If it HURTS, damn, I AM going to say something. Usually, he'll catch on and ask before I have to, but if not, I will say it is uncomfortable and we can switch to oral sex or manual stimulation for the duration. I'm not going to lie there in any kind of pain I didn't ask for!
I pretty much have to fantasize to have an orgasm, that's how I'm wired. I'm pretty sure My Man does, too. At least most of the time.
Years ago, when we had babies and I was tired and really not very horny, I'd want sex over with soon, (yeah, I did the timing thing, I had LITTLE time, with small kids and for some reason he was taking forever to Come. UNTIL he caught me, "Why do you always look at the clock when we start having sex? Are you timing me?" OMG, was I embarrassed.) in those days, I'd once in a while actually start thinking about what I was going to make for dinner, a shopping list and I began to think, "THIS has to change." We worked on it and I haven't made a shopping list or recipe during sex in years.