[mark2021]

Mike, based on my own experience with couples, abstinence ALWAYS helps because it makes it easier for the ejaculation reflex to trigger.

[mark2021]

Hello Eli. My name is Mark, and I’m one of the sex workers who “learns” vaginismus patients to have sex. I usually work with sex counselors or pelvic floor therapists. I’m not sure there are colleagues doing the same in other parts of the world though, so if I were you, I’d ask my PT if he or she knows if there are sex workers available to help you out.

I’ve been working with 30, 40 and even 50 year old vaginismus patients, who never had sex in their entire life. You’re not alone. As in your case, some of them have never kissed a guy or seen a penis before. So we start by showing them how things look like, how a penis feels – a bit of a biology lesson really. I show them how an ejaculation looks like, they can feel, taste if they want, play around with my penis, try things out at their own pace… after that, we try to do the same on them, so we explore the vulva, vagina, clitoris, try to discover what feels good, try to give them an orgasm, etc… and at the end, if the client wants to, we can have sex, which is usually a VERY emotional moment for older women. I recently worked with a 38 year old patient and she cried when she had her first orgasm while we were having sex.

If you have insecurities around intimacy, I think a sex worker is always a great investment.

[mark2021]

I’ve never heard before that not ejaculating could cause prostatitis. Prostatitis is an infection of the prostate, which is totally unrelated to the number of days it has been since you last had an ejaculation (see https://urologyspecialistsnc.com/mens-health-causes-of-prostatitis/)

It’s true that not ejaculating might cause a feeling of pressure inside but after a week or two, the body will usually get rid of the excessive fluids during a wet dream.

[mark2021]

Loreen, I’ve shared the bed with a few women who had no sexual experience at all. In some the hymen is already torn due to tampon usage or insertion of objects before they have sex. Others have a thick or rigid hymen that is still intact. There have been occasions on which I literally felt something blocking my penis from entering the vagina, so when the hymen is still intact it really feels like a barrier you need to get/push through. That’s also the reason why it’s easy to confuse vaginismus and a thick hymen. When someone has vaginismus, there is a barrier too, but this feels different. There is often no way to “get in”, no matter how hard you try. When you have a thick hymen, once you are past the barrier, the penis slides in without any issue. Sorry if this all sounds a bit technical, I don’t know how to explain it otherwise. My suggestion is to give it another go. When it’s still impossible for your partner to penetrate you, consult your doc.

[mark2021]

I hope you don’t mind I’m giving you a male perspective on this?

What your therapist told you is correct – a large percentage of men will have issues ejaculating from vaginal contact if they never had this kind of stimulation before.

You can un-learn that though (I’m not even sure if this is even a correct English word). The key is to let him to stop masturbation completely, and to stop stimulating him manually/orally as well. So he basically can’t have an orgasm anymore for a while. Nothing. No exception. You can already start doing that now. He’ll probably get a few nocturnal emissions, but that’s okay, that’s his body getting rid of the excess semen.

When he’s allowed to penetrate you, ONLY do that, so still no masturbation or stimulation. Even if he can’t finish because he gets too tired or has troubles keeping his erection, DON’T stimulate him to an orgasm. Wait a few hours and try to have sex again, or do another attempt the day after.

You will see that his body will start to make the switch in a few weeks. The more you try, the easier it will be for your partner to ejaculate from vaginal stimulation. It’s important your partner doesn’t resume masturbating for at least a few months though. Good luck!

[mark2021]

I’m sorry it took a while before I was able to answer here, I had some issues with my internet connection. Thank you all for you nice comments. Some of you have asked me to give details about the personal experiences I’ve had with clients, but I’m not a good writer, and certainly not in English. So I’ll try to do my best.

I honestly can’t remember every single woman I’ve worked with, but there is one 33 year old patient I can talk about if you want to learn something more about the way I work. She was my client right before the dreadful Covid virus entered our world. Her story is similar to what I’ve heard from other women, so you’ll get an idea of how things usually go.

