Navigating PIV sex with a history of painful PIV07/14/2010 at 8:17 pm | Posted in Uncategorized | 20 Comments
Tags: consent, experts, female sexual dysfunction, FSD, pain, relationships, safe sex, sex, sex education, sexology, sexual dysfunction, sexual health, TMI, vaginismus, vulvodynia
NSFW/TMI Note: The following post will contain frank (but not explicit or sexy) language about sex. There are no pictures but since we’re having grown-up talk, the content will go behind a WordPress cut. Everything should still appear in your RSS feeder, but if you’re reading from the main page, you’ll need to click to go on. Thanks!
Last month, I made a last-minute journey across the country to visit my long-term, long-distance boyfriend. We’ve been together as much as two people separated by a few thousand miles can be for a long time, thanks to the internet and cell phones. It shouldn’t be much longer now before we close the distance between us and our lives together truly begin. But until then, we’re doing the long-distance thing, meeting up once every few months, for about a week at a time.
We would not continue schlepping around the US, hauling luggage on board airplanes and taking time off work if we did not believe that such experiences were worthwhile. Every time we meet up again, I think we grow a little bit more and get a little more used to one another. It’s always a shock to our systems to go from living mostly solitary lives to suddenly being together nearly 24/7 – even if only for a week. But eventually we get used to each other again and relax, lowering our barriers to one another. (And then the week ends and it’s all teary good-byes until next time.)
I am aware that a week together at a time is an unrealistic model for what real life together will be like. I am prepared to be amazed and have to adjust to mundane reality.
And sometimes – okay, every time we see each other… – we like to have sex.
But, the kind of sex that we have may not be what first comes to your mind. Sex is complicated enough to begin with, even more so if your body and sexuality do not match what mainstream culture says it should look like. Media tends to marginalize folks who aren’t at least white, TAB, cis and het, and media largely oversimplifies sex, defining it as “Intercourse” specifically. That’s a hard kind of sex to have when you’re living with vulvar pain though, or any other impairment that hinders sexual function! And to define sex as intercourse means that you’re taking sex away from people who do not need to insert a penis into a vagina in order to have sex. It erases queer sexuality.
Still, every once in awhile, if we’re both feeling up for it… every once in awhile when we get together, my partner and I give PIV sex a try.
I’m happy to expand the definition of “Sex” to include activities besides intercourse, and to take intercourse off of its high-ranking pedestal. Yet for some reason I still stubbornly refuse to reject intercourse as a valid form of sex, even though most of the time I can’t even have it, and I know many, many other people likewise cannot, or choose not to, engage in it.
Please note though, what follows below should not necessarily be read as a how-to guide to PIV sex with a history of dyspareunia. This is stuff that I do. This is stuff that happens, to me. There is no “May” about it: Your mileage is going to vary.
Here’s the way that PIV sex with my partner used to look like, before I sought treatment for vulvodynia and vaginismus:
We both definitely loved each other and came to the decision to have sex mutually. We had basic sex education in school, especially in terms of pregnancy and STI’s, but the classes didn’t present any advanced materials. Certainly sex education was no help in terms of learning about pleasure or pain beyond “First-time sex hurts virgin women and you’ll probably catch an STI and die or get pregnant.” So we supplemented gaps in our knowledge with sex education from the internet. That way, I knew that I needed to be aroused and probably use lubricant to make things comfortable. We both knew how to make ourselves orgasm and liked making each other orgasm, and were prepared to practice safe sex. However both my boyfriend and myself were ignorant of sexual pain disorders, including vulvodynia and vaginsmus. (This was back in the day when blogs and articles about sexual pain were even more elusive on the internet than they are now.)
In preparation for first-time PIV, I had my first (surprisingly painful) gynecological exam and went on control pills. (In retrospect, me being on The Pill may have been a mistake but it seemed like a good idea at the time!) But by the time we first had PIV sex – or at least, attempted to – I still hadn’t been able to use a tampon, and I still couldn’t get comfortable with anything into my vagina. I had bought a small one-inch wide vibrating dildo and although I could sort of use it internally, it was never comfortable or pleasurable to have it inside of me. It worked better as a vibrator. And in real life, my partner’s penis is bigger than the dildo was.
