I had intercourse

02/23/2009 at 8:03 pm | Posted in sex, Uncategorized, vulvodynia | 3 Comments
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A rhetorical question:

Do you still have FSD if you are having S? Under the narrowest of definitions; for I have had sex many times under the broad view. Under the narrowest of definitions, where “Sex” is synonymous with “Intercourse.”  I don’t like that narrow view much.  I like the broader, more flexible view. The narrow view minimizes the importance & validity of other forms of sexual activity, & places too strong of an emphasis on one type of sex as the end-all, beat-all definiton.

Yet I do not wish to de-emphasize intercourse completely, pushing it below oral, mutual masturbation, anal sex, and others. That I was able to enjoy sexual intercourse means something to me on a personal level, too.

Finally, after a quarter-century of life – and at least 3 or 4 of those living with vulvar pain, I have had pain-free sexual intercourse. 2 or 3 years with treatment for vulvodynia & vaginismus, which fall under the “Pain” or “Medical reasons” category of female sexual dysfunction. 2 years post-surgery, about a year & a half of at-home dilator therapy, 1 year of chiropractic & acupuncture for some kind of not-vestibulitis flare, and 6 months of physical therapy.

I have seen both sides of the same coin (although I only just glimpsed one of the sides as it was spinning.) Do I still have a right to talk about this? Or am I supposed to pack it all in now & never talk about it again?

Pain-free sexual intercourse is a wholly different experience compared to my first attempts at it, which ended with me torn, bleeding & in pain (quite on accident, I assure you.)

I believe some of my exact words upon thrusting were, “My god is this what it feels like to other women? This doesn’t hurt!” There was zero pain. I don’t mean there was minimal pain, a 1 on a scale of 1-10. There was no “Ow!” just, “Oh!”  I felt a warmth and a weight and a fullness. I was even lucky enough to experience some pleasure from penetration – a thing which has always been elusive even when I search for it by my own hand.

I did not experience Dyspareunia. I didn’t tear or bleed. I was… okay. Whole & safe & sound.

I don’t know how I did that.

Is this that “Hope” feeling I have heard tales about? Does it really not have to be painful?

It wasn’t easy, don’t get me wrong. I had to work for it, knowing full well that even with hard work, there were no promises of ever having pain-free sex. The promise remains slippery as a fish. I have been conditioned to feel pain with intercourse, and some anxiety even with other sexual activities.

My ability to have intercourse may still come with a price – I went to physical therapy as usual while my partner was visiting, shortly before attempting intercourse. My physical therapist noticed a rather large, firm lump deep within my left labia. It wasn’t there the week prior. She recommends I see a gynecologist soon regardless (I’m long overdue for a routine pap smear,) and point out the lump to the gyno.
I have a feeling that the lump may be a cyst. With my partner around and indulging in my sexual whims, I was spending a lot more time in a state of arousal than average. I have a feeling my lubrication glands were getting overworked & clogged up. After another day of sexual stimulation, even I noticed the lump – it felt firm & sore. Enough to make sitting & sleeping difficult & requiring a dose of Tylenol.

So although the act of intercourse itself was pain-free, I still wound up experiencing some discomfort afterwards.
“You didn’t think it would be that easy, did you?”

There’s not a lot I can do about that if it’s a cyst. I can take warm sitz baths & give it a rest now that my partner has returned home. But I’m probably at a higher risk of developing cysts for the rest of my life now, following surgery. Although my understanding is that most of the time if you were going to get one, it would have appeared within the first few months post-surgery. Still. Healthy women without FSD can develop cysts so, I don’t feel too inferior about it. Happens to the best of us.

The lump seems to have decreased in size somewhat over the last few days to the point where I’m having trouble finding it again – which is probably a good thing. Perhaps I’ll get lucky & the fluid will find its way out of my body by itself. Maybe the gland isn’t totally blocked, just, clogged & overworked.

As I suspected, sexual intercourse did not change the dynamics of my current relationship. I laughed, I danced, I crowed when I was able to experience this activity so long out of reach.

But it did not change who I am or the state of my relationship.