First a warning, I don’t think the patients I have are “typical” vaginismus patients. Most of them do not only suffer from vaginismus, but also have several issues with accepting the way they look, they are afraid to establish intimate relationships, have had bad sexual experiences in the past, etc… so it’s a whole package in which vaginismus is the result of the sum of all the issues they have, or in which vaginismus is the cause, or one of the side effects. Vaginismus is part of the package, so to speak, and I’m not sure in how many patients this is the case. That’s something other people here on the forum probably know much better.

The same goes for Anna (I’m calling her Anna here but that’s not her real name). Vaginismus was just a part of the issues she had. Anna had a bad sexual experience when she was 14. She wasn’t raped but a male family member made her undress in front of him while he was touching himself, and he also touched her breasts. Technically she wasn’t raped, but the entire event did have a huge impact on her intimate live. Especially because her parents refused to believe what happened. Plus she wasn’t raped, there was no “proof” and it was her word against his.

When Anna got to know her first boyfriend at the university, they tried to have sex and found out penetration was impossible. Her boyfriend ended their relationship as soon as he realized he couldn’t have sex with her, and he said some pretty nasty things about the way she looked. This is a pattern I often see: when (male) partners are facing vaginismus, their initial reactions are usually *very* important and can worsen the vaginismus. In a LOT of women I’ve worked with, partners left them because of the vaginismus, which put even more pressure on them the next time they met another partner. It’s an endless circle. In Anna’s case, she completely lost faith in men and became a (not so) happy single.

When one of her best friends committed suicide, one of the last things her friend told her was that she had to learn to enjoy life again. This is something I often see: an unexpected “event” stimulates women to start working on their problems. Things like meeting the love of their life, finding an understanding partner, or an external event like the sudden death of a loved one… these can all trigger the idea “something should be done about it”. And this is where gyns and docs should be more understanding and willing to help their patients out, because I’ve heard some of them try to minimize the issues and even don’t recognize vaginismus at all. In Anna’s case, she was lucky and her doc send her to a pelvic floor therapist who worked with a sexologist and a psychologist during almost two years on her recovery.

As usually, my role was limited to the very last part of the therapy, and at that moment she could already use the largest dilator. In the mean time Anna turned 33, had almost no kissing experience and never had sex. Her libido was still very low, and while she technically got rid of her vaginismus, she had 0 interest in having sex. Usually I’ve read the file of my patient before, but despite that, the first few times we meet I usually take lots of time to listen to their story.

I’ve told it before here on this board, but I always ask my patients explicitly not to shave, not to wear special underwear, not to wear make-up… they CAN do that of course, but only if they really WANT to do it, not because they think it’s NEEDED. In fact, all those things are of 0 importance in the entire treatment. I explicitly tell them this, and to some this comes as a complete surprise. I know guys probably don’t read this board, but if there was one thing I could tell them it is: accept the body of your partner the way it is. Most of them have no idea how much indirect pressure males put on them. For instance, I’ve heard men say that a hairy vagina is “dirty”. No! EVERY vagina is hairy, so how could this be dirty? I find it really important to take that pressure away from the start. When a client wants to open the door wearing a jogging suit, without wearing her contact lenses and while still eating her sandwich, that’s perfectly fine.

I also tell them we’re not going to have sex immediately but that we’re going to take very, very small steps and discover each others body. Some of my patients already have sexual experience and clearly have seen a penis before, and/or know how to masturbate and have an orgasm, others have never touched or seen a real penis in their life and don’t know how an orgasm feels like. I also say to them they will have to get nude at a certain point, and at that moment I can already feel the “temperature” so to speak. Some say “okay, fine” and have not issues with that, others become very hesitant and without them knowing, therapy already starts at that moment. Anna was like that, she told me she found her breasts ugly, so I spent an hour talking about that. Why did she think that? Is that her opinion, or the opinion of her ex boyfriend? Has she ever seen other breasts? What makes her breasts ugly? It’s an informal – but super interesting – talk.

