About Last Night: What to do when sexual intercourse is painful 01-07-18

July 11, 2018

Q: Lily and I met last summer, and are crazy in love. The problem is that Lily can’t have sex. Her muscles clamp shut if I even try to use a finger, and persevering hurts her. It’s driving us both nuts. Last weekend, after we’d had a few drinks, she asked me to tie her up, and have sex with her, just to get it over and done with. I was shocked and upset. I could never do that. Help!

A: Lily might be suffering from vaginismus, which is an involuntary spasm, contraction or reflex of the muscles surrounding the entrance to the vagina. It can make penetration painful, or impossible. The severity of this response varies from woman to woman. It can be triggered by attempts to have sexual intercourse, as well as attempts to insert a finger, a tampon, a speculum … The danger is that, if it is impossible to take a pap smear, or perform other pelvic examinations, medical problems might be missed.

Primary Vaginismus occurs where a woman has never been able to have pain-free vaginal penetration, or intercourse, whereas with Secondary Vaginismus, a woman develops the condition after having been able to engage in these activities previously. In many cases, it is not clear what causes vaginismus. For other women the cause can be located in sexual abuse, persevering with intercourse when it is painful, surgery, or emotional trauma. It could be more common that the statistics suggest, because shame and embarrassment can lead to under-reporting.

Apart from any health risks, vaginismus causes personal distress for the sufferer, and puts a strain on relationships. The frustrating thing is that most of these women, like Lily, are able to get sexually aroused, and desperately want to have intercourse.

Fortunately, it is treatable, and the sooner it is diagnosed, and treated, the better. Lily needs to see her doctor, who will examine her in order to eliminate other health issues. Some questions may also be asked to try to identify what has caused this.

The most important thing to remember is that treatment can take time, so be patient.

There also can be a counselling component to the treatment, so be prepared to be involved with this if required. Having the support of a loving partner can be invaluable.

One treatment option involves a specialised form of physiotherapy, and Lily might be advised to use dilators. Often made of glass or smooth plastic, these consist of a set of rods, or “fingers”, that go up in size.

Using plenty of personal lubricant, the woman practises getting relaxed, then, taking it slowly, attempts to insert the smallest dilator. Over time, she tries to go up a size, but only when she feels comfortable.

The smallest is the size of a little finger, and the largest, penis sized.

At first, this needs to be practised alone, as it is essential to be as relaxed as possible. Further down the track, as her confidence increases, Lily might choose to incorporate these exercises into your sex play.

This journey will be easier if your relationship is in a good place, and you continue to enjoy pleasure and desire. Please stop saying that Lily cannot have sex. Too many people equate having sex with having penetrative intercourse, but that is only one aspect of enjoying great sex.

Agree to avoid any attempts at vaginal penetration. Psychologically, Lily needs to separate sex play from pain and disappointment. This can be very erotic if you are both willing to use your imagination. Sensual massage, passionate kissing, caressing and fondling, oral sex, mutual masturbation, role play, restraint games, anal play, and experimenting with clitoral stimulating sex toys … whatever appeals to you.

Once Lily trusts that you will not initiate vaginal penetration it is likely that she will enjoy having her vulva touched.

If, in time, she feels ready for sexual penetration, proceed slowly, with a little finger, your tongue, or a tiny vibrator. Vibrators massage the vagina, encourage engorgement, and can enhance sexual pleasure, but you must start small.

Enjoy fabulous sex today, whilst embarking, together, on this healing journey.

Email: abtlastnight@gmail.com

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