Category Archives: Painful Intercourse

How to Rethink Intimacy When ‘Regular’ Sex Hurts

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There’s no rule that says sex has to be penetrative.

By Breena Kerr

When sex hurts, women often feel alone—but they’re not. About 30 percent of women report pain during vaginal intercourse, according to a 2015 study in the Journal of Sexual Medicine which surveyed a subsample of 1,738 women and men ages 18 and older online.

Awareness of painful vaginal sex—sometimes lumped under the term Female Sexual Dysfunction (FSD)—has grown as more women talk about their experiences and more medical professionals start to listen.

Many conditions are associated with FSD, including vulvodynia (chronic vulva pain), vestibulodynia (chronic pain around the opening of the vagina), and vaginismus (cramping and tightness around the opening of the vagina). But they all have one thing in common: vaginal or vulval pain that can make penetrative sex anywhere from mildly uncomfortable to physically impossible. However, you can absolutely still have sex, which we’ll get to in a minute.

First and most important, if you are experiencing any type of genital pain, talk to your doctor.

There’s no reason to suffer in silence, even if it seems awkward or embarrassing or scary. Your gynecologist has heard it all and can help (or they can refer you to someone who can). The International Pelvic Pain Society has great resources for finding a licensed health care provider who specializes in genital pain.

“We don’t yet know why women get vestibulodynia or vulvodynia,” Kayna Cassard, M.A., M.F.T., a psychotherapist who specializes in vaginismus and other pelvic pain issues, tells SELF. “[There can be] many traumas, physical and psychological, that become internalized and add to vaginal pain. Women’s pain isn’t just ‘in their heads,’ ” Cassard says.

This kind of pain can affect anyone—regardless of sexual orientation or relationship status—but it can be particularly difficult for someone who mostly engages in penetrative sex with their partner. The important thing to remember is that you have options.

Sex does not have to revolve around penetration.

Hell, it doesn’t even need to include it. And for a lot of people, it doesn’t. Obviously, if P-in-V sex is what you and your partner are used to, it can be intimidating to consider redefining what sex means to you. But above all, sex should be pleasurable.

“The first thing to do is expand what ‘counts’ as sex,” sex educator and Girl Sex 101 author Allison Moon tells SELF. “Many people in heterosexual relationships consider only penis-in-vagina to count as sex, and everything else is some form of foreplay,” she says. But sex can include (or not include) whatever two consensual people decide on: oral sex, genital massage, mutual masturbation, whatever you’re into.

“If you only allow yourself one form of sex to count as the real deal, you may feel broken for enjoying, or preferring, other kinds of touch,” Moon says.

To minimize pain, give yourself time to prepare physically and mentally for sex.

That might sound like a lot of prep work, but it’s really about making sure you’re in the right mindset, that you’re relaxed, and that you’re giving your body time to warm up.

Heather S. Howard, Ph.D., a certified sexologist and founder of the Center for Sexual Health and Rehabilitation in San Francisco, publishes free guides that help women prepare physically and mentally for sex. She tells SELF that stretching and massaging, including massaging your vaginal muscles, is especially helpful for women with muscle tightness. (Too much stretching, though, is a bad idea for women with sensitive vaginal skin that’s prone to tearing.)

Starting with nonsexual touch is key, as Elizabeth Akincilar-Rummer, M.S.P.T., president and cofounder of the Pelvic Health and Rehabilitation Center in San Francisco, tells SELF. This puts the emphasis on relaxation so you don’t feel pressured to rush arousal.

Inserting a cool or warm stainless steel dilator (or a homemade version created with water and a popsicle mold) can also help reduce pain, Howard says. Women can tailor the size and shape to whatever is comfortable. If a wand or dilator is painful, however, a cool cloth or warm bath can feel soothing instead. Again, do what feels good to you and doesn’t cause pain.

Several studies have shown that arousal may increase your threshold for pain tolerance (not to mention it makes sex more enjoyable). So don’t skimp on whatever step is most arousing for you. That might mean some solo stimulation, playing sexy music, dressing up, reading an erotic story, watching porn, etc.

And of course, don’t forget lubrication. Lube is the first line of defense when sex hurts. Water-based lubricant is typically the safest for sensitive skin. It’s also the easiest to clean and won’t stain your clothes or sheets. Extra lubrication will make the vagina less prone to irritation, infections, and skin tears, according to Howard. But some people may also be irritated by the ingredients in lube, so if you need a recommendation, ask your gynecologist.

Now it’s time figure out what feels good.

Women with pain often know what feels bad. But Howard says it’s important for them to remember what feels good, too. “Lots of people aren’t asking, ‘What feels good?’ So I ask women to set what their pleasure scale is, along with their pain scale. I ask them to develop a tolerance for pleasure.”

