Vaginal and Vulvar Pain
- My vaginal opening feels very tight and when I insert a finger it is uncomfortable to the point of being painful. Is this lack of use or just vaginal dryness? For some reason, I am suddenly always horny and would like to be active with my husband.
- I have severe vaginal atrophy and dryness. I use Replens and a topical lubricant, but they barely help. Because of multiple family members with breast cancer, two gynecologists said, “Absolutely not!” to hormone replacement. Even if I touch myself indirectly, it hurts incredibly. It’s like my vagina is raw.
- I am unable to have sex with my husband due to my pain. When he tries, it feels like I’m tightening the muscles without realizing it or meaning to I’m suffering and so is my husband because we can’t have sex anymore.
- I can get aroused and I want to be sexually satisfied—I’m itching, squirming and don’t get a second’s sleep all night long. Sometimes I try to please myself gently, but touching is too painful, and I can’t reach orgasm. If I keep trying, I’m in pain for three or four days.
I keep getting questions such as these about vaginal and vulvar pain. It’s a big problem. Rather, it’s many big problems, because genital pain can be caused by a variety of medical conditions. You can tell that the examples above all have pain in common, but the type of pain, location, and what provokes it vary.
It’s essential to determine what condition is causing your pain, because each condition requires its own treatment. If you only know that it hurts, but you don’t know what is causing your pain, you can’t know how to treat it. That’s why your course of action should include these:
- Pin down your symptoms exactly, and learn as much as you can about what might be causing your pain. An
excellent new book to help you do this is The Vagina Bible: The Vulva and the Vagina—separating the Myth from the Medicine by gynecologist Jennifer Gunter. The second half of this book is a comprehensive resource about infections, conditions, symptoms, and treatments for sexual pain.
- Find the right medical professional to help you. If your gynecologist doesn’t take the time or have the skills to figure out why you’re in pain, ask for a referral. Don’t let your doctor dismiss you with “Why do you care about sex at your age?” or a similar attitude. If you hear that, divorce your doctor and find a new one who is sex-positive and age-positive.
- A pelvic floor therapist is trained to diagnose and treat sexual pain and might be the best professional for you. Find a provider here.
What can you do about sex meanwhile? If you’re partnered, be honest with your mate about what you’re feeling. Expand your sexual expression to include activities that arouse you and your partner without hurting you. If vaginal penetration hurts, but the vulva welcomes touch, explore ways to arouse yourself that bring you pleasure without pain. If all genital touching is painful, are there other erogenous zones on your body that invite erotic caressing? Are there ways you can pleasure your partner that you’re happy to do? Please view my “Great Sex Without Penetration” webinar: 90 minutes filled with helpful information and suggestions.
More about The Vagina Bible, which I recommend wholeheartedly: Dr. Gunter offers individual chapters on five sexually transmitted infections, seven vaginal/vulvar conditions, and six sets of symptoms. She explains clearly what each condition is, how it is diagnosed, and treatment options.
For example, tightness of the vaginal opening might be pelvic floor muscle spasm (PFMS), where the muscles that wrap around the vagina spasm and cannot relax, making penetration excruciating or impossible. This may feel like the vagina has shrunk and is too narrow, or it may feel like a roadblock is preventing penetration. Vaginismus is a type of PFMS where the muscles spasm only before sexual penetration, not all the time.
Most women have never heard of PFMS and most of the other conditions that can cause vaginal or vulvar pain, which is a statement about our society’s hush-hush attitude toward women’s sexual symptoms. We all know about erectile dysfunction, right? But how many vaginal conditions can you name? In Dr. Gunter’s words:
Pain with vaginal intercourse affects up to 30 percent of women. While for many women this is temporary, it can be very distressing. What is also upsetting is many women do not get a diagnosis, never mind therapy. Some women are led to believe that pain with sex is normal or that it is somehow their fault. Pain with sex is a medical condition.
Bottom line: If you have pain, read the relevant chapters of “The Vagina Bible,” then, armed with this information, consult your doctor.
Some additional resources:
- Painful Sex: Where to Go for Help. More resources and an overview of some reasons for vulvar/vaginal pain.