The first time we tried to have PIV sex, we had a small bottle of KY lubricant and some Trojan condoms ready. We had lots of foreplay, and I got turned on – I thought I was turned on enough… and fumbled around for awhile with the lubricant and condom, and trying to find a position that would allow my boyfriend entry. We were having some problems and it took a few tries.
Unfortunately once we got him in, it was so intensely painful we had to abort after about a minute – it was just too much. I was excited to be having intercourse, but nervous and uncomfortable too. And unfortunately I didn’t know the post-sex pain and discomfort would last so long, or to have such long-term consequences. I had always had some minor vaginal problems before having intercourse but things got more noticeable to the point of daily interference shortly after I first had PIV sex.
Psychologically, we both felt exactly the same about each other after having sex as we felt before. I was surprised that sex did not change our relationship. Sex education in school had taught me that sex (meaning PIV cis het sex) changes a relationship and that there would be enormous emotional upheaval. Didn’t happen.
But we didn’t know what was really going on with my body, so we tried intercourse again a very few times, taking additional steps to keep me comfortable. I was confident things could only improve. I did feel some hint of pleasure once while we were attempting PIV sex, but no it still ended with me hurting.
So, before I got treatment for the vulvodynia and vaginismus, vaginal penetration with everything always hurt. And yet all of these attempts (and doctor exams) were completely consensual. I wanted to have PIV sex, among other things, with my boyfriend. There was no coercion, force or malice, no guilting – in each case, my boyfriend and I asked each other about having sex before trying it out, so we were both active participants in the decision to have intercourse (as we are with all of our sexual activity.)
As far as I’m concerned, the pain was an unexpected accident, and would have happened no matter who I was with. We lacked the experience and education we have now, and there was something going on with me on a cellular level that was probably going to cause problems some day.
What a bummer. What’s the point of having PIV sex if it’s going to hurt anyway? Does it feel that way for everybody? Is this normal? How would I know? Why would anybody have sex if it hurts that much? After researching causes of vulvar pain online, seeing multiple doctors and grieving, I found a doctor who worked with me. I’m in a pretty decent place now, but getting here wasn’t easy and I don’t know how long I’ll be able to stay here. It took a long time. It’s an ongoing process. This is going to be a long-term thing. But physically I’m feeling better than I was.
So here’s what PIV sex with my partner looks like now:
One of the biggest changes is that now, I’m capable of inserting objects into my vagina. Sometimes there’s still discomfort or pain, but a lot of the time I’m comfortable. I’m learning to recognize my limits & warning signs and I back off if I don’t think it’s going to work out well.
So touch in and of itself doesn’t necessarily hurt my vulva & vagina anymore. Which has allowed the following events to unfold:
The same partner I mentioned above and I are still in a long-distance relationship, so we see each other once every few months. I think we have better communication now about what we want to do sexually. Before meeting up, we talk ahead of time about whether or not we even want to try to have PIV sex. This is because PIV sex is like, work, to us! Oh my god, there are so many little details that have to come together in order for us to make it happen, and sometimes if we want a totally stress-free time together it’s just easier to take it off the table for the duration of the trip! So sometimes, we may not even bother getting ready for PIV sex; maybe next time.
We still talk about what other sexual activity besides intercourse we want to do, but it’s more lighthearted… “What are you going to do to me?” “I want to do x to you.” This is part negotiation and part teasing to build up anticipation.
But on the other hand, since I know what intensely painful sex feels like, I’ve learned fear. I’m afraid of the pain. It’s an abstract fear. It gets in the way of me coming to terms with BDSM. I’m afraid I’ll backtrack to the beginning. And on some level I’m always aware that my partner could take advantage of me since there’s a size difference between us. But, he never has, so all I can do is trust him.
