Speed Dating Events

Women survivors may have difficulty with vaginal penetration because of two sexual problems.

Vaginismus is a reflexive tightening of the muscles in the outer third of the vagina when penetration is attempted. Women with this condition may have difficulty with intercourse as well as with insertion of a finger, dildo, or medical instrument.

Dyspareunia, or painful intercourse, is another dysfunction that can make intercourse difficult. In this condition, a woman experiences pain as burning, cramping, or sharpness that begins sometime during intercourse itself. Both vaginismus and dyspareunia can result from associating fear and pain of past sexual abuse with present intercourse. In some cases painful intercourse may be directly related to actual physical damage to vaginal tissues, nerves, and internal organs done during brutal sexual assault.

A woman who suffers pain during intercourse is likely to avoid sex. This avoidance can lead to further anxiety and discomfort. Natural arousal and lubrication may diminish, and vaginal sensitivity may feel more pronounced during the rare times that intercourse is attempted.

Conversely, some survivors have made matters worse by forcing themselves to endure painful intercourse. The abuse gets reenacted, and negative associations with intercourse are strengthened each time. As one survivor explained:

I used to feel I had to put up with pain for a man’s pleasure. I’d make myself have sex even when it hurt like crazy. I was mad at my partner and myself. It was the rape all over again.

No one should have to tolerate these kinds of pain or prolonged discomfort. But there is much a survivor can do to eventually be able to enjoy sexual experiences involving vaginal penetration. One way is to improve how you think of intercourse and vaginal penetration. If you conceive of intercourse as intrusion and force—something done to you—you may be setting yourself up for a bad experience. (At a seminar I gave for survivors, one woman pointed out that the term penetration was upsetting to begin with. She suggests survivors think of enveloping instead. A great idea! Imagine that you are enveloping your partner, giving your partner an internal hug. This reduces the sense of threat and reminds you that you are in the driver’s seat.)

Changing our thinking can also be a powerful tool in helping relax muscles in the vagina. When you imagine the inside of a vagina, what do you picture? If you see it as a hard little tunnel with a thick steel door, you will approach the possibility of intercourse differently than if you see it as a warm, moist, earthy nook with soft moss and lovely flowers, or a smooth and stretching balloon capable of expanding to many times its size.

Relaxation techniques can be helpful as well. The Kegel exercises described earlier can give a woman a sense of control over the muscles in her vagina. After a woman becomes practiced at Kegels, she can try tightening her vaginal muscles and then relaxing them fully as entry occurs. Slow breathing techniques, commonly used in childbirth, can be incorporated to further facilitate relaxation during intercourse.

I have known survivors to have excellent success using vaginal dilator exercises to overcome problems with intercourse. Vaginal dilators are tube-shaped medical devices that vary in size from about one-half inch in diameter up to the average size of a penis. There are several different kinds: Some are shaped like small rubber penises, some are made of nonbreakable glass, and others are made of smooth white plastic. Vaginal dilators allow survivors to slowly and progressively feel in control of and comfortable with vaginal penetration.

Here are some suggestions for how to use dilators in a healing program:

1. Warm the smallest-sized dilator in a glass of hot water by your bedside. Take a hot, relaxing bath. Dry off and sit back on your bed, reclining on soft pillows.
2. Take the warm dilator, dry it off, and cover the tip with a personal lubricant. Place a large dab of lubricant over your vaginal opening.
3. Relax, breathing fully and steadily. Do a few Kegel exercises to tighten and relax your vaginal opening. When you feel ready, slowly insert the tip of the dilator into the opening of your vagina. Angle the tip downward, toward your tailbone, because this will help steer the dilator comfortably into your vagina and under and around your pubic bone. Insert the dilator only as far as you want to, then rest and continue with relaxation techniques to keep yourself calm and your vaginal muscles loose.
4. Work toward being able to insert the dilator three or four inches inside yourself, and rest it there for about twenty minutes a day every day. The more regularly and routinely you do the insertion, the easier it becomes.
5. Once you are comfortable with resting the smallest dilator inside yourself, experiment with moving it around. Remember, the dilator is helping you slowly stretch the inner muscles of your vagina. Move the dilator up and down, back and forth.
6. Repeat this exercise with the smallest dilator for at least one week. When you feel ready, progress to the next size of dilator. Stay with one size of dilator as long as you need to until you feel relaxed and comfortable with insertion and movement. Master each size before moving on to the next.
7. Continue the exercises until you have mastered the largest dilator. Then you can repeat the exercises guiding your partner’s hand as he or she inserts the dilators and moves them around. Eventually, with your partner’s cooperation, you can continue the exercises using your partner’s fingers or penis.

If you reach a block in inserting a particular dilator, use relaxation, breathing, imagery, and creative problem solving to help. You may want to shift down to an easier size for a longer time, or you can bridge from one size to another slowly during the same twenty- minute period.

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