Dear Dr. Kate, Any Treatments for Rough Sex Syndrome?

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Dr. Kate is an OB/GYN at one of the largest teaching hospitals in New York City and she answers your medical questions here once a week. To ask her your own question, click here.

Dear Dr. Kate,

I’m a girl who likes it rough. Not a little bum-smack here, a little hair-pull there, but slap-me-across-the-face, black-bruises-for-two-weeks rough. The thing is, this predilection presents a rather annoying problem that I haven’t been able to find an answer for just yet. What do you do to relieve the pain caused by torn or scratched inner labia? I tried epsom salt baths, which work okay, but is there a product out there that I can rub on the affected area, like during the workday? So many things that you’d think might be appropriate are “for topical use only”, so other than Astroglide, I haven’t been able to find anything to soothe the affected area. Oh, and just in case you were wondering: yes, I use safewords with my partners – most of the time I’m really enjoying myself when the injury occurs; yes, I practice safe sex; and yes, I give myself a long resting period after stuff like this happens so that it can fully heal before I engage again.

— Hurts So Good

Dear HSG,

You’re right, there are very few products that are designed for internal use — the vulva and vaginal canal are very sensitive to chemicals, and most over the counter products haven’t been tested internally. You can ask your gyno for a prescription for topical estrogen cream, which not only may be soothing but will actually promote healing.

But I wonder if sex play that leads to actual injury is really healthy for you, physically or emotionally. All injuries that break the skin put you at increased risk of infection, even if you’re always using condoms. (And I’m not just talking about sexually transmitted infections [STDs], but infections of any laceration from your native bacteria — believe me, an abscess on your vulva is no fun to experience or have treated.) You say “most of the time” you’re really enjoying yourself…I think a realistic and healthy goal for the bedroom is to enjoy yourself 100% of the time, especially when you’re playing with fire like you are.

— Dr. Kate

dr_kate_100Dr. Kate is an OB/GYN at one of the largest teaching hospitals in New York City. She also lectures nationally on women’s health issues and conducts research on reproductive health. Check out more of her advice and ask her a question at

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17 Comments on "Dear Dr. Kate, Any Treatments for Rough Sex Syndrome?"

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1 year 1 month ago

Good blog post. I certainly appreciate this
website. Keep it up!

Madamoiselle L
4 years 11 months ago

S. Bolivar, I kind of understand what you are saying, but from my POV ANY sex, or intimacy, if you are not already “in a healthy relationship” will have the same consequences.

Just like we look for partners who share our morals, our politics, and many other traits and choices, finding partners who enjoy the same kinds of sex we do is always a challenge. I, personally, wouldn’t settle for anything less than exactly what I want in a partner. Everything from his work ethic and what he does for a living, to how he feels about child discipline (I would never date people who hit children) to how they spend their money, whether they drink too much or do drugs, and what kind of sex they like is all part of finding someone you can spend your life with. None of these things are really something you need to capitulate on.

Introduce your new man to some gentle forms of Kink slowly. Show him new ways to make love. If he’s an open person, happy to have new experiences, cool things will happen. If he becomes “offended” or refuses to experiment, you have the option to leave. Some things, especially if you love them, simply will destroy the relationship if you try to “make it work” without them.

You have every right to get what you want out of your relationship. If he isn’t into what you are into. I could guess there are going to be other issues you two won’t be able to resolve. DON’T SETTLE!


S. Bolivar
4 years 11 months ago

The only drawback that I’ve seen to having Rough/extreme sex (assuming it’s consensual) is that if you leave your partner who enjoys said activities. It can be difficult to readjust to a more mild level, that most people enjoy.

These have been my experiances, also if you and your partner are not already in a healthy relationship BEFORE you begins such practices it may invoke feelings of guilt or isolation when attempting to understand it.

I myself enjoy rough sex tremondously, but it has led to complications in my Sex life now that I am seeing someone who isn’t so into that type of things.

Madamoiselle L
5 years 1 month ago

katherine, I am guessing you don’t participate in, nor really know *anything* about BD-M/s, D/S or other relationships which openly recognize the Power Dynamic which is present in ALL sexual relationships. CONSENSUAL Dom/Sub relationships do NOT end up with someone “in the trunk on the way to the landfill.” (Do we have an eye roll emoticon?) They are a way a lot of people enjoy each other, work out stress, find themselves, feed their needs and just have fun, their own way. You don’t have to participate, and you don’t have to like it. But, demonizing something you know nothing about simply shows immaturity and intolerance and even Prudery.

Some people like it Rough. You may not. That’s fine. I am sure a few people in The Lifestyle may be playing out “past abuses” (and for some, it works better than “therapy”) but the misstatement that everyone involved in BDSM lifestyle or even the occasional Bondage and Domination Scene is somehow sick and doesn’t realize what they are doing and are “headed for the landfill” is ridiculous, unsophisticated and uneducated.

Take a swing over to the Sex Toy Store mentioned on Em&Lo’s site ( and look at the Bondage toys, note the number of items on people’s Wish Lists, then go to the discussion forum and see the number of normal, happy well adjusted people who participate. You may actually learn something about a world you know NOTHING about.

Good luck. I hope you actually can relate or tolerate instead of simply react after educating yourself on these issues.

5 years 1 month ago

This is extremely interesting to me. I tend to think that if you are not basing your opinion on anything other than the stuff in head inserted there by inaccurate information that says that pleasure should hurt you, you may need to get some more information from a professional. I remember hearing quite a few newscasts where adults were apparently in mutually consenting activities such as this that gradually went too far or the perpetrator was grooming her for the eventual ride in the trunk and dump in a landfill. Making a mistake and oops does not cut it with me. How these activities or the potential for more serious injury or death could be appealing is beyond me. Also the doctor was ethically obligated to inject what she did even without the person asking.

At least on some level she is beginning to understand that this activity is somewhat questionable. I am wondering if she hasn’t been a victim in the past somewhere in her life and sees this as pleasurable activity because she accepted it in the past and didn’t have a choice or her partner has convinced her because she doesn’t have the ability to set limits on these activities with her partner or to say no. I know a close friend that in the past had to work extremely hard in therapy to get out of this type of situation and it came to light that she was just replaying her abusive past.