Pelvic floor muscles need exercise, too
Dear Dan: I’m a 40-year-old married straight woman. I gave birth to our first kid in 2015 and our second earlier this year. My perineum tore and was stitched both times. I have not been able to have sex with penetration since having our second child. My OB/GYN said I’m “a little tighter now” due to the way the stitching was performed. My husband is very well endowed and I can’t imagine how on earth I’m ever going to get that thing back in me, let alone enjoy it. We have a history of pretty hot sex and I really miss it. I’ve been searching online for some sex toys to help me. I’ve never used sex toys before. I’ve always been able to have thrilling orgasms easily without any devices. I still can with manual stimulation. But I want to have sex with my husband. I’m confused and I just don’t know what I need to help me open back up and get through the pain. Please help!
Thanks In Advance
Dear TIA: “Unfortunately, this situation is very common — but luckily there are options to help her get her groove back,” said Dr. Rachel Gelman, a pelvic floor physical therapist at the Pelvic Health and Rehabilitation Center.
Also sadly common: OB/GYNs shrugging off concerns like yours, TIA.
“I see that all the time,” said Dr. Gelman. “Part of the problem is that the pelvic floor/muscles aren’t on most doctor’s radar. That’s due to many factors — cough, cough, insurance companies, cough, our dysfunctional health care system, cough — but to water it down, it’s the OB/GYN’s job to get someone through pregnancy and deliver a healthy baby. And when that’s accomplished, the feeling is their job is done.”
But so long as you’re not able to have and enjoy PIV sex with your hung husband, TIA, there’s still work to do.
“TIA needs to see a pelvic floor physical therapist,” said Dr. Gelman. “A good PT would be able to assess and treat any pelvic floor dysfunction, which is often the primary cause or a contributing factor for anyone experiencing pain with sex, especially after childbirth.”
At this point Dr. Gelman began to explain that pushing a living, breathing, screaming human being out of your body is an intense experience and I explained to Dr. Gelman that I’ve had to push a few living, breathing, screaming human beings out of my body, thank you very much. Dr. Gelman clarified that she was talking about “the trauma of labor and delivery,” something with which I have no experience.
“Labor and delivery can have a significant impact on the pelvic floor muscles which can cause a myriad of symptoms,” said Dr. Gelman. Pain during PIV sex sits high on the list of those symptoms.
“The fact that TIA had tearing with the deliveries means she most likely has scar tissue, and a PT would again be able to treat the scar to help decrease any hypomobility and hypersensitivity,” said Dr. Gelman. “A pelvic floor specialist can also instruct her in a home program which may include stretches, relaxation techniques, and dilators — dilators are graduated cylinders that are inserted vaginally to help stretch the vaginal opening and promote relaxation of the pelvic floor.”
A set of “graduated cylinders” is essentially “a bouquet of dildos,” TIA. You start with the smallest dilator/dildo, inserting it every day until you can insert it without any pain or discomfort, and then you “graduate” (nudge, nudge) to the next “cylinder” (wink, wink). You can order a set of dilators online, TIA, but Dr. Gelman wants you to find a doc that specializes in sexual medicine first.
“There are some good medical associations that she can check out for resources and to help locate a provider in her area,” said Dr. Gelman. “The websites of the International Society for the Study of Women’s Sexual Health (ISSWSH), the International Society for Sexual Medicine (ISSM) and the International Pelvic Pain Society (IPPS) are where she should start.”
Follow Dr. Gelman on Instagram, @pelvichealthsf.
Dear Dan: I’m a 30-year-old woman, and about a year ago I started taking improv classes to help combat my social anxiety. I met a lot of awesome people in my class, but I took a particular shine to this one guy. He was a gentle soul, very sweet, and really funny. We quickly became friends. Eventually I developed feelings for him and asked him out. He appreciated the offer but told me that he was gay. I was shocked and disappointed, but I wanted to keep our friendship so I tried to get over my feelings. But not only haven’t these feelings gone away, I’m actually falling in love with him. He recently confessed to me that he’s still semi-closeted and dealing with a bad breakup so I really don’t want to add to his problems. This is such a mess. I found this wonderful guy who I care about and yet nothing will ever happen because I was born the wrong gender. What can I do?!?
Introvert Makes Pass, Regrets Overture Very Seriously
Dear IMPROVS: Nothing.
You can’t make that gay guy fall in love with you, IMPROVS, anymore than I could make Hasan Minhaj fall in love with me. Getting over him is your only option, and that’s gonna take some time and most likely some space, too. (I’d recommend seeing less of your crush after this class ends.) But give yourself some credit for doing something proactive about your social anxiety, for taking a risk, and for asking your classmate out. You didn’t take that improv class to find love, right? You took it to combat your social anxiety — and it sounds like you won a few battles, IMPROVS, if not the war. The takeaway here isn’t, “It didn’t work with him so why should I bother ever trying again with someone else?”, but, “I did it — I made a connection, I asked someone out — and I’m going do it again and hopefully it’ll work out next time.”
Dear Dan: I’m an early 30s hetero-flexible man in an open marriage with a bi woman, though both of us have been too chicken to actually go through on acting on the “open” part. Neither of us are hung up on jealousy, so that’s not a factor here. I recently confessed to my wife that I have had a long-standing desire to sleep with a trans woman. Yes, I know that it’s immature to not have disclosed all my kink cards prior to marriage, but I have my reasons, and thankfully, my wonderful wife let me off the hook and was very supportive. I expressed to her that I have considered seeing a professional trans escort rather than trying for a “hook up” situation. Her reaction was highly negative, as she has the impression that anyone in the sex trade industry is — by definition — a victim. Where do I go from here? I am uncomfortable with the idea of putting myself out there to meet a trans woman in my city (especially since I’m not looking for a relationship), but I don’t want to violate my wife’s trust and see an escort.
Don’t Know What To Do
Dear DKWTD: Put yourself on a dating and/or hookup app, say that you’re partnered and only looking for something casual, and add that you welcome responses from trans women. Some trans women are rightly annoyed by all the cis men out there who only wanna hook up, DKWTD, and never date or be seen in public with them. But trans folks are just like other folks — some are taken, some are looking, some are taken and looking. If you get grief from a trans woman who’s annoyed that you aren’t open to dating women like her, DKWTD, let her vent — her frustrations are perfectly legitimate — while you wait for a response from a trans woman looking to buy what you’re selling.
P.S. The trans escorts I know — women who freely chose their jobs — will be surprised to learn that they’re victims, at least according to your highly opinionated and woefully misinformed wife.
On the Lovecast, Is there a urologist in the house? Yes, yes there is: savagelovecast.com.
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