- Vaginal Renewal™ program from A Woman’s Touch Sexuality Resource Center: Self-help program for maintaining a healthy vulva and vagina after menopause.
- A Senior’s Guide to Lubrication: A good lubricant is essential for comfort, whether you experience pain or just the normal dryness of aging.
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This article was originally published in a slightly different form in October 2019 as “Ask Joan: Intimate Pain” on Senior Planet, where Joan Price answers questions in her monthly column.
Rekindling Desire (3rd Ed.) by Barry and Emily McCarthy
Rekindling Desire (3rd Ed.)
by Barry and Emily McCarthy
Reviewed by Mac Marshall, PhD
“The most disruptive sexual problem is low desire.”
Do you find that you have little desire for sex with your partner? As a couple do you have sex only a few times a year, if at all? Does one of you want more sex than the other, resulting in arguments, recrimination, blame, and hurt feelings? Are you convinced that your “sex light” has gone out? Do you wonder how to bring back intimacy in a marriage? To rekindle desire is to revitalize, reawaken, and reignite it, and that is the focus of Rekindling Desire (3rd Ed.) by Barry and Emily McCarthy. Their motivation for writing this book is to provide “new insights, support, and hope for couples facing desire problems, a no sex or low sex relationship, and desire discrepancy.”
In our youth and young adulthood, most of us experience spontaneous desire, driven by our hormones. Typically as we age, the hormonally triggered desire for sex becomes less pressing. Many people begin to feel less sexy, less desirous, in and beyond their 40s. That doesn’t have to be the end of sex! We can revivify the relationship by understanding “responsive desire.” Learning to give each other sensual pleasure, including plenty of touching, will stimulate responsive desire for sex in both partners.
Rekindling Desire will be of particular help to those in low-desire relationships, or to couples where there is a discrepancy in desire, with one person pursuing sexual connection while the other distances. It offers thorough explanations of what sex therapists have found to be effective for resolving sexual problems and dysfunction resulting from low desire.
This 247-page book is organized into three parts: Awareness (5 chapters), Change (6 chapters), and Relapse Prevention (4 chapters):
- When and Why Couples Lose Sexual Desire. “Desire problems can occur among all types of couples and all age groups.”
- Whose Problem Is It? Hers, His, or Ours? “Sexual desire and desire problems are best understood as a couple issue.”
- Turnoffs: Poisons for Sexual Desire. “A myriad of psychological, bio-medical, and social/relational factors can poison desire.”
- Finding Your Voice: Celebrating Female Sexuality. “The biggest mistake people make is to define female sexuality narrowly. Sex does not equal intercourse. Sexual satisfaction does not equal orgasm.”
- The New Male Sexuality: Confronting Autonomous Sex Performance. “For the great majority of males…sexual dysfunction causes low desire. The main male sexual dysfunctions are premature ejaculation (PE), erectile dysfunction (ED), and ejaculatory inhibition.”
- Being an Intimate Sexual Team: Discovering Your Couple Sexual Style. “Your couple sexual style has two dimensions: first, how to balance each person’s sexual autonomy (“sexual voice”) with being an intimate sexual team; second, how each couple sexual style integrates intimacy and eroticism.”
- Building Anticipation: Bridges to Sexual Desire. “The prescription for sexual desire is positive anticipation, an emotionally intimate relationship, nondemand pleasuring, erotic scenarios and techniques, sharing orgasm, feeling emotionally bonded and satisfied, and maintaining a regular rhythm of sexual contact.”
- Attachment: Enhancing Intimacy. “The essence of intimacy is feeling emotionally open, securely attached, and personally valued.”
- Nondemand Pleasuring: Let’s Play Touchy-Feely. “Pleasuring includes affectionate, sensual, and playful touch, both inside and outside the bedroom.”
- Challenging Inhibitions and Avoidance: Be Sexually Present. “It is both an individual and couple task to increase awareness and challenge inhibitions.”
- Creating Erotic Scenarios: Vital Sexuality. “The essence of eroticism is scenarios and techniques that increase anticipation, subjective and objective arousal, and erotic flow. This includes, but is not limited to, intercourse.”
