Libido Issues

[Heather34]

Hi ladies. One of Dr. Pacik’s treated patients writes:

“I had botox for my primary vaginismus almost a year ago. I managed to achieve intercourse two weeks after the procedure I was so pleased. I dilate most days whenever i can with the purple and pink dilator mostly and sometimes the blue but I feel the pink is an adequate size for me to achieve intercourse. During sex with my boyfriend I have no feeling of pleasure of any sort, most of the time I don’t feel pain when I am in control meaning I am on top and I am doing all of the thrusting. I feel pain and discomfort if my boyfriend thrusts so we have only managed the me on top position. Before I have intercourse I always dilate for at least and hour and 45 mins to prepare my vagina, we use plenty of lube too, I always find that if I leave the dilator in my vagina right up to the moment before my boyfriend and I have intercourse that this is when intercourse is most comfortable. We don’t do that much foreplay because I don’t like the feeling In my vagina when the dilator is inserted. During intercourse I can feel my boyfriends penis going in and out of my vagina at the entrance muscle but I have no sensation or pleasure at all it feels as if my vagina is numb past that point. Intercouse only lasts about 10minutes at a time and doesn’t happen too often. I can achieve orgasm through clitoral stimulation and most of the time i do but sometimes I don’t reach climax at all with my boyfriend. I feel that lately I don’t get as turned on as i used to and don’t have the desire for any sexual stimulation but I still carry out intercourse to pleasure my boyfriend while getting no pleasure from it myself.”

What tips, suggestions, advice can you provide ladies???

[Heather34]

Hi ladies. One of Dr. Pacik’s treated patients writes:

“I had botox for my primary vaginismus almost a year ago. I managed to achieve intercourse two weeks after the procedure I was so pleased. I dilate most days whenever i can with the purple and pink dilator mostly and sometimes the blue but I feel the pink is an adequate size for me to achieve intercourse. During sex with my boyfriend I have no feeling of pleasure of any sort, most of the time I don’t feel pain when I am in control meaning I am on top and I am doing all of the thrusting. I feel pain and discomfort if my boyfriend thrusts so we have only managed the me on top position. Before I have intercourse I always dilate for at least and hour and 45 mins to prepare my vagina, we use plenty of lube too, I always find that if I leave the dilator in my vagina right up to the moment before my boyfriend and I have intercourse that this is when intercourse is most comfortable. We don’t do that much foreplay because I don’t like the feeling In my vagina when the dilator is inserted. During intercourse I can feel my boyfriends penis going in and out of my vagina at the entrance muscle but I have no sensation or pleasure at all it feels as if my vagina is numb past that point. Intercouse only lasts about 10minutes at a time and doesn’t happen too often. I can achieve orgasm through clitoral stimulation and most of the time i do but sometimes I don’t reach climax at all with my boyfriend. I feel that lately I don’t get as turned on as i used to and don’t have the desire for any sexual stimulation but I still carry out intercourse to pleasure my boyfriend while getting no pleasure from it myself.”

What tips, suggestions, advice can you provide ladies???

[Darcy@CSCSNH]

This is a very common question that I hear from many of my patients. Once the painful penetration has been overcome there is a joy and elation that intercourse has finally become successful. However, the newness of this experience wears off once sex with your partner is “just another moving dilator.” What I mean by that is that sex is much, much more than just penis-in-the-vagina. Intimacy, close contact, sharing of very close and personal parts of ourselves are not something that can be overcome easily. Pleasure and satisfaction drive human behavior to seek out this activity again to find more pleasure and satisfaction. If physical pleasure is missing, it makes the experience less exciting, and less likely to be a behavior we look forward to or to actively seek out. Your description of your preparation for sex is very clinical. With almost 2 hours to “prepare your vagina” you are focusing on only one aspect of what it takes the female body to be ready for sex. I am a huge fan of bottled lubricant. There is nothing better for a woman than good, wet, slippery surfaces. However, there is a lot more to being sexually ready than being wet and having a vaginal opening that is dilated and non-spasming. Foreplay is an essential part of being ready emotionally as well as physically for sex. Your dilator may be able to help you relax the vaginal opening, but stimulation to your skin (arms, lips, legs, breasts, thighs, clitoris, behind-the-ear, etc.) help to build anticipation and arousal. It is during the arousal phase of the sexual response cycle that the vagina elongates and the pelvic organs pull up into the belly, making more room for deeper penetration (which could explain why your boyfriends thrusting is painful). It is also during this phase that blood flows to the vulva, making the area swell and become protective to the bony areas of your pelvis. The walls of the vagina also stretch and relax, also making penetration easier. By the way, the ‘numb’ feelings deeper in the vagina past the opening is normal. There are not a lot of nerve endings deeper in the vagina, its Mother Natures way of making childbirth a bit more tolerable. In addition to the physical changes in our bodies during arousal, our brains begin to release a tremendous amount of hormones and neurochemicals that create feelings of wellbeing. Orgasm is just icing on the cake after that, but can also add to the experience.

Female on top position is a great way to gain back a sense of power. You have control of the depth of penetration, speed of thrust, and the ability to pull out immediately without feeling like you are being trapped underneath your partner. However, unless you are laying out flat against his chest, it is very difficult to have any direct stimulation from his penis. However, if you sit up in this position, it is easy to have self stimulation with your hand, his hand, or a vibrator during sexual penetration. Only 30% of women (with no history of sexual disfunction) are able to have an orgasm without some type of clitoral stimulation. That means 70% of us need some kind of direct stimulation to the clitoris to have enjoyment during sex. Why is all this detail important? Well, intimacy often requires the ability to “lose ourselves” in our partners. Not to just “carry out intercourse to pleasure my boyfriend.”

Many of the people that I counsel have to go back to the beginning in many ways. Learning how to explore each others bodies, and to play, become a vital part of learning how to become sexual. Practicing sexual touch during your daily or weekly dilating exercises, can help to break the cycle. Use a much smaller dilator while stimulating (or having your boyfriend stimulate) your clitoris. This will help you adjust to the feeling of the dilator in your vagina, without feeling overwhelmingly full. Learning how your body reacts with touch for pleasure, not just to dilate, is a very important exercise. Now that you have been able to overcome the barrier of the physical vaginismus block, working with yourself and your partner to overcome the emotional barrier of pleasure is the next step.

[Dr. Pacik]

It has been a joy working with Darcy who is a very caring therapist. She has been effective with my patients and has brought them to higher levels of sexual functioning. This is why I ask her to comment on threads every so often.
Libido is of course a highly complex issue. For many of my patients, libido was good in earlier years and continued to diminish with the frustrations of vaginismus. For others, libido was never very strong. Some of my post procedure patients are simply unable to get aroused and satisfied, but are at least happy that they have become functional.
It is my opinion that in these situations post procedure counseling is enhanced by visiting with a qualified sex counselor, therapist or educator. They can be found in your area by visiting the AASECT website http://www.aasect.org/
Another area of diagnosis and treatment relates to hormone studies done with blood testing. Some women have naturally low testosterone, and testosterone replacement has been shown to be effective in certain cases of low libido. A clinic specializing in female sexual dysfunction can help with these studies.