This is kind of embarrassing to admit, but when my boyfriend and I have sex I sometimes cannot distinguish the difference between pleasure and pain. I love him to death and really want our lovemaking to be wonderful, but I am afraid that there is something wrong. Is it me, or is it something we do or don't do? Is there a reason for this? -- iVillager ''P"

Dear P:

Thanks for this delicate question. Most women at one time or another have faced this dilemma, and you deserve an answer. Pain may be an indication of trouble, often an infection or inflammation. It can also be a result of vaginal dryness. Despite your genuinely loving feelings for your boyfriend, painful sex is not something to take lightly or ignore. And it certainly is not the stuff that keeps romance alive. Both of you must address this concern and work as a team to resolve it.

Here are three steps I suggest you take:
Step One: Get a thorough exam and medical assessment. By now you should have a good gynecologist you like and trust. If not, go to www.ppfa.org and seek out the clinic nearest you. I spent years working with and at Planned Parenthood, and their approach and quality of care is stellar. Painful intercourse -- or dyspareunia, as it is called -- is a legitimate sexual complaint that requires treatment. You may be suffering from an undiagnosed sexually transmitted disease, such as chlamydia or genital herpes, or you may have lesions, cysts or something else. So get checked out. You want to be safe, not sorry.

Step Two: While you are at the GYN's office or clinic, ask your doctor if you have distinct hymeneal tags. These are the little skin flaps that are the remnants of the hymen, the thick membrane covering the opening to the vagina in young women. If you want, you can look for these yourself using a hand mirror. The hymeneal tags are usually lost when you have intercourse for the first time (known as ''losing your virginity'') or, more commonly, from strenuous athletic activity or the use of tampons. But often those tags stay partially intact, causing irritation if you are new to penetrative sexual activities.

Step Three: Make sure you are sufficiently aroused. Many of my female clients report that they are not really turned on during sex, and as a result it becomes painful. Perhaps you dally too long in foreplay touch (kissing, breast stimulation, caressing) or he has lost his erection intermittently, delaying insertion. When this happens, if you cannot keep highly sexually aroused, your body may not produce enough slippery juice to facilitate his sliding in and out without creating annoying friction. Also, latex condoms (which I absolutely recommend for safer sex) can dry out the vaginal lining. By adding a lubricant you can avoid this problem and the pain that goes with it. Go to my site (www.yoursexcoach.com) or other adult online stores (www.goodvibes.com) and buy a quality product, such as Astroglide, Probe, Eros or the all-natural Kama Sutra oils. These will diminish your chances of drying out and feeling discouraged about your pleasure potential. Be sure, too, to read and follow my Love Lessons workshop on The Secret of Sexual Arousal.

Whatever you do, stay focused on other ways to enjoy each other while you sort this out. Get a video on sensual or sexual massage (available from www.lovingsex.com or my site, www.yoursexcoach.com) for a healthy, painless way to feel pleasure with your partner until you heal what ails you.