All About The Female Genitals and Female Sexuality
When dyspareunia (painful intercourse) is severe it can be associated with what the muscles have learned to do best in the presence of pain-contract. A broken bone is associated in the area of the break with severe muscle spasm. When an eye responds to the pain of something within, it responds the way it knows how: by having its circular musculature close. So we see an eye squinting and filling with tears. A vagina does the same in the presence of pain - it contracts. And it can learn to contract so that when anything comes near it-the speculum of a gynecologist, a finger of a physician, or the penis of a partner - it goes into spasm. Severe muscle contraction is called vaginismus.
Masters and Johnson, in Human Sexual Inadequacy, point toward their 100 percent cure rate using the "Haslam technique": slowly stretching the vagina's entrance with a graduated series of dilators. Other therapists suggest using first the little finger, then a larger finger, then two, then three. Whatever the method, this is an easy complaint to fix.
It may occur for the most interesting reasons. Polly, for example, was the oldest of nine children, and because both her parents worked at two jobs, she was totally responsible for raising all her younger brothers and sisters. "Since then," she said, "I've developed some very negative ideas about having my own children." Her husband, meantime, insisted she might one day change her mind. She answered that challenge by creating the perfect cop-out. She denied him intercourse, telling him that it was only because her vagina wouldn't let her. This is typical: every time the woman tries sexual intercourse, it doesn't work because the very, very first time she had intercourse it hurt. It hurt cerebrally, it hurt vaginally, and her muscles did what muscles do in reaction to pain - contract.
Dilators and fingers are introduced. And in the meantime, if it seems appropriate, the woman is told about how to have an orgasm with masturbation and orgasm produced by touching outside the vagina. Sexual intercourse is suspended until the woman and her vagina are ready - and in the meantime other sexually satisfying behavior is tried.
Sandra was 23, first experienced sex at 16, and married the man a year later. She worked part time as a market researcher. She said (my comments in brackets):
What brought me here was a sexual problem. I'm having pain during intercourse, which is causing me to not be interested in having sex intercourse with my husband. The pain started following an automobile accident, where, besides a broken tailbone and ribs, I suffered injuries to my vagina. Just outside the opening I was torn, which caused me to bleed a lot and I had to have surgery. When I went back for my checkup after leaving the hospital, the examination was extremely painful. I remember being on this table with all these doctors in the room. I didn't feel like a person, just like an object. One of the doctors introduced himself and he didn't try to examine me because he knew it hurt. But another doctor did.
The pain was terrible, I couldn't believe the pain. I think the incident in the hospital and my injuries to myself have a lot to do with my problem. But I'm not sure that I'm not just using it to cover up how I feel about other things. (I'll buy that - read on to see why!)
I'm not certain if I love my husband or if he loves me. Now when I have intercourse with my husband I feel like an object, and he doesn't care how I feel. I can really be turned on and then I just stop everything inside me and I can't enjoy it. Things he does really aggravate me, and that resentment seems to block how I feel in bed with him. He acts like it's too much trouble to take time with our son, and when he does he usually criticizes.
He didn't come on like the other guys I dated. He was shy. It was two weeks before he even put his arm around me. I kind of felt secure. I was brought up in the Catholic religion and very strict parents. My dad had been illegitimate, and I felt like he was afraid I'd do something wrong. He loved me, I think, but he never showed me enough. I think back now and I know he had problems of his own. My brother died before I was born. Then I came along - sickly all the time. I guess they were afraid something would happen to me, too. Dad never got his boy again - only five girls. I tried to please him. I went out for basketball, but he never came and watched me play.
My experiences with sex ... I remember when I was five years old and I walked in when my dad was taking a bath. He was in the tub. I couldn't see anything, but I remember the shock on his face when he saw me. He called for my mother to come and get me out of there. I couldn't understand at the time what the big deal was all about.
The first sexual experience was with my husband-to-be. I was sixteen and, I don't know, I really didn't like it. He came very quickly, and he's never made any effort since to control his ejaculation. I have even offered to pay for the appropriate premature ejaculation cure, and he laughed at me. I feel guilty about sex, because I did it before I was married, and that was always something I was taught not to do. Nice girls didn't do that, and I was a really nice girl.