In Anna’s case, I used my “book of boobs”, which is a book I bought once in a bookstore. It contains thousands of pictures of breasts, and when she took a look inside the book and I told her EVERY single one of those breasts are normal, she started to cry. I don’t know how it works in the States but here girls are never shown real nudity during sex education, only pictures. So they really have NO clue on how normal, average breasts look like. The only material they can compare them to, are the pictures in woman’s magazines, Instagram and Facebook. In her own words, Anna had “large hanging breasts with big, ugly aureola”, and all I could see when she removed her bra were standard looking boobs. Yes, they were hanging. Yes she had big aureola. But that’s perfectly NORMAL.

Next time I saw her, I asked her if she would feel comfortable removing her bra again for me. She didn’t hesitate one second. Those are the moments I know we’re getting somewhere. Usually the first intimate contact we have – me putting my hands on their breasts – follows shortly after. At the end of Anna’s session, I removed my shirt and Anna was able to give me a hug while her breasts were touching my chest. I still remember her words that day: she called that “a triumph”, which indicates how hard some of these women are struggling with their body image.

In lots of other patients the second part – being comfortable showing their vulva – takes at least two or three consults, but Anna went a lot quicker. During our next session she told me she enjoyed my cuddle last time and wanted to do it again, so she was actually already showing initiative on her own, which is positive! When I asked her if she was ready to remove her pants as well, she said something I’ve heard a thousand times before. It basically comes to this: ok, I’ll do it, but I’m warning you, it looks terribly ugly down there. That “terribly ugly” usually means they have large inner labia sticking out. Again, something that over 80% of all women have, but you never see this on pictures, so there is usually some convincing needed to make them see this is entirely normal. I’m probably repeating myself, but more “exposure” to nude bodies would help these women a lot, if you ask me.

One thing I also like to stress is that I always assure them I won’t penetrate them with my fingers at this stage. I do touch their inner and outer labia, clitoris, the vulva in general, but I promise my patients I’ll never put my finger inside. I found out over the years this is crucial to them to be able to relax and enjoy the feeling of someone touching their vulva. There shouldn’t be a “danger” involved at this moment of me unexpectedly putting something inside.

The next part can vary a lot between my clients – this mainly depends on how much they know about the male sexual organs, how they feel about them, and how many experience they already have with sex. Some women are “experts” cause they masturbated their partner as a kind of surrogate sex in their relationship. Others don’t even dare to touch a penis. Anna told me when she tried to have sex with her boyfriend, he ended up masturbating and ejaculated all over her body, which she found immensely humiliating. She told me that was her “punishment” cause she couldn’t give her boyfriend “what he wanted”. Anna reveled to me she stumbled upon porn on the internet a few years ago and seeing how a guy ejaculated actually made her literally sick. So as I’ve said this part differs among patients, but in Anna’s case we worked on learning her how to GIVE me pleasure, so basically shifting the idea of a guy doing it on his own towards HER giving the pleasure to the guy. In her case she already touched a penis so she knew more or less how things worked, but there are women who need a biology course and a detailed explanation on every single part of the male genitals. To get things clear: I’ve written down this text in a few minutes but in reality these sessions can take weeks and weeks, it all depends on the client.

The next step – learning them how to masturbate – is very important to me and I dare to say it’s even more important than getting rid of vaginismus. Anna had no experience with masturbation and orgasms, and she’s not an exception. I have seen lots of statistics on this in my career, and it always surprises me how little women masturbate. So what I usually do is sit down on the bed with my back against the wall, and ask them to sit between my legs with their back on my chest. This enables me to reach towards their vulva, and/or put their hand on mine to guide them. This is also a key moment in which they need to open up and tell me what they like. A bit more to the left, a bit more to the right, harder, faster… SAYING what they want is already a big step to some. After a while I put my hand on theirs, and they become in charge. During the last step I touch their body but they need to do the work themselves. I learn them to interpret the signals their body gives them: when is their orgasm imminent, when do they need more time? We go SLOW, it’s not a race, there should be plenty of time to get sexually excited. The goal is not an orgasm, the goal is to get so excited you WANT to feel something inside of you. But how can they feel they are ready to have sex? How can they know they are wet enough? Plenty of questions women never ask themselves, but which are ultra important to women with vaginismus.