Without a full understanding of what causes really vulvodynia in the first place, I don’t know if I’m at risk of developing either ever again. Is whatever process that caused it, still floating around within my body? Waiting, latent, biding its time…

I remain cautious, protective, reluctant to lower my guard & freely indulge in this newfound sexual option. Having known vulvar pain for so long, I must forever remain vigilant, lest it rear one of its ugly hydra heads. Will it return? Will one of its siblings pop up, in the form of a string of infections, cysts, muscle tension, pudendal neuralgia, et al? Will the hormonal shifts that happen with menopause drain my libido and cause my vulvar tissue to become inflamed once again? Will I develop an adhesion in the clitoral hood & have difficulty orgasming?

I believe that at least the vaginismus remains in place. I’ll probably have to maintain my stretches, kegels & dilator work long-term to keep it under control. I can still feel my pelvic floor muscles tensing against my conscious orders to relax. They’re doing it right now if I take my mind’s eye off of them.

Psychologically, any improvement or decrease in my mood following intercourse has been short-lived. My outlook & philosophy on life seems to be the same. I am not going to be going out and throwing any large parties. I do not currently feel depressed, either. Sexually, as my vulvar specialist put it, I “Probably won’t be swinging off any chandeliers.” I remain ~some kind of feminist, even as I struggle to cobble together a working definition for myself.

Relationship wise, I cannot detect any change in my or my partner’s behavior or overall mood. My ignorant, mean high school sex ed teachers constantly droned on about how “Sex changes everything,” but maybe it does not always. Or maybe it already did from a few years ago, when we just started being intimate, and we have already worked through the change. After this most recent attempt at intercourse though, we treated each other the same after as we did before. We still enjoy other sexual activities. We still play video games. We still tease each other. We still love each other. We still aren’t married yet, nor engaged.
And we’re both still nervous about intercourse. Some performance anxiety & a fear of pain & injury remains.

After all, sexual intercourse isn’t exactly easy on my partner either. It’s a pretty athletic endeavor and a real production for a pelvic pain patient. The basic setup required lots of materials & tools. It took multiple attempts to get the angles just right and then to actually keep my partner’s penis inserted. I’m definitely not ready for the kinds of positions seen in the kama sutra guides – or ready for more basic positions, either. I’m still figuring out how to line the angles up for spooning, woman-on-top, etc. And being in missionary position requires quite a bit of arm & leg strength, for both my partner and myself. Neither of us were able to achieve orgasm in this manner or maintain the state of intercourse for very long.
Intercourse is a pretty complicated dance and certainly one requiring a lot of practice & patience.

Which isn’t going to be an easy thing for me to have for at least several more months, seeing as I remain in a Long-Distance Relationship.
Which means, I have no idea what the long view looks like. My partner has returned home for a few months, and so I am once again a solitary creature for an unknown length of time. There’s a lot that can happen within a few months. I don’t know what will happen next time I see him. How am I going to do this again?

This may not be over yet. Or even if it is (hopefully,) I might like to continue speaking the words aloud. I know full well that it is possible to have vulvodynia, vaginismus, difficulty orgasming, low libido, and others, to varying degrees and still be able to enjoy intercourse & other sexual activity. Or not. And I still see places where alternate views of sexuality & sexual wellness are lacking. Still a gap needs a bridge.

And so I still feel the need to continue forward.

“Still the road keeps on telling me to go on. Something is pulling me. I feel the gravity of it all.”

I don’t like this sex book

01/04/2009 at 4:59 pm | Posted in book review, sex, Uncategorized, vulvodynia | 2 Comments
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I have a confession to make.

Although I’ve been citing Let Me Count the Ways as a source of information on sexual dysfunction, and I intend to take some of its knowledge with me along my FSD journey,

I didn’t actually like it all that much.

Actually, I had quite a lot of problems with it…

I always hate marking up my books with pencils & pens. I feel like I’m defacing the book.
So I came up with a compromise system…

letmecount-bookview1

Every sticky note represents one or more of my comments on what the authors were saying. Every time I had a thought on something, I wrote it down. I can peel the notes off when I’m finished using them, and the book remains in tact.
Also makes finding pages of interest much faster 🙂

letmecount-bookview2

Obviously I had a lot of thoughts on what the authors were saying. Sometimes, I was in agreement. Other times, I felt highly critical & suspicious.

