glans of penis is shorter than usual, resulting in a lot of tension when pulling the foreskin back during an erection. This may result in the frenulum tearing during more vigorous sexual activity which ends up in severe pain and bleeding post intercourse.

Frenulum breve does not improve over time and needs to be surgically corrected. Many men that have frenulum breve, may choose to not engage in sexual activity due to the fear of pain, and in others; it may cause erectile dysfunction due to the inability for full erection to take place with a short frenulum.

How do we identify a short frenulum?

It’s quite easy to identify a short frenulum by self-examination. Pull down your foreskin and observe the belly or the underside of your penis. If there is tension on the foreskin to the glans penis, or if the region is painful to touch then you may be suffering from a short frenulum. Otherwise, you will feel some discomfort when retracting your foreskin completely.

Other signs that may indicate a short frenulum also may include, pain or discomfort during sexual activities, the head of the penis curves downwards during an erection and the skin of the glands of your penis cannot be completely pulled back.

However, this can be easily confused with phimosis. With phimosis, the frenulum is usually not seen at all, and you’d likely be having this since childhood. If there is a suspicion of either a short frenulum or phimosis, it’s best to consult your physician prior to initiating treatment. Ideally, treatment should be done before becoming sexually active to prevent future discomfort.

How to treat a short frenulum?

The recommended treatment for a short frenulum is frenuloplasty or frenulum breve release surgery. This procedure is usually done in your doctor’s office under topical anesthesia. Your doctor will apply a numbing agent over your frenulum region. Your doctor will release your frenulum, and then suture it to aid in the recovery process. This surgery usually takes 30 minutes and the patient can return home after the procedure.

Complete healing usually takes 2 weeks after surgery and sex should be avoided for at least a month post-surgery to allow the wound to heal and to prevent scarring. Swimming and hot tubs should be also avoided for 2 weeks to prevent infection and to aid in the recovery process.

Usually, circumcision will be done concurrently if you are not already circumcised as the recovery period is the same.

What do I need to do pre-surgery?

Your doctor will usually explain in detail prior to your surgery regarding the do’s and don’ts and the process of the procedure. Otherwise, it’s advisable to trim pubic hair to avoid possible risks of infection. If you are worried or afraid of pain your doctor will prescribe some painkillers and numbing agents to be taken prior to the procedure to reduce discomfort.

How do I look after my wound post procedure?

Usually, your physician may secure a post-operative site with a small dressing that can be removed 2 days after the surgery. After that, you may return to your normal routine of showering. Your doctor will provide an antibiotic ointment to aid in recovery and to prevent infection. Otherwise, the sutures that are used will be absorbed into your skin over a period of 4 weeks.

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