To explore what feels good, partners can try an exercise where they rate touch. They set a timer for 5 or 10 minutes and ask their partner to touch them in different ways on different parts of their body. Sex partners can experiment with location, pressure, and touch type (using their fingertips, nails, breath, etc.) and change it up every 30 seconds. With every different touch, women should say a number from 0 to 10 that reflects how good the touch feels, with 10 being, “This feels amazing!” and 0 meaning, “I don’t like this particular kind of touch.” This allows women to feel a sense of ownership and control over the sensations, Howard says.

Another option is experimenting with different sensations. Think tickling, wax dripping, spanking, and flogging. Or if they prefer lighter touch, feathers, fingers, hair, or fabric on skin are good options. Some women with chronic pain may actually find it empowering to play with intense sensations (like hot wax) and eroticize them in a way that gives them control, according to Howard. But other women may need extremely light touch, she says, since chronic pain can lower some people’s general pain tolerance.

Masturbating together can also be an empowering way for you to show a partner how you like to be touched. And it can involve the entire body, not just genitals, Akincilar-Rummer says. It’s also a safe way for you to experience sexual play with a partner, when you aren’t quite ready to be touched by another person. For voyeurs and exhibitionists, it can be fun for one person to masturbate while the other person watches. Or, for a more intimate experience, partners can hold and kiss each other while they masturbate. It feels intimate while still allowing control over genital sensations.

If clitoral stimulation doesn’t hurt, feel free to just stick with that.

It’s worth noting that the majority of women need direct clitoral stimulation to reach orgasm, Maureen Whelihan, M.D., an ob/gyn in West Palm Beach, Florida, tells SELF. Stimulating the clit is often the most direct route to arousal and climax and requires no penetration.

Some women won’t be able to tolerate clitoral stimulation, especially if their pain is linked to the pudendal nerve, which can affect sensations in the clitoris, mons pubis, vulva, vagina, and labia, according to Howard and Akincilar-Rummer. For that reason, vibrators may be right for some women and wrong for others. “Many women with pelvic pain can irritate the pelvic nerve with vibrators,” says Akincilar-Rummer. “But if it’s their go-to, that’s usually fine. I just tell them to be cautious.”

For women with pain from a different source, like muscle tightness, vibrators may actually help them become less sensitive to pain. “Muscular pain can actually calm down with a vibrator,” Howard says. Sex and relationship coach Charlie Glickman, Ph.D., tells SELF that putting a vibrator in a pillow and straddling it may decrease the amount of direct vibration.

Above all else, remember that sexual play should be fun, pleasurable, and consensual—but it doesn’t need to be penetrative. There’s no need to do anything that makes you uncomfortable physically or emotionally or worsens your genital pain.

Complete Article HERE!

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Sexual pain after cancer treatment an unspoken affliction for many women, UC Davis oncologist says

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Sexual pain is a common, but unspoken, aftermath of women’s cancer treatment. Doctors can be reluctant and patients too embarrassed to discuss it.

But it’s an all-too-real aspect of cancer treatment for women, according to Dr. Vanessa Kennedy, a gynecological oncologist for the UC Davis Health System.

Dr. Vanessa Kennedy, assistant professor in gynecological oncology, UC Davis Health System, Sacramento.

Dr. Vanessa Kennedy, assistant professor in gynecological oncology, UC Davis Health System, Sacramento.

“Some patients are two to three years out of treatment and they’re dealing with sexual pain and no one’s talked about it. Patients hesitate to bring it up because it’s a sensitive issue,” said Kennedy, who recently discussed the problem in the journal Obstetrics & Gynecology. Her co-author, Dr. Deborah Coady of New York University Langone Medical Center in New York, is author of the book, “Healing Painful Sex: A Woman’s Guide to Confronting, Diagnosing and Treating Sexual Pain.”

Kennedy estimates that about 50 percent of female patients with cancer – of any type – experience some form of sexual pain, due to physical changes caused by surgery, chemotherapy and radiation. It can range from vaginal dryness caused by early menopause to anatomical changes that can make sex uncomfortable.

Some women feel guilty they’re even concerned about their sex lives, given what they’ve been through battling cancer. “There’s some guilt that they should just feel lucky to be alive and shouldn’t ask about these other things,” she said. But when sexual health is addressed, “They’re actually relieved to know they’re not alone.”

Twice a month on Fridays, Kennedy holds a regular clinic, seeing UC Davis patients who’ve been referred for post-cancer problems with sex. She works with patients on a number of interventions, including physical therapy, lubricants (even coconut or olive oil), vaginal dilators and couples counseling to re-establish intimacy.

Kennedy said doctors and medical students need to learn to be comfortable broaching the topic. “A lot of students and providers are still a little bit nervous asking about sex,” she said. “How do you get comfortable talking about these things? You just do it. It’s just like asking a patient about changes in appetite or changes in sleep. Sex is another thing (on the list). Get over it and ask about it.”