The book is on the National Vulvodynia Association Reading List. That’s the foremost reason why I got it – the NVA listed it as a book of interest. Having gone through Let Me Count the Ways, I understand why it’s on their reading list – it’s useful for couples experiencing difficulties with intercourse. You don’t necessarily have to have vulvodynia or even be female to find the book helpful.

But on the other hand, I don’t understand why it’s on the NVA reading list, because it never explicitly uses the word “Vulvodynia,” or “Vestibulitis.” So begins my criticisms of Let Me Count the Ways. It refers to pelvic pain several times, including one patient who probably did, in fact, have vestibulitis, as evidenced by the following:

I asked Pam if intercourse was ever painful, and she answered slowly.
…Yes, about half the time.”
…And that was the start of medical treatment for Pam, as well as gradual sexual reconciliation of these nice people. By the time they had been sexual together many times with their hands, mouths, and some sex toys, a minor surgical procedure had eliminated Pam’s vaginal pain, and they could proceed-slowly, with their new sexual and communication skills-to intercourse. And neither Pam nor Pete called Pam uninterested in sex ever again
(Emphasis mine, p. 84-85).

Vulvar vestibulitis is not explicitly mentioned here. It’s possible that Pam still had a strong hymen in place, or something else.
But we’re not talking about her using antifungals or antibiotics, and surgery for vaginismus is… not really there, since it’s a muscular issue.
I speculate that this patient most likely had vulvar vestibulitis – but I have no way of being 100% sure because the authors never talk about it. Pelvic pain is my main concern, but the book is vague on the types of pelvic pain & possible medical causes for it. That’s a real shortcoming. And why, if the authors never talk about vulvodynia directly, is it on a reading list of books relevant to vulvodynia? This would fit more comfortably on a list of general sexual education books.

Instead, for the most part, the authors place a strong emphasis on erectile dysfunction, failure to communicate, and sexual boredom.
None of which applies to me right now.

Despite the authors’ openness to gender play as a sex activity, I felt the patients used as case study examples throughout the text adhered to stereotypical male/female gender roles. Patient Sam is a ruggedly handsome carpenter (20,) John is another carpenter (80). (There’s a joke here somewhere, I just know it.) Vera is a small, attractive psychologist & new mother (48). Pam is a “Tall, graceful teacher” (84). Karen is a petite redhead travel agent (191). It goes on.

The examples may be based on factual cases. They may be reflecting the greater demographic – certain fields are still dominated by one sex. Or maybe the authors embellished actual cases in the interest of humanizing the characters for the readers.

Still, something put me off about not seeing any male grade school teachers, male nurses, or female executives. Why did the authors point out some of the patients jobs & attributes, but not others? What does being a travel agent have to do with anything?

On a positive note, the case studies do deal with people of various ages, young & old. There’s no ageism.

But then on a negative note, the book explicitly mentions one patient of Asian decent, but does not go out of its way to point out patients of other backgrounds.
Why did Klein & Robbins point out this one Asian patient? Why not use case studies with Black or Hispanic patients? Why so few ethnicities?

I wonder why their patient pool lacked more diversity. After all, if a thie Ebony Magazine article is any indication, blacks can deal with sexual dysfunction, too.

For all this talk about sexual diversity the authors go on about, there wasn’t much diversity in their patient examples. That might be a turn-off for nonwhites & non heterosexuals slogging through this text.

There were no homosexual couples. There were no transgendered people. This makes some sense in that the book is all about going beyond the borders of intercourse as defined by one man, one woman – but it doesn’t get into communication & sexual problems that can still pop up in non-heterosexual relationships.

Perhaps this is just a marketing thing. Or perhaps it is reflective of the authors’ own privileged backgrounds – maybe they didn’t even realize they left out minorities.

Another criticism is that, although the book remains on the NVA reading list, it’s dated now. This isn’t the book’s fault but… it is 11 years old. And it is showing its age.

11 years down the road, we can look back at the author’s statements in hindsight and say “What are you talking about?” The book was published before Sex & the City, and well before Web 2.0. Back in 1998, the internet was still fairly new in homes – that’s the same year I finally got a computer, primitive by today’s standards.