I think it’s my favorite part of the therapy, because this is such an intense experience for most of my clients and I tend to get emotional myself from time to time. When Anna had her first orgasm, we both cried afterwards while she was lying in my arms (I know men aren’t supposed to say this, but I’m not ashamed to admit this).

(I also want to add a personal note here for parents reading this. I’ve got American friends with kids and they already told me once their teenage daughter isn’t allowed to have sex “under their roof”. As far as I understand, this is something a lot of American parents say, and this causes most teenagers to have sex in the backseat of their car. Correct me if I’m wrong here, but I have the impression they go from kissing to sex in the most uncomfortable circumstances, with lots of stress and the idea they might be caught. Personally, I’m convinced you can offer your kids a “safe haven” to experiment with nudity and sex, and let them discover each others bodies STEP BY STEP. I’m convinced this can even prevent some cases of vaginismus!)

During the two or three last sessions, I usually work with the dilation set again. Not that it’s needed, but I found out that inserting them in my presence “convinces” them for one reason or another “it still works” and this makes the final step – the penetration – a lot less invasive. It’s also the one time on which everything falls in place we’ve “practiced” before. And I have to be honest here as well, in Anna’s case everything went smooth, but a lot of vaginismus patients are still in pain at this stage, which means I can penetrate them, but it still hurts them. Those things are reported back to the pelvic floor therapist and in reality, things don’t work out fine from the start in some cases.

Sometimes people ask me if I get sexually excited when working with clients, and the answer to that is: no. For me there needs to be some attraction to a female before that happens, and honestly, that has never been the case. I am usually able to get an erection and ejaculation, but under some circumstances, I need Viagra in order to have sex with clients. I also need a day or two days in between two sessions to “recover” after I ejaculated. And one other thing: I never kiss with my clients. It’s hard to explain why, but I find that to be a limit I can’t cross.

There you go, that’s what I wanted to tell you. I hope I don’t regret I’ve been too open to you guys… Remember that in almost all cases something can be done about vaginismus, but that when you decide you don’t want to get treatment, that’s a good decision too. It’s your body and there are plenty of other ways to have sex, without incorporating penetration.

I’m always prepared to answer your questions!

[mark2021]

@recessivegenequeen I was a sex worker for three years before I met a client who told me she had vaginismus and was seeing a pelvic floor specialist for this. She was single and wanted to “see” if things worked our okay in bed so I got involved in her therapy. I presume I made a good impression because her specialist talked about me to other clients and the next year I had someone else calling me. Before I knew I was working with three different specialists and I was following trainings on the subject. Vaginismus patients take up a lot of my time AND energy though. But the work itself is really rewarding.

A small example. Before the pandemic I’ve seen a 45 yo who was raped when she was 18 and she never had sex again after that traumatic event. She had her very first orgasm in front of me and that was so intense we both cried. It’s a super emotional job, which limits the amount of patients I can work with at the same time. Which also means I’ve never advertised my services, there is simply no need.

Another example. It always surprises me how much pressure sex can put on women. This sounds probably stupid to some of you, but one of the first things I tell my clients is that they don’t have to shave their armpits, legs and/or pubic hair. Some of them do this because they feel better that way, but strangely enough a majority says they think it SHOULD be done before they can have sex with me. When I tell them they don’t have to do that – and I know it sounds stupid – but that single fact already makes them feel more at ease – “He takes me as I am”. Something in that style. Same thing when someone says to me she wants to have sex with the lights out because she’s worried I might see her cellulite. I’ll do exactly the opposite: I’ll touch her on those spots, tell here there is nothing wrong with her boobs or thighs… I’ll do everything to remove the weight on their shoulders before I start having sex with them.

As I’ve said: super intense but super rewarding at the same time.

[mark2021]

Hello ella2021 and recessivegenequeen, this is definitely an interesting issue and I hope you don’t mind I’m adding my viewpoint here.