- Maintaining Gains: Keeping Sexuality Vital and Satisfying. “The core of relapse prevention is awareness that intimacy and sexuality need continual time and energy.”
- Intimate Attachment: Enhancing Your Bond. “Intimacy dates are a powerful resource for preventing relapse and reinforcing relational satisfaction.”
- The Erotic Marriage: Lusting for Life. “You need to challenge routine and mechanical sex, which is a death knell for desire. Eroticism….must be actively cultivated.”
- Valuing a Satisfying, Secure, and Sexual Relationship. “Commit to maintaining a vital sexual bond. Try to go no longer than 2 weeks without some kind of sexual contact. Sex cannot be taken for granted or treated with benign neglect.”
Each chapter is packed with information and also includes a case study, an exercise, a summary, and key points. This is a book you’ll want to study, not read quickly.
In Barry and Emily McCarthy’s view, rekindling desire relies heavily on a couple’s ability to engage in frank, clear, nonjudgmental communication. They see their book as an adjunct to therapy for those who wish to reawaken intimacy and passion in their relationship. “This is a book of ideas, guidelines, and exercises, not a ‘do it yourself’ therapy book,” they state. “It is not a substitute for sex, couple, or individual therapy.”
Barry McCarthy, PhD is a professor of psychology at American University, a diplomate in clinical psychology, a diplomate in sex therapy, and a
certified couple therapist. He is the author of over 100 articles, 33 book chapters and 21 books. He has presented over 450 professional workshops nationally and internationally. He received the SSTAR Masters and Johnson award for lifetime contributions to the sex therapy field.
Emily McCarthy received a B.S. degree in speech communication, and her writing and wisdom provides a balanced humanistic perspective. This is Barry and Emily’s 14th co-authored book. They have been married for 52 years.
Purchase Rekindling Desire (3rd Ed.)
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Mac Marshall, PhD is a retired anthropology professor, researcher, and author who is delighted to explore sexuality studies at this time of his life.
Arcwave Ion Review
by Shamus MacDuff
If you enjoy fellatio from a skilled, pleasure-giving partner, then you will like the Arcwave Ion, a new stroker sex toy for penises that feels more like a blow job than any other sex toy I’ve tried.
The Ion is innovative and unusual. It uses the same Pleasure Air Technology that the Womanizer pioneered for vulva owners, now re-engineered for the penis.
The lower half of the Ion contains the motor and controls, and the upper half is of soft silicone with a ribbed “tunnel” into which the penis is inserted. First, rub some water-based lube inside the tunnel and on your penis. Then situate your frenulum over a round hole in the base. Once the Ion is turned on, you will be also!
The three control buttons are easily accessible and increase or decrease intensity through eight levels. The sensations are so pleasurable and unusual that an orgasm rapidly results. While it works best with an erect penis, the Ion will also accept a flaccid one.
How Does It Work?
The Pleasure Air Technology sends pulsating airwaves to Pacinian pleasure receptors in the frenulum, producing sucking and massaging sensations that lead to powerful orgasms. Pacinian corpuscles in the frenulum are analogous to those in the clitoris. They are nerve endings in the skin that are highly sensitive to vibration and pressure.
“Female Orgasm for Men”?
That these corpuscles occur in the frenulum as well as the clitoris has led Arcwave to claim that the Ion produces “a female orgasm for men.” This strikes me as both odd and counterproductive. Odd because it is impossible for one gender to know what another gender’s orgasm feels like. It’s counterproductive because few penis owners—whether gay or straight—wish to experience a female orgasm. The quick, strong male orgasms that the Ion facilitates stand on their own and needn’t imitate female versions. To me, this strange marketing strategy seems to turn Freud’s infamous idea of penis envy on its head.
More Pros:
- Fully waterproof!
- The 6-inch long Ion twists apart into two halves for easy cleaning.
- The Ion comes in a handsome 8-inch-tall hard plastic case that charges the Ion during storage.
Just a Few Cons:
- The Ion is rather noisy, sounding like a large dog lapping up water (other reviewers have likened the noise to a bike pump or a small pneumatic drill),
but that did not detract from my enjoyment. - The combination of the Ion and its charging case is bulkier than other penis toys so it would be less convenient to carry in luggage on trips.