Klein & Robbins bring up the internet several times throughout the book and talk about how it was to revolutionize sexuality. And indeed, it’s made things more interesting. There are now social networking sites where you can find partners interested in the same things as you, and for better or worse, porn sites are common. You can buy sex toys online and have them delivered right to your door in nondescript packaging.

The authors make a vague reference to Teledilonics on page 190, but the technology still isn’t there yet. They overshot this one…
This isn’t a major criticism, since it’s not the book’s fault it’s so old & busted.

There’s a couple of other passages I’m not comfortable with.

In talking about expanding the definition of “Sex,” the authors encourage looking at the world from a different perspective – a more erotic perspective. “Once all of you is an erotic being, and all erotic activities are equal, the entire world is a sex toy… You and your partner can walk down the street and speculate about the kind of underwear the other pedestrians are wearing – if any” (140).

I like the idea of expanding the meaning of sex, and I like the idea of taking a different perspective, but… I’m not comfortable getting behind the last of this statement, which I have bolded. This sounds like the authors are encouraging sexual objectification.

I’m not okay with it when guys make snide comments to me on the streets or whoop at me out of their car windows. I really don’t like being sexually objectified. When I’m with my partner or maybe a close friend, I appreciate having the sexual side of me acknowledged & respected… but I can do a lot of different things besides just that one sexual component. I am not just a toy.

I don’t think I would like it if people ogled me & speculated about what underwear I’m wearing – at least, not if I knew it. And sometimes, the objectifier makes it blatantly obvious that he or she is completely sexualizing you, by making some kind of “Tell.” A vocalization, an uninvited pat on the behind, following you around… There’s debate about how much you yourself can actually do about it, too, for risk of a violent backlash if you correct the objectifier.

Dude, I don’t even know you. Let me be. Go eroticize that telephone pole over there instead.

So I’ve not yet come to terms with “Eroticizing everything,” at least, not when “Everything” includes “everyone.”

Then there’s one passage that really bothered me… one that really stood out as strange… this one bothered me the most, I think.

Warning: Possible sexual assault triggers

It goes like this.
“One can observe the clash of competing sexual values within American culture in many contexts: … universities claim to support women’s independence but pass rules to hold men accountable for female students’ drinking…” (emphasis mine, p. 60.)

Wait, what? There’s no elaboration here on what they mean by that. I know the rest of the context is that they are discussing some contradictions in sexual values in the US. Other examples included pre-teen access to contraception but a lack of sexual education & conservative Christians opposing abortion but refusing to prevent it from happening in the first place by providing access to contraceptives to teens (60).
I can’t ask the authors what they mean by the sentance in question about college students drinking, but I have a pretty good idea…

I have a sneaking suspicion that Klein & Robbins are referring to the relationship between alcohol consumption & sexual assault on college campuses. And it sounds to me like they are blaming the female victims when that happens. This line reads to me very much like “Why should guys be punished for what happens to college women when women drink? It’s their own fault.” That is what I am hearing.

Once again I must point out the obvious: It is not the fault of the victim; the onus is on the perpetrator of sexual assault. This is a particularly bad implication to make when you’re writing a book about sexual dysfunction. Are the authors really that short-sighted that they do not see how a sexual assault could in and of itself lead to some sexual struggles later on in life?

Am I reading this wrong? Am I looking too far into this? Do you see where I’m coming from?
Tell me now, does this sound like victim blaming to you? It sounds like victim blaming to me.

It’s possible that the authors are referring to other alcohol-related problems that female students may encounter, such as cutting into study time and dealing with hangovers on school days, but this is the big giant red flag that jumps out at me. There’s no way for me to ignore that.

Triggers end here

I’ve never been really good at “Take it or leave it.” Sometimes, I read things that I really like, and then the author screws something up & I don’t like it as much anymore…
But at the same time, I don’t want to leave behind the good parts. This is another one of those times where I am just going to have to cherry pick what I do like, and criticize the rest. Some parts of this book are flawed, and these parts need to be criticized. Klein & Robbins can not be called THE experts on sexuality because they tarnish their own reputation, for the reasons outlined above. I am not going to sing blind praises for Klein & Robbins.