As a student, I’ve had several girlfriends and most of them were still virgins when we started dating. I’m not claiming it ALWAYS hurts when girls have sex for the first time, but it IS really common, especially when the hymen is still intact and/or the girl has never put things inside. Most of my girlfriends knew I had previous partners so they sometimes asked me how it felt for them to have sex for the first time and I’ve always been very open on this. It can hurt and that’s perfectly fine. However, and this is where I think both of you have a point: when the pain goes on for weeks, that’s not normal.

Both messages can be combined if you ask me: you can perfectly tell girls pain during the first time is to be expected/totally normal, but that sex should become painless after a few attempts. And if the pain continues, they should seek medical assistance. By doing that, you avoid that women are worried too soon, and at the same time you’re giving the message that pain during sex is not okay.

I think guys have a role to play here too. I know one of my friends was too rough the first time he had sex with his girlfriend and she was in so much pain she got traumatized and ended up with vaginismus because of this. I wish these things were talked about more… my advice is to go slow, take small steps, first discover mutual masturbation, penetrate with a finger, have plenty of foreplay … before having sex. Some couples have sex for the first time in VERY uncomfortable places/positions, like the backseat of their car while running the risk of being caught… those are usually not the best experiences.

I found this to be shocking but what recessivegenequeen wrote is true: some women them think sex is ALWAYS painful and that pain is a NORMAL part of sex. I’ve heard there are even gyns and docs giving this message to their patients, which is totally wrong.

[mark2021]

Hello Rabbit.

A large majority of women I’ve worked with, were single. It’s not hard to imagine when patients have a partner, my presence is often not needed. I’ve worked with three couples in the past, which is not much when compared to the total number of clients I’ve helped out. In all three cases men had issues with sex as well.

In some patients penetration stays impossible, even after therapy. Therapy can help, but doesn’t work for everyone unfortunately. Some of them get to a certain stage, but not far enough to enable full penetration. Something I’ve also seen is that vaginismus sometimes comes back at some point their life – for most women there’s always this “danger” lurking around the corner.

Most of my clients were between 20 and 30 yo, but I’ve also had several 30+ and even 40+ clients. Some of them never had sex before and were diagnosed with vaginismus during a visit at the gyn or when they tried to insert tampons or menstrual cups.

Not being able to have an orgasm is often related to not being relaxed, not feeling at ease, not accepting your body, finding sex ‘dirty’… all these thoughts prevent them from reaching a climax.

I’ve always tried to separate my professional and my private life. When the therapy stops, I also stop seeing my clients, although most of them still keep me updated on important steps in their life, like meeting a new partner, getting married or giving birth.

It is hard for me as well to see so many women are struggling with the way they look… There are influencers on Instagram trying to do something about this by showing their own imperfect bodies and insecurities. This is something that absolutely has to be done more!

[mark2021]

Thank you both for your nice comments.

I don’t have any statistics to back this up, but in my own experience it seems that in about 1/3th of all women, vaginismus is primarily a physical problem. Penetration hurts, but those women have little to no issues with sex as a whole. They want to be intimate with their partner, they masturbate, they can/want to have orgasms, etc… a therapist and dilation exercises can usually help these patients.

In the second group the physical pain women have due to vaginismus, has an influence on the way they experience and think about sex. The pain causes them to be less interested in sex as a whole, they start avoiding intimacy, orgasms become unnecessary, sex drive declines, etc. This is usually where the work of a therapist is combined with a sexologist.

In the last group, vaginismus is caused by a combination of physical and psychological issues, either from the start or sometimes even before the first penetration has been attempted. Those women typically suffer from a low self esteem, they think something is wrong with their body, they are afraid to have sex, they had a bad experience in the past (rape, boyfriend that kept on insisting on sex despite pain, etc…).

I mainly work with the third group, a group which is typically impacted by the negative body image that many women have. Most of them are convinced that all the clients I see have the perfect body – except for THEM – while in reality I’ve never seen the perfect body in my entire career. Some women barely have boobs, others have large nipples, saggy breasts, pointy breasts, breasts with stretch marks… and while they all think they are “abnormal”, the opposite is true. Getting them to show me their breasts is a huge task that might take several sessions. When they finally dare to remove their bra, most of them begin to cry. It sounds ridiculous, but for most patients this is a very emotional moment – a first bridge they’ve crossed.

