This week I wanted to write a blog detailing my top 10 tips of what has helped me the most in overcoming my Vaginismus. To be clear, I am an not completely cured, but I had a very severe case (level 5 according to Dr. Pacik's classification,) and I've made loads of progress and can have sex now, so I have a lot to share about what got me to this point, which follows below.
Healing Psychological Trauma First: When you start this journey, it's important to acknowledge that you most likely have emotional and physical pieces adding to the puzzle that is your problem. Since we are so often told that this is in our head we tend to get angry and defensive towards our doctors and want to prove there is a physical explanation for our pain. While there may be, it's not wise to jump into dilating until you've assessed your full history and pasts traumas which led you here. This can be grueling and emotional trying, so try to find a good therapist who specializes in sexual issues to help guide you. If not, at least order a workbook to journal through your thoughts on your own and lay your anxieties to rest.
Removing the Handle from my Dilators: My set of dilators is the medical grade, hollow plastic one that you used to be able to order with the book set from www.vaginismus.com. I was of course terrified of it at first and had to hide them away for a month after receiving them. When I did started using them it took a great deal of time to size up for each one. I believe it was when I got to D1 (the 2nd size) that I realized why I was struggling so much: the handle caused the angle of insertion to be unnatural. Think about it, a penis, dildo, tampon or anything else going in there wouldn't have a handle attached to it. I personally have short arms and trying to strain myself to hold the handle and push in the dilator while half lying down in bed proved to be nearly impossible for me, but I was so focused on following everything outlined in my program verbatim that I was too scared to do anything differently. These are my biggest words of advice: you have to do what works for you. That stupid handle was holding me back for months and I had no idea until I couldn't find it one day and inserted the dilator without it, suddenly, like magic, it slipped all of the way in!
Purchasing Silicone Dilators for the Larger Sizes: My kit had 5 dilators and after about a year and a half I became confident with all of them except for D5. This one just felt SO rigid and uncomfortable that I couldn't handle more than the tip. That's when my physical therapist told me about Soul Source's colorful silicone dilators. I thought "wow, they certainly look more friendly" seeing the pictures on the order form, but little did I know they actually FELT friendly, too! Here's the thing you have to understand about the varying types of dilators. They each serve a different purpose. The hard ones do stretch your PC muscle better because they don't allow for any give. The softer ones, however, are more life like and help prepare your body and mind for what a penis feels like, if that's what you are ultimately working to insert. This is why I highly recommend having both. The silicone ones are pricey and they mean you can't use silicone lube (which is less sticky and lasts longer) unless you put a condom over them, which I absolutely do. Now I use the middle sized plastic dilator and then 2 silicone dilators after it (depending on the size of my partner). I had to order a larger size dilator than what the kit came with and this also worked wonders in helping me have sex with a few people!
Starting Dilation with a Lube Shooter & Vibration: Initially on this journey I was doing like everyone else and just lubing up the dilator and lubing up my vulva, then going for it. Thus, the first insertion was always difficult because I wasn't lubricated internally yet. This of course doesn't help relax your body in anticipation of penetration. One day a girl on my worldwide forum in my program posted about using a lube shooter and I was sold. I went straight to a sex shop and bought one. So these little guys are created for anal sex, since there is no natural lubrication in that area, thus I buy them in the gay district, but you can even order them off Amazon. They're super cheap, like 3 for $10, but they do break easily so expect you'll have to replace them eventually. It's basically just a plunger that you fill up with your desired amount of lube (I use a small amount, like a centimeter's worth) and then insert into yourself before anything else. This way you are already, wet so whatever enters next can glide right in. Another huge tip from physical therapists is to start your session with a vibrator so that your muscles can be prepared for what's coming. Think of it as a massage for your vagina. Your PC muscle has knots that need to be worked out, like any other muscle in the body, so using a vibrator to relax the muscle first can help it not seize up when the dilators approach.
Daily Foam Rolling & Fit Stick: Another big helper to loosen tense muscles is a foam roller. I've had one for years due to my sciatica and didn't realize how much my tight butt muscles were affecting my pelvic floor. Especially if you have Pudendal Neuralgia, make it a point to purchase one of these and use it every day. I roll over mine on each side after work when I'm tense from either lots of sitting or lots of walking. I also use what's called a fit stick. It may sound crazy, but after I purchased one of these and rolled it along my thighs I ended up losing my virginity. It worked THAT well. Now I make it a point to use both of these every evening, especially before dilating, to make sure all of the surrounding muscles to my pelvic floor are relaxed before I start doing my actual stretches.