I would also recommend against further purchases of this book, unless you are one or more of the following:
A collector of sexual education literature
A collector of out-of-print books
A collector of NVA reading list books
Genuinely curious to find out “Oh is it really THAT bad?”
In posession of unlimited time & money – because the book is out of print, you’ll probably have to pay extra to get it, and it takes time to read.

I think there are better, more sensitive books out there than this.
And I think I may have found one of them, which I can review at a later date.

Welp. The authors themselves stated that when creating your own definition of sex & tapping into your own eros, you’re probably going to encounter a lot of ambiguity.

I guess this book is in and of itself, one of those ambiguous situations.

On “Normal” sex

12/06/2008 at 2:41 am | Posted in general, sex | 1 Comment
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It seems that the ability to have sexual intercourse, and to prefer it over all other types of sexual activity, and to perform at some quantifiable level, is the norm for adults… and I suppose that’s also viewed as normal for some of them-thar teenagers having sex. We see actors & actresses having this type of sex often enough on mainstream television and in movies. When hot naked sex scenes aren’t explicitly depicted, there is still plenty of innuendo to allow the reader to fill in the blanks. The camera pans over to a couple in bed with the sheets pulled up to their chests. Mom & Dad walk in on a young couple lying face-to-face naked in the boyfriend’s bed. A cop knocks on the window of a car with sweaty scantily clad people in it.

Now before you tune out about “Oh god another post about sex in the media and how it’s bad for the moral fiber of the country oh god I’ve already heard this one a million times,” let me assure you:
This is not about whether is “Too much sex” in the media, or among teenagers, or outside of wedlock.
This is not about whether or not “Too much sex” is inherently bad for the health & morality of whatever country you’re living in.
Indeed, it seems that what I’m saying between the lines is actually, “There is too little variety of sex in the media and in conversation.” Forget about the given quantity of sex we see – why do we see one type of sex so much to the exclusion of others?
This is about the quality of the sex surrounding us.

When movies want to deal with other kinds of sexual activity besides intercourse, the alternative activity needs to be named, because normal “Sex” means “Intercourse.” It does not mean, “Oral, anal, kinky, et al.” It means one man puts his penis in a woman’s vagina and thrusts for awhile until one or both orgasm. When referring to other kinds of sexual activity, the specific type in mind will need be called its proper name, or a slang term. Doing so requires more work on the part of the viewer and the speaker to point out that no, we are not dealing with intercourse. Depending on whether we’re dealing with a comedy or a drama, the sex scenes depicted – both intercourse and not – will be treated with varying degrees of dignity & respect.

It is worth noting an example here of the sexual double (or multi?) standard – The teen classic coming-of-age sex comedy, American Pie does treat sexual intercourse with much more respect than it does oral sex & masturbation. When the main male characters do eventually have intercourse their female partners, two of the scenes slow it down & aren’t very funny at all. Romantic music plays. In the rest of the movie, oral sex & masturbation were the laughingstock.
I wonder why that is (except not really.)

But sometimes sex doesn’t come so easily for some of us.
At least, not that kind of sex, the default meaning. Intercourse.
And it’s kind of a bummer to be constantly reminded of that.
It may not have been the smartest move on my part when I watched, Boogie Nights while experiencing peak vestibulitis.

When you have FSD, this standard definition of sex may be out of reach – at least, hopefully, temporarily. When we treat intercourse as the default, it creates anxiety & pressure to perform on a level that may be too far out of reach for some. We can do lots of other neat, interesting things – but we can’t do this one simple task that so many others can.

Sex therapists, (such as Klein & Robbins,) some doctors & some patients with sexual dysfunction will advise expanding the defnition of sex beyond the borders of penis-vagina man-woman intercourse. This is good advice – it’s much more useful than “Have a glass of wine and relax,” since, don’t you think we’ve tried that already? Such a view reduces pressure to perform & creates a more relaxed atmosphere with regards to other sexual activity.

We must expand the meaning of “Sex” beyond just “Intercourse.” That is the default meaning of sex when it is not otherwise elaborated upon. That is “Normal” sex. Other types of activity must be explicitly spelled out. The audience’s reactions to such alternatives may vary from disgust to amusement.