If we think there’s a chance we want to try PIV sex though, then I need to get ready for it. If I haven’t been dilating consistently, I need to pick that up again, ASAP. The more time I have to dilate at home and get used to having something inside of me again, the better. It takes me a while to work my way from one of the smaller dilators to one of the larger ones anyway. My goal is to be able to consistently use the largest one – 1 & 1/2 inches wide, pain-free.
We need to have adequate supplies on hand. I’m not on the pill anymore, so we need to have condoms that I like (usually polyurethane or polyisoprene) and I’ll need to have a lot of lubricant within arm’s reach.
After we meet up, I some time to adjust to being around my boyfriend physically. After a few days and a multiple hook-ups with each other, I’m much more comfortable and so we might talk again about if and when we might like to try having intercourse. So far I usually initiate this conversation, because I want and am feeling up for it. And when I bring this up, it usually means I’m interested in trying it some time later on the same day or soon.
Okay, so let’s say that we’ve talked about PIV and decide we want to go for it. Great! Now all we need to do is…
Make sure we have a hearty meal, use the bathroom, take a shower, give me some time to stretch out on my own, get some cushions into position, lay some towels down so we don’t have to go to sleep in a mess, relax together and see how far our makeout session goes, grab the lubricant and dilator kit, begin dilating while hooking up,
THEN if everything is going swimmingly and I’m totally ready for it, roll a condom onto my partner’s penis, dump a bottle of lube onto it and myself, and fumble around to find a position that feels comfortable for both of us when we finally go for it. Then we have to line up the angles just right, clumsily switch out the big dilator for his penis, and sloooowly ease him in. If I tense up or feel pain, we have to hold still for a moment while I relax and see if the feeling passes. If it does, then you may proceed…
(Edit 7/15/10 – And I forgot to mention all the physical therapy pelvic floor stretching that I continue to do on a regular basis because if I don’t, my pelvic floor gets all tense and tight and uncomfortable. And I also forgot to mention how, when we are attempting PIV, I also need to do kegels/pelvic floor drops. If I’m tense to begin with, I usually have to do a kegel on purpose, followed by a pelvic floor drop – which means relaxing after the kegel. Breathing helps. Exhale. Because if I’m tense or mid-clench on a Kegel, then it means my vaginal walls are tightly closed. The kegels and pelvic floor drops apply to dilating at home as well.)
Then, say we manage to have PIV sex. One time when I did it, I didn’t have any pain at all! In fact I rather enjoyed the whole experience.
But my doctors and physical therapist have warned me, I may still experience some discomfort during and after. “Discomfort” though, is quite different from burning pain.
And I still have a bartholin’s cyst, so I’m probably going to need to spend some time in the sitz bath before and after to give that fluid chance to drain. So there may be some post-sex care needed – warm sitz baths, ice packs, pain killers – whatever works.
AND, my partner and I still aren’t used to the sensation of PIV – it’s a relatively new experience, so we may have some unrealistic expectations about it, or we may need to adapt in order to feel what we want to.
So it turns out that PIV sex is not as easy as it sounds. You may think I’m making it sound like it’s more complicated than it really is, but no – it really is complicated and involved. Perhaps needlessly so, but if we just try to dive in spontaneously, so far it’s not happening. Maybe some day, later on, I can be as spontaneous with PIV sex as I am with other sexual activity with my boyfriend.
And so far, even after all those arrangements, most of the time, we still can’t have PIV sex! There’s a lot of places for something to go wrong. We’re hungry or too tired or just plain don’t feel like it. Maybe I’m suspicious of some vaginal irritation felt during the day. Maybe my pelvic floor is too tense, the vaginismus is acting up. I can’t get the dilator to go in. I can get the dilator in, but only halfway because it’s too painful. I’m feeling too stretched out and start to worry about tearing (there’s a mood-killer.) I have to pee. I feel fine but we can’t line angles up and “Find the hole,” to put it crudely. Etc…
If we can’t get PIV sex to work, it’s not the end of the world. We don’t have to stop having sex when that happens (but we aren’t obligated to continue, either.) Most likely we’ll still have sex, just not PIV, and we’ll both probably still orgasm.