Right now I couldn't care less about having sex with my husband. I think we went through most of our marriage where I pretended that I enjoyed it. I was brought up and was told, I guess, like, when you get married and you really love the guy, you just want to do everything for him, and everything is supposed to be oh, so perfect. (And it wasn't perfect, so she concluded something was wrong. Most people don't question the myth, questioning themselves instead.)
Sometimes just before we have sex intercourse I fantasize or I think that I'm really getting into it and then it doesn't work and, oh, I feel so frustrated. I can't understand why we were always told or always thought it would be a certain way, and it wasn't. I want more kids, but then I don't. If I felt I was doing everything right with the only one that I have, then maybe. There's so much to raising a kid. If I had been raised differently, then maybe I wouldn't have so many problems and maybe doing so many things wrong with my son's life. (Liability: She isn't taking responsibility, is blaming Mom, and Dad.)
I think ... well, I wonder what it would be like to have sex with someone else. My husband's told me he's never had intercourse with anyone else, but I don't believe him because I found a letter that he'd written a girl, and I felt like I was betrayed.
Each time it usually was one of his friends that'd come on to me. Like when he was away, his supposedly best friend who was married and they were expecting a baby, and I trusted that he was just trying to be nice and friendly and trying to console me while my husband was gone, well, he kissed me and that was as far as I let it go, but I felt guilty about it.
And then about a year ago, when we were having trouble, again it was a friend of my husband's who told me that he loved me. I didn't believe him. I thought he was just after what he could get. I never let it go farther than a kiss each time. I liked it, but then I felt guilty afterwards. "When I think about what it would be like with someone else, I think I really would like to try sex, because I feel like I'll have missed something to go through all my life just having intercourse with my husband. I feel guilty when I have these thoughts."
(Sandra was declining to take control of her life - feeling guilty about premarital sex, blaming an auto accident and Mom and Dad and society for the flaws in her partnership, dreaming about having an affair and feeling guilty about that. I noticed that she never mentioned the word "orgasm " and asked if she had them. She said no. I told her she had a choice - she could be sexually responsive and satisfied, or not, as she wished. She and her partner weren't communicating. As in - 'I'm not certain if I love my husband or if he loves me.' I suggested they talk to each other. They did, and she learned to get in touch with her feelings and doings, learned to experience orgasm through masturbation, and practiced with her husband. They're still together. And sexual intercourse doesn't hurt now.
I was fascinated some year ago while talking to an Ayurvedic therapist to learn that he believed that every woman who has yeast infections has got some form of boundary issues. In fact, he told me he had never seen a woman with yeast infections of the vagina who did not have boundary issues. Click here to see more about yeast infections. This is a big claim to make, but it makes sense to me. It's hard to identify the differences between women who have regular yeast infections and those who do not - except in psychological terms, which of course are not quantifiable by the medical profession and cannot be seen externally. But the invasiveness of Candida could well be a metaphor for the invasion of personal boundaries during childhood, adolescence, or even adulthood.
The Absence Of A Vagina
Another doctor described a case of Tanya, who was 14 when her parents brought her in. She was one of several girls seen over the years who had only a dimple where the vagina should be. The old procedure to create a vagina surgically needed doctors to develop a plastic phallus. With the woman under anesthetic they make an incision where the vagina ought to be and, through blunt dissection, they create the potential space. They then take a split-thickness graft from a portion of the person's skin and invert it over the phallus. Now the skin side envelops the phallus and the moist subcutaneous tissue is outside the phallus. This is then inserted into the blunt space dissected and in some way it is kept in place. The graft should now take against the sides of the new vagina and, interestingly, as the graft (or most of it) took, over time it has the appearance of mucous membrane.
Even with the best results, there was the possibility of contracture. Unless the false phallus was in for a long time, the vagina might contract down and become foreshortened and form strictures. A way to prevent this, of course, was continuing dilatation through intercourse. Doctors couldn't very well suggest this as part of a 14 year old's postoperative recovery, however, so the practice was to delay surgery until just before the young woman married. And that presented more problems. The terrible thing about waiting was that people felt abnormal, and when you feel abnormal, you don't get into dating situations easily.
In Tanya's case the doctor told her parents about a mechanical procedure: to twice a day exert pressure against the dimple with her finger. She came back every two weeks, and six weeks later she had a nine centimeter vagina, which not only was truly remarkable of itself; it had the pliancy that you never would see following surgery.