Women in South and Central Africa, and Indonesia are reported to be carrying out "dry sex", a practice which not only leaves them in pain but also increases their risk of HIV. 'Dry sex' involves women reducing moisture in their vaginas in order to make intercourse more pleasurable for men.
This can can lead to cuts, sores and inflammation in the vagina, and increases the chance of a condom breaking, which in turn increase the chance of the women contracting sexually transmitted diseases including HIV.
Journalist Wendy Syfret reports for VICE that dry sex is borne out of a cultural belief that men find sex more pleasurable if a woman's vagina is dry, and that men will reject women whose vaginas have been ‘stretched out’ by sex.
She says that to achieve the desired dryness, women in South Africa insert, chalk, sand, pulverized rock, herbs, paper or sponges before sex. They also douse their vaginas in detergents, antiseptics, alcohol and bleach.
Women in Indonesia also have different versions of this practice according to LoveMatters. In Java, they 'smoke out' their vaginas by standing over burning herbs, and in other areas, it is common to insert a cigar-shaped stick made of a plant root.
While World Health Organization consultation papers show global health officials are aware the problem exists, most of the research on it is decades old and there are no broad figures on its prevalence, Dailymail UK reports.
A 2009 study looking at how dry sex spreads HIV in Zambian women found knowledge of the practice was widespread. Around two-thirds of the 812 women polled had used traditional dry sex medicines at some point in their lives, and about half were currently using them.
But a reluctance to discuss sexual health meant the practice was not debated. The researchers concluded:
'Most of the available information has been anecdotal, speculative or inadequate - mainly because of cultural reluctance to discuss or investigate personal sexual issues.'
Similarly, a sexual health clinician and campaigner, Dr Marlene Wasserman, commonly known in South Africa as Dr Eve, told VICE most people are aware of the problem but it is not talked about, and hasn't received enough attention from the country's Government for policies to be drafted.
She said the continued practice of dry sex shows the lack of education relating to equality and women's rights in the area. She explained that both men and women fail to understand that the vagina is capable of expanding during sex - and then back to its usual size afterwards.
'It's definitely a class issue. Basically, a woman's reputation depends on the size of her vagina. Among women who are less informed and less educated, there's an unbelievable ignorance around the idea the vagina adapts to the penis.
There is also an incorrect cultural belief that if a woman has a partner with a large penis, her vagina will remain permanently 'stretched' - and future partners will think she is promiscuous.
The practice is ingrained in culture, passed between generations of women.
'Men aren't saying to women, "Put Dettol in your vagina". Instead, they insinuate a woman is promiscuous due to the state of her genitalia.
For women dependent on their boyfriends or husbands, attaining commitment and pleasing them is extremely important. The idea that pain is normal or acceptable during sex has taken hold, and most women in South Africa would not think of sexual pleasure as something they necessarily have a right to.
'I've been part of a task force with the World Association of Sexual Health, and we've launched the declaration of sexual rights - the right to pleasure - and we've been really pushing that.
'Women are surprised that's one of their rights. We know 33 percent of women have and tolerate painful penetration. That becomes part of what they expect from sex.'
Dr Wasserman has a radio show which attempts to dispel myths about sexual health. She also hosts seminars for young adults and parents in order to educate people about healthy sexual practices.
'It's about educating people and trying to raise awareness. The conversation began when we realized HIV was impacting more heterosexual women in South Africa than gay men.
'There was a drive then to say to women: "Don't put Dettol in your vagina; don't dry your vagina out. This is dangerous." But the conversation hasn't gotten going, and women are suffering.'
She draws similarities between the practice of dry sex in developing countries and the vaginoplasty operations Western women undergo in order to tighten their vagina.
'They're having their own genital mutilation,' she said of the women who opt for these procedures. It's just a little more advanced and expensive than putting creams in your vagina. But isn't the principal the same? It's incredibly unhealthy as well to go have your vagina tightened because you want to have a honeymoon experience or have your partner think you're youthful.'
Please women, let's be more careful with our health. And to the men, try to reassure and encourage your women that they're just fine, and don't need to harm themselves for your pleasure.