What's Sex Got to Do with It?

This post was written by H&W instructor Dee Hartmann PT, DPT. This year, H&W is thrilled to be offering a brand new coure instructed by Dee, Assessing and Treating Women with Vulvodynia.This course will be offered in September in Waterford, CT.

What's love (and sex) got to do, got to do with it?

Tina Turner said it well. (Obviously I’m taking a little liberty here.) Some think that love and sex go together, you know, like bread and butter. Others? Not so much. Many think that love thrives even though the sex may slow down because of things like babies, work, stress, dinner with friends, and cleaning the bathroom…you name it. A lot can come between you and a good bedroom romp. But what if those bedroom romps had NEVER been good? What if the only fireworks you remember when earning your womanhood badge were akin to hot, searing sparklers—held way too close for comfort above your knees and between your legs. What’s with that, right?

Tina goes on “…that the touch of your hand/makes my pulse react…”. We all remember that feeling, that first titillation. It was there “…It’s physical/Only logical/You must try to ignore/That it means more than that”.

Boy meets girl. Hugging. Touching. Kissing. All that normal stuff that’s so good. Further progression might be awkward and clumsy but ‘it’ usually works nonetheless. But not always. Sometimes, the sex afterglow is more like, “Wow. That was way overrated…and who lit the fire in my vagina?” That burning pain lingers for days and celibacy, though considered, doesn’t really seem like a good alternative. You try again and again and along with more failed attempts, the pain gets worse. Your brain begins to think that any time anything comes too close to your vagina – like a tampon, fingers, a vibrator, the doctor, or a bicycle seat – it needs to shut the doors for business. As we say in the business, the pelvic floor muscles go into overdrive. Everything can get a bit goofy. You become all too familiar with your work bathroom as your bladder doesn’t seem to want to hold as much as it used to. Emptying your bowels becomes an effort. And those tampons that wouldn’t go in? Now you know why. There’s no room for anything down there! Armed with the sparkler analogy, the only help you get from most medical providers is “just relax, honey” or “have a glass of wine first” or “maybe your boyfriend/husband is just too big for you.” That stinks. And it’s not normal. Sex and reproduction (remember we’re the only mammals—besides dolphins—who do it for fun) are built in to our primitive brain, just like breathing and eating. “It may seem to you/That I'm acting confused/When you're close to me/If I tend to look dazed.” After the whole relaxing and drinking things fail and you kind of like your partner’s parts, what’s a girl to do?

“I've been taking on a new direction/But I have to say/I've been thinking about my own protection/It scares me to feel this way.” Once pain and fear have taken the place of excitement and arousal, your sexual future may appear less and less clear. As you and your partner begin experiencing nothing but frustration, there are my tips for making it through this tough stage.

1) Your best tool is always communication, communication, communication. First and foremost, sex should never hurt. Never. Ever. Discuss it with your partner long before you’re in bed, the lights are out, and you’re pretending to be asleep to dodge foreplay. Desire and arousal go together to create increased blood flow and lubrication, but no one can deny that it’s pretty hard to get excited about a hot stick in the eye (my analogy). Fear of impending pain can throw a wet blanket on the whole idea of sex unless you’ve agreed first to work together.

2) You may have learned to fear touching because of where it might lead, but avoiding hugging, touching, cuddling, and kissing is the first step in the wrong direction. Enjoying your partner’s touch—sexual or not—is a prerequisite for good love-making and will make you both happier in the long run.

3) Make a deal that there will be no sexual contact until you’re ready and will help you to begin dealing with the pain. Keeping your love alive matters for your relationship. Holding back in resentment and fear of the next sexual move chips away at the trust you’ve built.

4) As you begin to regain control, try to be the intimacy initiator at least once a week (or some predetermined time frame). Getting yourself mentally prepared goes a long way to gently urge arousal. Often it takes putting a sticky note on the fridge or work computer screen to remind you to think about it during the day (we women have so many other more important things to think about; sex, even in the best of times, usually doesn’t make the top five). Partners love it as they’ve usually shut down their advances to avoid yet more frustration, rejection, and heartache.

5) Once you’re ready to go for it, remember that your body that might not be too excited about entertaining an extended stay visitor. By agreeing to short visits in the beginning, the brain catches on and doesn’t shut down into protection mode. Go for more foreplay rather than less. Then, once his climax is close at hand, actual penetration time is kept at a minimum. You’ll be happier. He’ll be happier. And your vulva will appreciate the plan.

And here’s where Tina and I part ways. She may have gotten to go on singing (and making millions), but I get to gently guide women to their desired sexuality. Incredible women fill my office every day and continue to amaze me with what they’re able to do with and for their bodies. I don’t fix anyone. Instead, I help them find the power they need to fix themselves. “What's love got to do, got to do with it/What's love but a sweet old fashioned notion.” Call me old fashioned but I can’t think of a greater gift as women’s health PTs than to be able to help women feel more comfortable as women. And to think they call this work!

Want more from Dee? Consider joining us for the Septmber course!