It’s even worse when it comes to showing their genitals. Almost none of these women know how a “real” vagina looks like. It still amazes me how many of them think having large inner labia is “ugly” or “abnormal”, while almost everyone has this. A large part of my work consists out of talking to them, convincing them nothing is wrong with their boobs or genitals and getting them to the point they are willing to show me their naked body. Once that hurdle has been taken, women seem to open up and trust is established. Some of them start asking questions about their body and insecurities themselves, like “look at this, what do you think about that, is this normal, etc…”. It’s a process that can take days to weeks in some, but it’s absolutely necessary. Also: it keeps amazing me how many women don’t know how real bodies look like. That’s definitely due to the picture perfect world on Instagram, but I also blame sex ed at school, where teachers often only talk about how to avoid a pregnancy, but never about different body types for instance.

The next step I take usually involves masturbation exercises. Some women know how to have an orgasm but can’t do it when someone else is present – which in most cases also means they can’t come during sex. The majority though, never masturbated before. For me it’s an essential part of love making, and I usually don’t continue before they are able to have an orgasm on their own. A small part needs a bit of guidance, in others there is a steep learning curve involving instructions on how to touch the clitoris. Some of them think it’s so weird to touch themselves they can only do it when they can put their hand on mine. Others are so overwhelmed by the feeling an orgasm is imminent they’ll stop touching themselves and never come. In my entire career I’ve seen over fifty women having their first orgasm, and even after all those years it moves me to tears when I see how those women are engulfed by emotions afterwards.

Next in line is… my own body. Many of my clients don’t have a clue on how the male body works. I show them how they can give me an erection, what feels nice and what doesn’t, how they can position and move their fingers, how they can make me ejaculate and how an ejaculation looks like. I’ve had clients who were afraid to look at my penis when I came. Others were afraid to get semen on their body. Some women have an aversion towards semen. They find it hard to watch an ejaculation, to smell or touch the semen. I even had a few patients who vomited when I came. I try to explain to them what I feel, what I like, why semen looks like that, etc… These are all issues we work on before going to the next stage, which is penetration itself.

Most therapists recommend the usage of lube to vaginismus patients, and I know this might sound controversial to some of you, but I’m not in favor of doing that. I think it’s too “easy” and you give your client the impression that you just put some lube in there and you’re okay to have sex. Enough foreplay is an important key factor to me, so I help women determining if they are wet enough – most of them don’t even know how to check that. When they aren’t wet enough, I forbid any kind of penetration. It always amazes me how many women tell me they were too dry to have sex but their partner insisted on sex so they did it anyway. What exactly turns women on is something very private and individual. I always tell them it’s okay to fantasize about other men, strange situations, unrealistic encounters, and I encourage them to touch themselves during foreplay. Anything they want, as long as they’re wet enough.

It might amaze you but once all these hurdles are taken, penetration itself often goes smoothly, mostly due to the preparations that have been done with the dilation set from the therapist. I always take things slow, which means that the first time I only penetrate for a few seconds and that’s it. The next time I start moving in and out a bit, and the amount of movement is build up over a few sessions. It’s weird to say this, most vaginismus patients I had, had little to no issues with penetration itself.

The very last step is usually penetration plus the client giving herself an orgasm during of after sex. Some of my colleges think penetration itself is enough as a goal, but I think learning women that their orgasm is an integral part of sex is actually a positive thing. You’d be amazed at how many (“normal”) women don’t come during sex with their partner and I’ve always found this a shame.

@recessivegenequeen asked if I was the only one doing this. I know I’m not. But it’s not like we have some kind of association, we all work individually and each of us has its own group of therapist he works with. It’s still controversial though, the fact we exist is never “advertised” to patients, but only offered as part of the therapy when needed. My official occupation is “massage therapist”, but that is mainly due to the lack of a VAT code for sex workers.

Feel free to ask if you’ve got other questions. I’m glad to help!

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