There’s a difference in how men and women cancer patients deal with sexual health, Kennedy contends. For men who’ve undergone prostate cancer treatment, there’s an emphasis on restoring their sexual function. For women, there’s often physical pain and a loss of intimacy, along with the added fear by some that their partners view them as less desirable. In some cases, where sex has become nonexistent, patients confide that their partners have threatened to leave or cheat on them.

Kennedy, who did fellowship training at the University of Chicago, which has a sexual health program for women cancer patients, says research on women’s sexual health issues is lagging, compared with that for men with prostate cancer. Next April, she’s hosting a national gathering of the Scientific Network on Female Sexual Health and Cancer, which promotes research and information for women patients and their providers.

“Sex is a quality-of-life issue and a core of our well-being,” Kennedy concludes. “We have to bring back the intimacy and make this a part of the body that’s associated with pleasure, rather than an uncomfortable, negative place.”

Complete Article HERE!

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Why Can’t I Orgasm During Sex? Chronic Pain And 5 Other Factors That Affect Ability To Climax

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Imagine this: You and your partner are getting hot and heavy in between the sheets. You’re feeling sexually aroused — but you’re unable to climax. In frustration you ask yourself: “Why can’t I orgasm during sex?”

The Kinsey Institute indicates 20 to 30 percent of women don’t have orgasms during intercourse, compared to only 5 percent of men who don’t climax every time they have sex. Men and women who are unable to sustain an erection or reach orgasm, respectively, are usually labeled as having some type of sexual dysfunction. However, the inability to orgasm could be triggered by several issues that range from physiological to psychological.

Below are six causes of why you have trouble orgasming during sex.

Tight Condoms

Condoms are often seen as an “evil” necessity that reduces sensitivity and sensations for men. The truth is condoms can inhibit male orgasm if they do not fit properly. A condom that is too tight can feel like the penis is in a chokehold, which can be distraction, and make it difficult to keep an erection. A 2015 study in journal Sexual Health found about 52 percent of men report losing an erection before, or while putting a condom on or after inserting into the vagina while wearing a condom.

Stress

High levels of stress impact your psychological and physiological health, which can interfere with the ability to orgasm. This makes it harder to concentrate on the sensation and relax during sex. Women with high salivary cortisol and stress levels have significantly less desire to masturbate or have sex with their partner.

Stress causes us to produce fewer sex hormones, like estrogen and testosterone, and more cortisol and stress hormones. When the body releases cortisol, a fight-or-flight response kicks in, and redirects the blood flow away from the sex organs, causing you to breathe shallowly.

couple-holding-hands

Depression

Depression affects your mood, and even the desire to have sex. A 2000 study in the American Family Physician found 70 percent of adults facing depression without treatment had problems with their sex drive. This is because sexual desire starts in the brain as sex organs rely on chemicals in the brain to jumpstart your libido, and change blood flow. Depression disrupts these brain chemicals, making sexual activity more difficult to initiate and enjoy.

Chronic Pain

More than 75 million people live  with persistent or debilitating pain, according to the national pain foundation, which can often lead to a low sex drive. Chronic pain sufferers find it difficult to feel pleasure during sex since the body hurts all the time. This is unfortunate since having an orgasm can alleviate some pains and aches.

Prescription Meds

Drugs tend to be among the most common causes of sexual problems. Prescription meds are responsible for as many as one of every four cases of sexual dysfunction. A 2002 study published in Family Practice found statins and fibrates (used in lowering LDL “bad” cholesterol) may cause erectile dysfunction, while later research has found both men and women taking statins showed increased difficulty achieving orgasm. The levels of sexual pleasure declined along with LDL cholesterol.

Negative Body Image

When you feel good about your body, you tend to feel better psychologically as well. The mind-body connection is imperative in sexual pleasure. For example, if you feel bad about your body, it;ll become more difficult to enjoy sex and have orgasms. A 2009 study in The Journal of Sexual Medicine found women between the ages 18 to 49 who scored high on a body image scale were the most sexually satisfied. Positive feelings associated with weight, physical condition, sexual attractiveness, and thoughts about our body during sex help promote healthy sexual functioning.

Complete Article HERE!

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Heightened Awareness: Anxiety Can Lead to Pain During Sex

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Clearly anxiety can be an obstacle to a healthy sex life and needs to be talked about.

By Carrie Weisman

clenched-fists

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Are you getting any closer? A pocket-sized primer on female sexuality

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By Clarissa Fortin

Stay curious between the sheets, friends.

