It is a relatively common myth that penises can be too large.
阴茎是有可能太大的，这是一个相对常见的迷思。

As a professional, I can assure you they generally are not.
作为专业人士，我可以向你保证，一般不会太大。

From time to time I receive a query from a girlfriend wondering if her potential new partner is perhaps too large. One of the perks of having an obstetrician and gynecologist as a friend is you can ask everything — and get informed answers.
不时会有某个女性朋友来问我，可能成为她新伴侣的男人阴茎会不会太大了。和妇产科医生交朋友的好处之一就是你什么都能问，并且能得到可靠的答案。

I remind them that vaginas have been finely tuned by hundreds of thousands of years of evolution to stretch. If they are interested and if this gentleman is a safe choice, personally and medically, then break out the lubricant and have a ball. If it hurts, stop and give me a call — not immediately, but perhaps the next day.
我提醒她们，经过几十万年的进化，阴道已经可以极好地适应伸缩。如果她们有兴趣，并且这位先生从人品和医学角度来说是安全之选，那就用上润滑剂尽情享受吧。如果感觉疼痛，请马上停止，并且给我打电话——不是马上打，而是等到第二天。

It is also not uncommon for me to hear about penis size from people I barely know. Once I was out for dinner with my future ex-husband and some people I had never met. When the opportunity presented itself, the woman turned to me, just as I was taking a mouthful of pasta, and said, “We can’t have sex. His penis is just too big.”
我也经常听我几乎不怎么认识的人提起阴茎尺寸这回事。有一次，我和后来成为我前夫的人，以及一些我从没见过的人共进晚餐。到了恰当的时机，一个女人转向塞了满嘴意大利面的我，说：“我们没法做爱。他的阴茎太大了。”

It was one of those record-scratch freeze-frame moments, because I can almost guarantee that this man did not miss his calling in the pornography industry. If they both want to believe it is huge, great. But the truth is they probably do not have a size problem; they more likely have a medical condition known as dyspareunia.
这是那种万籁俱寂的时刻，一切仿佛都静止了，因为我几乎肯定，这个男人并没有到可以去色情片产业里找份工作的水平。如果他们两人都愿意相信它确实太大了，那很好。但事实是，他们的问题可能不是在尺寸；更有可能是因为一种叫做“性交困难”的医学问题。

“Does it feel like he is hitting a wall?” I asked.
“你是不是觉得他好像是在撞一堵墙？”我问。

They both looked at me as if I were psychic. I am not. Women for whom tampons and sex are painful because the vagina feels too tight or small almost always have a condition called vaginismus. This means the muscles of the pelvic floor that surround the vagina are inappropriately taut. Typically these muscles relax with sexual stimulation and then contract rhythmically with orgasm. When they are tight it can cause pain with sex, a fit issue and even pain or difficulty with orgasm. Sometimes the pain can be worse after sex.
他俩都看着我，仿佛我是通灵的巫师。我不是。因为感觉自己的阴道太紧或太小，在塞入卫生棉条和性交时会产生疼痛的女性，几乎都有一种名为阴道痉挛的问题。这意味着围绕阴道的盆底肌肉不适当地绷紧。通常这些肌肉会在性刺激下放松，然后在性高潮中有节奏地收缩。当它们过于紧张时，可能会导致性交痛，这是一种健康问题，甚至会导致高潮疼痛或高潮困难。有时在性行为之后疼痛会更加剧烈。

This woman I met briefly is no different than the patients I have been seeing for 25 years. She has pain with sex, she had told multiple providers, and not only had she never been offered a treatment, but she also had never even been given a diagnosis. The best modern medicine has left her with is internet mythology — and not even vaginal mythology, but penis mythology! This enrages me.
这个萍水相逢的女人与我25年来见过的许多患者没有什么不同。她跟许多医疗人员提过自己的性交痛问题，不但没有给出过治疗方式，连诊断都没得出过。最先进的现代医学，丢给她的是一个互联网神话——而且甚至不是阴道神话，而是阴茎神话！这让我怒火中烧。