When you can’t have the default definition of sex, it can be very easy to fall into the trap of sexual avoidance. “If this activity can’t end in intercourse, then there is no reason to pursue it. I will only wind up disappointing my partner and myself. He (or she) really only wants this one thing which I cannot do… to do otherwise will be a letdown.” A few people may trudge onwards through distressing intercourse anyway, goaded on by a sense of duty – but this can worsen painful and/or distressing symptoms & lead to feelings of resentment for one or both parties involved.

Sometimes, when you have FSD, you gotta get real creative, real quick.

So I’ve expanded my definition of “Sex” to include sexual activity besides just intercourse. Intercourse isn’t working for me right now, but I can still do lots of other things. You don’t necessarily have to turn off your turn-ons. Just keep an open mind.

I suppose you could say to me, “That’s easy for you to say.” I’m one of the lucky ones – I’m sexually greedy enough so that I’m not willing to stop having other types of sexual activity with my partner.
But I am in a long-distance relationship too. That means my partner & I are used to going long periods of time without partnered sexual activity. And when we do get together, it always takes awhile to become re-acquainted with each other physically. That means that we have to slowly explore each other’s bodies & experiment each time we see each other.

Okay so I’ve expanded my definition of sex. I take satisfaction from the non-intercourse sexual activities. I still get to have fun & satisify my partner. Whatever I do doesn’t necessarily have to lead to intercourse or even orgasm.

The alternatives can be the obvious ones I’ve already mentioned – oral sex, anal sex, masturbation – as well as some more creative works.
Some alternatives suggested by Drs. Klein & Robbins include but are not limited to:

Integrating sex toys
Massage – regular or erotic

Mutual or solo masturbation
Sharing & executing fantasies
Dancing – for or with your partner
Showering/grooming with your partner
Making your own porn with the camcorder
Reading erotica or watching porn together with your mate

(All paraphrased from Let Me Count the Ways.)
Their big theme is emphasizing “Outercourse” rather than intercourse, which can be considered a state of mind (141).

Not listed here but coming to me just off the top of my head is cybersex.

Not that you have to do any of the things on this list, if you or your partner are uncomfortable doing so. When it comes to sex (the wide and narrow meaning,) consent and safety come first.

And not that this list is all-inclusive. You can probably think of a lot of fun, interesting things you’d like to do that I didn’t list here!

We can get into a tricky spot when we start thinking about some of the sexual alternatives – keeping an open mind like means we may have to confront our negative feelings about certain kinds of sex. If intercourse is “Normal,” then are the alts “Abnormal?” (And I’m thinking to myself here, “No, of course not.”) Sometimes we may even have to weigh the social consequences of engaging in such activity. Dealing with FSD might be as good a time as any to think about BSDM & kinky (yet still non-penetrative) activity. Maybe we shouldn’t be so quick to dismiss all pornography everywhere. Is a facial shot another expression of the patriarchy degrading women, or a safe, non-penetrative, pain-free alterantive to intercourse? Klein & Robbins warn the reader that we when we do explore alternative forms of sexual expression, we may have to deal with some ambiguity. I’m not sure that even I will be able to fully resolve my own mixed feelings regarding some sexual activities.
But maybe I can live with that.
After all, ultimately the choice of sex – under this expanded definition – must be that of the individual’s.

I have but one problem with expanding the definition of sex, and really it may not be a problem at all –

I still want to have that default definition of sex, too.
Despite all my setbacks and all my failed attempts – I still want to have intercourse with my partner.
I don’t want to remove “Intercourse” from the meaning of “Sex.” I still want to include it.

Luckily most of the people I’ve encountered in my life want me keep the option of intercourse on the table. My doctors, my boyfriend, my friends, and even my family, all want me to to have a healthy sex life & enjoy intercourse.

But perhaps we can de-emphasize intercourse and raise the alternatives higher up the list when we talk about sex. Perhaps for some of us, intercourse is something that will only be available on the menu on a rotating basis. A “Special,” if you will, or a desert rather than the main course. A lovely treat, but all the items on the menu are delicious as well.

You don’t necessarily have to give up on sex just because you aren’t having “Normal” sex.


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