- It is not designed for partnered sex (unless your partner likes to watch).
Bottom Line:
The Arcwave Ion adds a delightful and very interesting new experience for penis pleasuring. The Arcwave Ion joins an outstanding group of other penis toys, such as the Manta from Fun Factory and the JETT and Pulse (in several iterations) from Hot Octopuss.
Personally, I am very happy to have this new toy, and I predict you will be, too. It may just launch your level of pleasure into the ionosphere!
See the Ion in action
Thank you, Arcwave, for providing the Arcwave Ion in return for an honest review.
— Shamus MacDuff, age 77, was oblivious to the delights of sex toys for penises until about three years ago. He’s been making up for lost time! Read his other posts here.
Love in the Time of Corona by Diana Wiley
Reviewed by Mac Marshall, PhD
Echoing the title of Gabriel Garcia Marquez’s novel, Love in the Time of Cholera, Diana Wiley, PhD wrote Love in the Time of Corona during the early months of 2020 as a “guide to redeem, refresh, and renew your relationship while in quarantine.” She is a marriage and family therapist and sex therapist now in her 70s. Given the stresses of the COVID-19 pandemic, Wiley’s main message is that “enjoyable sexual activity between partners can distinctly benefit a couple’s mental and physical health.”
The information in Love in the Time of Corona is relevant for couples of any age, and especially helpful to seniors who are more likely than younger adults to have been in a year-long lockdown.
Wiley’s book is 144 pages of larger-than-usual type for easy reading. It is organized into ten chapters covering these topics:
- Communication. “While you are adapting to each other’s personal habits during quarantine, you could also use this unusual time as an opportunity to learn more useful information about your partner.”
- Planning for Sex Dates. Have and express clear intentions, and then “Take time to communicate and agree on what each of you wants from your date night at home. And then set the date.”
- Mindfulness About Sex. “Entering a mindful state during lovemaking can help you be more present in the moment so you can fully surrender to sexual ecstasy. It helps you get out of your head and into your body.”
- The Importance of Touch. “How you touch your partner (and how your partner touches you) can sometimes be tricky to navigate, even under the best of circumstances. But when you are’ locked down’ together, as during the COVID-19 pandemic, the stakes can be higher because of the increased stress and anxiety inherent in the situation.”
- Suggestions for Sensory Revitalization. Limit screen viewing, get outdoors often, learn a new skill, and regulate your consumption of news. Enjoy food and music, pamper your body, and explore different kinds of kissing. “Having good sex is such a grand, multi sensory experience of intense pleasure” that no one “should be ashamed to claim this biological heritage.”
- The Need for Laughter and Playfulness. “Humor, and the playful spirit that often accompanies it, has detoxifying and defusing effects that go a long way toward keeping relationships intact.” Wiley observes that “couples who laugh together last together.”
- The Significance of Novelty. “Novelty offers a myriad of benefits in addition to increased sexual charge. Researchers have discovered that the desire to have new experiences…is positively associated with much of what helps us thrive in the world.”
- Learning More About Sex. “Did you know that people who have more sexual knowledge are more confident in their sexual conduct?” This chapter recommends a variety of books, instructional videos, podcasts, and interactive online courses.
- Expressing Gratitude to Each Other. Minimize criticism. Manage your frustrations. Express thankfulness more often: “It’s an easy, simple, and surprisingly effective survival strategy for your relationship during this time in quarantine.”
- Recommit to Your Relationship. “This pandemic can serve as an excellent opportunity to
reexamine and clarify your values. Sit down with your partner and share your hopes and dreams.”
Wiley’s writing style is engaging and conversational. Her suggestions will help you engage more fully with your partner. You’ll come away convinced (or reminded) of the central importance of sexual pleasure for strong, happy human relationships.
Learn more about Diana Wiley:
- Dear Dr. Diana: A Sex Therapist’s Advice for Couples in Quarantine
- Dr. Diana Wiley: Licensed Marriage & Family Therapist, Board Certified Sex Therapist
- Purchase Love in the Time of Corona
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Mac Marshall, PhD is a retired anthropology professor, researcher, and author who is delighted to explore sexuality studies at this time of his life.