Counseling couples about coitus during menstrual flow.

For some couples sexual intercourse during menses is both acceptable and pleasurable, while for others it is an undesirable or unacceptable sexual pattern. When counseling couples about having sexual intercourse during menses, one need to keep in mind both the advantages and possible disadvantages. Pelvic inflammatory disease (PID) is the most threatening risk of having coitus during menses. A woman who has experienced PID or a woman at high risk of developing PID may want her partner to use a condom if she wants to have intercourse during menses. Religious reasons may keep couples from sexual intercourse during menses. Women with very short monthly cycles may, from time to time, ovulate during menses. The use of tampons during menses may make the vagina very dry, and extra lubrication may be required. If sexual intercourse during menses does not lead to orgasm for the woman, pelvic congestion may be increased, thereby increasing the dysmenorrhea a woman experiences. The advantages of intercourse during menses are: pregnancy is far less likely to occur; by diminishing pelvic congestion, orgasm may significantly decrease the amount of dysmenorrhea a woman experiences; blood may be a good lubricant; and there are less days of abstinence in the monthly cycle.