Pain with sex is common; almost 75 percent of women have experienced it. For many, the pain comes and goes and reasons for this transient pain include inadequate foreplay, breast-feeding (which lowers estrogen), infection and other causes.
性交痛是很常见的；几乎75%的女性都经历过。对于很多人来说，这是一种时有时无的短暂性疼痛，其原因包括前戏不足、哺乳（会降低雌性激素）、感染和其他原因。

Pain that is more persistent affects 7 to 22 percent of women, and up to 45 percent of menopausal women and 60 percent of cancer survivors report pain with sex. Pain with sex is up there in prevalence with migraine and low back pain, and yet it is woefully understudied and rarely discussed. The number of articles indexed in PubMed, a search engine for scientific literature, for dyspareunia is 3,694, and the number for erectile dysfunction, one type of sexual problem for men, is 19,796.
大约有7%到22%的女性会感受到更持久的疼痛，45%的绝经期女性和60%的癌症幸存者声称自己有性交痛。性交痛和偏头痛与腰痛一样普遍，然而这种疼痛被严重忽视，很少有人讨论。在科学文献搜索引擎PubMed的索引中，关于性交不适的文章只有3694篇，而关于男性勃起功能障碍的文章有19796篇。

Muscle spasm (my dinner diagnosis) is one of the most common diagnoses, but other common causes include nerve pain, skin conditions, low estrogen and endometriosis. There are psychological factors, but that does not mean that it is in your head. Ever.
肌肉痉挛（这是我在那次晚餐上给出的判断）是最常见的诊断结论之一，其他常见原因还包括神经痛、皮肤问题、雌激素水平低和子宫内膜异位症。心理因素也有影响，但是不等于说这是你头脑中的问题。从来不是这样。

If sex hurts, many women begin to anticipate the pain, which increases the pain response and diminishes lubrication and libido. If every time I offered you the finest chocolate in the world I hit you with a hammer at your first bite, you would soon learn to dread and fear chocolate. You may also reflexively flinch at the smell of chocolate, or even when I walked into the room, and lose your taste for chocolate altogether. For some women sexual trauma can also be a factor and start a cycle of pain.
如果在性爱中感到痛苦，许多女人就会有对疼痛的预期，这会增加对疼痛的反应，并且减少润滑和性欲。如果我给你吃世界上最好的巧克力，但是每当你吃第一口时都用锤子砸你，你很快就会习惯于恐惧和害怕巧克力。你也可能会在闻到巧克力的气味时条件反射地产生畏缩，甚至我一走进房间就害怕，你会完全丧失吃巧克力的胃口。对于一些女性来说，性创伤也可能是因素之一，并且引发疼痛的循环。

Getting facts ahead of fallacies in medicine is hard enough, but with sex there are many more layers. Most people receive a less than adequate sex education, and many do not learn how to talk about sex. When I ask a woman if she has discussed her pain or her sexual needs with her partner, it is not uncommon for me to hear, “I can’t.” That many doctors do not feel comfortable discussing sex only compounds the issues.
获取事实，战胜医学谬误，这本来就很困难，但是和性有关的问题还有更多层面。大多数人接受的性教育不够充分，许多人不懂该如何谈论性。当我问一位女士，是否曾与伴侣讨论过自己的痛苦或性需求，我经常听到对方回答，“我做不到。”许多医生不愿意讨论性问题，这只会令问题更加复杂化。

There are also some other solutions:
还有其他一些解决方案：

Addressing the sex itself. Treating pain with sex involves addressing the physical aspects, making sure technique is appropriate, discussing emotional consequences, and, of course, looking at the relationship. If you are deeply unhappy, you may not get the kind of sexual stimulation you need or be able to mount an adequate sexual response. No medical therapy can compensate for not liking your sexual partner.
解决性本身的问题。治疗性交疼痛的问题，需要解决身体方面的问题，确保使用恰当的技巧，讨论情感反应，当然，也要审视双方的关系。如果你非常不开心，你可能就无法获得你需要的那种性刺激，或者无法产生足够的性反应。任何药物治疗都无法改变你不喜欢自己的性伴侣。