Having Multiple Partners: I know this one isn't an option for everyone, but having more than one sex partner was a true game changer for my progress. In my program, you were supposed to have sex with someone 4 times a week in order for your body to get used to it enough to loosen up and no longer have pain. That's pretty frequent for a non-live in partner. I've still never reached this level of frequency, which is why I haven't completely overcome, but I have accomplished 3 times in a weekend and it makes a world of difference. If you have sex the day after having sex you will notice how much easier it is the 2nd time. This concept applies regardless of who the person is (so long as they are someone you fully trust and are comfortable with). If you feel safe with the person you are practicing with then it will ideally get simpler each time you attempt, but we all get busy and I've never found someone who is ready and willing to commit to that much sex. I have a feeling this is less of a concern if you are younger, but I'm in my mid 30's so we're all pretty swamped with careers, grad school, buying homes, you name it. The most success I've had has been when I was in a semi-open relationship with a larger partner who just didn't have the time so I would have sex with an ex some time during the week before having sex with him. This helped my body accommodate him better than just dilating and we were actually able to enjoy ourselves.
Non-Goal Oriented Sex: This one is huge. When you get in the mindset of conquering your Vaginismus it's easy to lose sight of the fact that sex is supposed to be fun, not work. Don't make it a habit to shoot for penetration with every sexual encounter. This can really kill the mood and hurt your relationship with your partner. It's important to schedule time to just enjoy each other sometimes, get caught up in a hot make out session, touch each other, give a sensual massage, or engage in oral. And remember, lack of an orgasm doesn't represent failure. It's about the journey, not the destination.
Trying Unique Positions: My program was adamant that woman-on-top was the perfect starting position for insertion because the woman then has control of the depth and motion. However, this suggestion refuses to acknowledge that this position causes you to tense up your legs, leaving you more likely to form "the wall", blocking insertion entirely. It's also really hard to dilate in this position to prepare yourself for the real deal. This is another example of where you just have to figure out what works for you and acknowledge that this could be completely different depending on your partner because penises come in all shapes and sizes just like vaginas do. Every time I tried man-on-top instead I would get so scared and couldn't handle the man being in control of the motion so that was also an epic failure for me, but at some point we experimented enough to maneuver into a unique position that I haven't seen named or described anywhere that allows me to relax my legs AND control the motion! Basically I lay perpendicular to the man on my back with my legs spread over his straight legs (he's on his side) so that I can use my hips to slide up and down. This works great because once you feel comfortable enough you can actually let him thrust in this position, too, and he can reach your clit for stimulation or your breasts. Now I always start in this position to loosen me up before transitioning to another more traditional one so my body will be ready before a less comfortable one.
Using a Toy for Clitoral Stimulation: Speaking of stimulation, did you know that most of us need it? Roughly 70% of us can't orgasm without the clit being involved so don't be afraid to rub it with a finger or something else to handle penetration. I found out just a few years ago that I am one of the women who requires this and couldn't believe it was never brought to my attention before! I realized that whenever I don't have vibration against it my muscles just instinctively tense up! Once I have it, though, I can have penetration for usually about 20 mins! I can' recommend this enough. Invest in yourself and get a sex toy, or a few, or several to push you over the edge from pain to pleasure. You can try having your guy wear a vibrating cock ring that makes contact with you when you slide down to meet it or hold a small vibrator, like a bullet, against yourself during the movement. The vibration will make it so that you barely feel the insertion and actually desire it, instead of wanting to recoil and pull it out. Pics of some examples can be found here.
Using a Numbing Cream That Isn't Purely Lidocaine: So, like many others with Vulvodynia, I tried applying prescribed Lidocaine from my gyno to my vulva and it burned like hell. I had to instantly run to the bathtub to wash it off and was crying. I remember being SO disappointed because by this time I knew that there was a large physical aspect to my Vaginismus and had already tried muscle relaxers and estrogen cream to try to remedy it while also dilating and going to physical therapy. Well friends, this is the very last change I've to my sex routine as I discovered it during quarantine. There actually exists a natural, aloe vera based cream you can order off the internet that has a strength of 4% Lidocaine instead of the 5% from the pharmacy: Desert Harvest's Releveum. This cream can be applied directly to the vulva or inserted vaginally if you know you have nerve pain (like me) in a given spot. It may sound like this would cause you to be numb to feeling what is happening so that you won't enjoy sex at all, but that hasn't been my experience. Just use a small amount in the required spot and have the guy wear a condom so that he doesn't experience numbness. Problem solved!
These are my top 10 explanations of little things that made a world of difference for me. We're all different, but I hope you found at least one of these enlightening and relevant to your own situation. Now that I'm at where I'm at my next goals are to tackle inserting a menstrual cup, keeping in a super sized tampon, getting through a pap smear with a regular sized speculum, and of course, actually finishing sex for either person. I know these things will happen for me one day and I won't give up until they do. I hope you've learned something from my experiences and can apply it towards meeting your own goals!