You may notice that “Have an orgasm” is not on my list of complicated steps outlined above. This is because although orgasm is important to me, I have not had any major problems reaching orgasm, and so it’s not on my list of worries. We both know how to make ourselves and each other orgasm. At some point, if not through PIV, we’re probably both going to climax. I need to keep that step towards the end of an attempt at intercourse though because if it happens early on (relatively speaking) with either one of us, PIV isn’t happening.
And whether we have PIV sex or not, is not entirely on me. All the steps I take to prepare for PIV sex are only half the fun. Consensual intercourse depends on the cooperation of my partner, too. My partner has to affirmatively consent, (hopefully enthusiastically) so the presence of an erection in and of itself does not mean you have given consent. He needs to feel just as calm, comfortable and as sexually interested as I do.
But since he’s been present for all of my painful sex experiences, he worries about my safety. If he’s too nervous, not getting enough stimulation or just not ready he may not be able to maintain an erection. Or we may not be able to get the condom onto him.
But you see, the scenario described above is why I’m having a difficult time relating to one sexologist’s view of vaginismus that says, “Outwardly, women with vaginismus consent to intercourse; on a core level, however, they say No.” I have vaginismus, and yes, more often than not, it gets in the way of my partner and I having intercourse. But when that happens to me, it’s not necessarily because of a lack of consent. Would you please take me at my word when I say that in the moment, with my boyfriend, I want it.
Yet still, often, I cannot do it. I just have this thing with my body that sometimes acts out. So, to re-affirm consent, my partner and I communicate through the whole above described scenario. When we are unsure how to proceed, we use what are essentially Check-ins like those used in BDSM scenes. It’s not exactly a “Green, yellow, or red?” Which loosely translates to, “Would you like me to continue, proceed with caution, or shall we move on to something else?” In our case, the check-ins we do are much more vanilla, more like those described in this erotic scene by Kate Furnivall, quoted on Clarisse Thorn’s blog. The check-ins my partner and I make look more like that. “Are you okay? Ready for me now?” Or me going, “Okay I’m ready whenever you are!”
Sometimes, after initial difficulty with penetration, we give it a break for awhile. And then after a few minutes working with a dilator and continuing with other sexual activity, I might decide I’m ready to try again. Or I might not.
Well, maybe that sexologist, Naomi B. McCormick, isn’t talking about me. She says, “Typically, psychological, not medical, factors contribute to the problem [vaginismus.]” Well I guess we can say that I’m an atypical case (synonymous with “Not normal, abnormal, freakshow, weird, etc…” I really wish McCormick would have used different language here… or explored those not-typical cases,) since I’m still dealing with vulvodynia in addition to the vaginismus. So, I have medical factors at work here. My vaginismus is not completely psychological. Something about this statement bothers me because it sounds like the vaginismus is all in my head – like, if I really wanted it to happen, I’d just let it happen already.
But there is a physical thing going on inside my pelvic floor, tightening it up. My whole pelvic floor is messed up. Which is something I can address in the physical world.
Whew. PIV sex is a lot of work. I wonder if it’s like this for everybody. Based on what I’m seeing on television in magazines, I’m guessing “No.” Or maybe secretly, “Yes, but you’re not supposed to talk about that.”
So if it’s so much work, then why do I even bother trying to have it? If it’s so hard and most of the time it doesn’t even work, why not settle down and enjoy other sexual activities? Hmmm… well I can think of a couple of reasons that I do what I do.
Bbut since this post has somehow broken the 3,000 word mark already, I think I may save that for another day. Or maybe not, since we should all by now be fully aware that there are many, many reasons that women have or do not have sex. And if I have to explain to you all the reasons that I still sometimes try to have PIV sex – I’ll just feel like I’m having to defend that decision and I don’t think I should have to defend why I do or do not have the sex you think I should or should not have.
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