Lubricant can help many women who have pain with sex, and no, it does not mean there is something wrong. The other myth that I frequently dismantle is this idea that women should achieve some kind of fantasy wetness. I have heard many women tell me that lubricant helps their pain, but their male partner does not like it or judges them for it. That, my friends, is messed up. No one thinks you are less if you need glasses. Some people have always needed glasses, and some of us, ahem, need glasses as we age. Who cares as long as you can see?
润滑剂可以帮助很多女性缓解性交疼痛，它并不意味着你有什么问题。我经常打破的另一个误区是，女性必须能够通过某种性幻想使阴道湿润。很多女性对我说，润滑剂可以帮助她们减轻疼痛，但她们的男性伴侣不喜欢它，或者指责她们使用润滑剂。我的朋友们，这个想法太差劲了。如果你需要戴眼镜，没人会瞧不起你。有些人一直需要戴眼镜；我们中的有些人，呃，随着年龄的增长，也会需要戴眼镜。只要你能看清楚，谁在乎戴不戴眼镜呢？

Foreplay is part of the sexual response cycle, but what is needed or desired varies greatly from person to person. At the dinner table the gentleman was quick to note that there was “enough” foreplay. I looked at my plate to keep my professional side-eye in check. This is why I always initially see women for consultation without their sexual partners. While foreplay alone rarely cures painful sex, most people actually want more than they are getting, so doubling up on foreplay is good sex hygiene, and, most important, it is fun.
前戏是性反应周期的一部分，但每个人对前戏的需求或欲望差异很大。在那次晚宴上，那位男士很快指出，他们的前戏“足够长”。我盯着自己的盘子，避免露出职业性的侧目。这就是为什么我总是先让女性在没有性伴侣陪同的情况下进行咨询的原因。虽然前戏本身很少能治愈性交疼痛，但大多数人实际上想要的前戏比她们得到的要多，所以将前戏的时间延长一倍是很重要的性卫生知识，而且，最重要的是，它很有趣。

Finding a good doctor. Many women who find the right practitioners will have their pain with sex treated. In addition to a doctor and physical therapist, a sex therapist and psychologist may be helpful. For some women, treatment can be challenging because they may not find the right providers and a few have conditions that are difficult to treat. Some therapies are costly, and others do not fit with the person’s sense of self. Some women have past sexual traumas that have never been discussed or are simply too painful to address, but doing so can go a long way.
找一个好医生。许多找到合适医生的女性能把性交疼痛治好。除了医生和理疗师，性治疗师和心理咨询师可能也会有所帮助。对有些女性来说，治疗可能具有挑战，因为她们可能找不到合适的治疗师，还有少数人的症状难以治疗。有些治疗费用高昂，也有些与患者的自我意识不相符。有些女性遭受过性创伤，却从未跟人提起过，或者那种创伤太过痛苦，难以启齿，但进行治疗会很有助益。

Treating pain with sex is incredibly rewarding; it is the only medical condition I treat in which my patient shows up giggling at her follow-up visit. “I didn’t know it could feel so good!” is a common response. Even when we don’t resolve the pain completely, getting a diagnosis can be incredibly validating and many women tell me just being taken seriously is very helpful.
治疗性交疼痛非常值得。它是我治疗的唯一一种病人在复诊时会咯咯笑的病。“我以前真不知道会感觉这么好！”——我经常听到这种反应。即使不能完全缓解疼痛，得到诊断也能产生不可思议的效果，很多女性对我说，被认真对待就很有帮助。

A woman who experiences painful sex is not broken. She has a medical condition, and she is hardly alone.
性交疼痛的女性并非无可救药。她只是遇到了一点医疗问题，这种情况并不罕见。
(本新闻网址：https://www.geilien.cn/news/weishenmo/nysexhurts.html)

Jen Gunter是一名在加州执业的妇产科医生。

翻译：晋其角、王相宜