Closer: Notes from the Orgasmic Frontier of Female Sexuality
by Sarah Barmak
(Coach House Books, 2016; $14.95)

If it weren’t for Sarah Barmak’s Closer: Notes from the Orgasmic Frontier of Female Sexuality I might have gone for years of my life without ever finding out what my clitoris actually looks like.

“Illustrations of it resemble a swan with an arched neck,” Barmak writes. “When I saw an closerillustration of the clitoris’s true shape for the first time I felt like a blind man finally seeing a whole elephant when all he’s ever known was the tip of it’s trunk.” I realized while reading those sentences that no one in my Catholic high school health class ever bothered to show me such an image and I’d never thought to seek one out.

I consider myself a feminist and a sexually liberated woman. Yet, there are still surprising gaps in my understanding of my own body. And that’s why a book like Barmak’s is important. Closer tackles its subject with eloquence, intelligence and humour.

The book is split into five essays that tackle the “fear of pleasure,” the history of female sexuality, the science and psychology of the orgasm, the “female sexual underground” and the politics of acknowledging female desire.

While each essay has its own strengths, I think the most effective chapter is “A History of Forgetting.” This section aligns the historical “discovery” and “loss” of the clitoris with the individual experience of a woman named Vanessa — an actual interview subject.

We first meet Vanessa on the table at the doctor’s office filming herself masturbating in order to prove to the doctor that she can indeed ejaculate. We learn that Vanessa has been having a series of problems — pain after sex, recurring yeast infections and so on — that no doctors can figure out.

From here Barmak momentarily leaves Vanessa’s story behind and turns her attention to the clitoris itself, noting that “the mapping of the human genome was completed in 2003, years before we got around to doing an ultrasound on the ordinary human clit.”

While the tendency is to see history as ever moving forward and progressing, Barmak counters that “women’s sexuality began by being celebrated, then was feared as too potent, before being downplayed and denied in the scientific era.”

The Christian church, the scientific revolution and various other factors resulted in a demonization and rejection of female bodies. It’s a generalized historical account to be sure, but Barmak does point readers in the direction of Naomi Wolf’s Vagina, a much more comprehensive book on the subject.

What makes this essay so powerful is the way it revisits and concludes with Vanessa and her struggle. Her story held up against the larger history of the clitoris itself demonstrates all too well an overall contempt for and neglect of the female genitalia.

Along with research and anecdotes, Barmak amasses a diverse collection of interviews with doctors, researchers and sex educators. I was excited to learn many factoids that I will surely whip out at dinner parties in the future — for instance, vaginal self stimulation actually blocks pain in women, and even women who are paralysed can sometimes still feel sexual pleasure because of nerves which bypass the spinal cord and communicate directly with the brain!

Barmak combines this research and traditional journalistic writing with first-person narration, bringing her own experience into the story. This means attending seminars and workshops, watching a demonstration of a female orgasm at Burning Man, and getting a vaginal massage.

Barmak is open about her own skepticism and trepidation during these investigations. “I like to consider myself open to new things,” she writes. “Yet, the idea of a strange lady’s gloved fingers all up in my jade palace falls somewhat outside my personal boundaries.” She goes through with it and the personal account makes for a richer narrative overall.

A note about the term “woman”: Barmak uses it throughout the book to generally refer to the cisgendered female experience. If I have any strong critique of the book it is that by celebrating the distinctly female anatomy, the book sometimes verges on unintentionally emphasizing a gender binary. This is something Barmak herself seems aware of. She notes on pg. 21 that “the word woman can refer equally to cisgender, intersex, genderqueer and transgender women all representing varied shades of experience.” While it’s good that the acknowledgement is there, I think a declaration like this belongs even earlier on as a note for readers to keep in mind before the book even begins.

That said, Barmak does make an effort to include the experiences of typically marginalized women such as trans women and women of colour in her narrative. “Being white affords privileges even in non-mainstream spaces of revolt such as sexuality,” she notes.

The topic is something “that requires far more depth and attention than this little book can offer,” Barmak says and while this seems like a partial cop-out for having only a few pages devoted to women of colour and trans women specifically, Barmak makes a valid point. Issues regarding sexuality faced by marginalized women warrant entire books altogether, preferably penned by a writer who has lived those experiences.

Nevertheless, I think this book would have been more complete with a sixth section devoted specifically to these issues.

At its core this book is compassionately optimistic, celebrating the innate complexity of sexual pleasure itself and arguing in favor of orgasms for all, something I can definitely get behind.

Sex educator and vlogger Lindsay Doe has a motto she repeats at the end of each of her videos: “stay curious.” Closer isn’t the definitive book about female sexuality and it doesn’t claim to be. But it made me curious about my own body, and even more curious about the wonderfully vast array of experiences we humans have between the sheets.

I recommend it to my friends of all genders, my boyfriend, my sisters, and especially the woman who started it all, my mother.

Complete Article HERE!

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